Vaginal Wet Mount
Test OverviewA vaginal wet mount (sometimes called a vaginal
smear) is a test to find the cause of vaginitis, or inflammation of the vagina
and the area around the vagina (vulva). Vaginitis is often caused by an infection, but
it may also be caused by a reaction to vaginal products such as soap, bath
oils, spermicidal jelly, or douches. Vaginitis may cause symptoms such as
vaginal itching, pain, or discharge. Infections that can cause
vaginitis are common and include: - Yeast infection. A vaginal
yeast infection is caused by a type of yeast called Candida albicans. A yeast infection is also called a candida infection, or
candidiasis. A vaginal yeast infection often causes itching and a white, lumpy
discharge that looks like cottage cheese. It also causes pain with sexual
intercourse. A yeast infection is not a
sexually transmitted infection (STI).
- Trichomoniasis. Trichomoniasis is an infection caused
by a
parasite (Trichomonas vaginalis). It is sometimes called trichomonas infection, trichomonal
infection, or simply trich (say "trick"). Trichomoniasis causes a vaginal
discharge that is yellow-green, foamy, and bad-smelling. Pain with sex or
urination may be present. Lower belly pain may also be present. Trichomoniasis
is spread by sexual contact and is an STI.
- Bacterial vaginosis. Bacterial vaginosis is a
change in the balance of bacteria that are normally present in the vagina. The
vaginal discharge is thin and milky with a strong fishy odor. Many women have
no symptoms. Bacterial vaginosis is not an STI.
- Other sexually transmitted infections (STIs). Infections such as
chlamydia,
genital warts,
syphilis,
herpes simplex, and
gonorrhea can also affect the vagina. These infections
are found by doing other tests.
A vaginal sample may be tested by: - Wet mount. A sample of the vaginal discharge is
placed on a glass slide and mixed with a salt solution. The slide is looked at
under a microscope for bacteria, yeast cells, trichomoniasis (trichomonads),
white blood cells that show an infection, or
clue cells that show bacterial vaginosis.
- KOH slide. A sample of the vaginal discharge is
placed on a slide and mixed with a solution of potassium hydroxide (KOH). The
KOH kills bacteria and cells from the vagina, leaving only yeast for a yeast
infection.
- Vaginal pH. The normal vaginal
pH is 3.8 to 4.5. Bacterial vaginosis, trichomoniasis,
and
atrophic vaginitis often cause a vaginal pH higher
than 4.5.
- Whiff test. Several drops of a potassium hydroxide
(KOH) solution are added to a sample of the vaginal discharge. A strong fishy
odor from the mix means bacterial vaginosis is present.
Why It Is DoneA vaginal wet mount is done to find the
cause of vaginal itching, burning, rash, odor, or discharge. How To PrepareDo not douche, use tampons, or use
vaginal medicines for 24 hours before the test. A vaginal wet
mount is not done during your menstrual period. Menstrual blood on the slide
can change the results. If you are or might be pregnant, tell your
doctor before the vaginal wet mount is done. How It Is DoneYou will take off your clothes below the
waist and drape a gown around your waist. You will then lie on your back on an
examination table with your feet raised and supported by stirrups. This allows
your doctor to look at the genital area. Your doctor will put a
smooth, curved speculum into your vagina. The speculum gently spreads apart the
vaginal walls, which allows your doctor to see the inside of the vagina and the
cervix. Samples of fluid inside the
vagina are taken with a swab or spatula. The sample is put on a slide for
testing. How It FeelsYou may feel some discomfort when the
speculum is inserted, especially if your vagina is irritated and tender. There
may be a small amount of bleeding after this test. RisksThere are no problems from collecting a sample of
vaginal secretions. ResultsA vaginal wet mount (sometimes called a
vaginal smear) is a test to find the cause of vaginitis, or inflammation of the
vagina and the area around the vagina (vulva). Your doctor may talk to you
about the results after the test. If the sample needs to be looked at by a lab,
the results may be ready in 1 to 2 days. Vaginal discharge Normal: | No abnormal vaginal discharge
is present. A small amount of discharge is normal. |
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Abnormal: | A white, lumpy discharge that
looks like cottage cheese may mean a vaginal yeast infection is present. A
yellow-green, foamy discharge that has a bad odor may mean
trichomoniasis is present. A thin, gray-white vaginal
discharge with a strong fishy odor may mean
bacterial vaginosis is present. |
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Wet mount Normal: | No yeast, bacteria,
trichomoniasis, or
clue cells are found on the slide. White blood cells
are not present or very low in number. |
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Abnormal: | High numbers of white blood
cells often mean a vaginal infection. Yeast cells found on the wet mount mean a
vaginal yeast infection is present. Trichomonads on the wet mount mean
trichomoniasis is present. Clue cells means bacterial vaginosis is present. If
many Gardnerella vaginalis bacteria are present, this
also may mean bacterial vaginosis is present. |
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KOH slide Normal: | No yeast is found. |
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Abnormal: | Yeast cells means a yeast
infection is present. |
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Vaginal pHfootnote 1 Normal: | Vaginal
pH is 3.8-4.5. |
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Abnormal: | Vaginal pH is higher than
4.5. |
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Whiff test Normal: | Adding potassium hydroxide
(KOH) solution to vaginal discharge does not cause a fishy odor. |
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Abnormal: | A fishy odor made by the whiff
test means bacterial vaginosis is present. |
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What Affects the TestReasons you may not be able to
have the test or why the results may not be helpful include: - Having your period.
- Using a vaginal
medicine, such as a nonprescription vaginal yeast medicine, 2 to 3 days before
this test.
- Having sex within 24 hours before the test, which can affect
the vaginal pH.
What To Think About- Some causes of vaginitis are not found by a
vaginal wet mount, including
atrophic vaginitis and some STIs, such as
herpes simplex. Atrophic vaginitis can be found on a
vaginal smear when dye is added to the vaginal discharge on the slide. The
slide is looked at under a microscope for cell changes that show atrophic
vaginitis.
- Sometimes a sample of the vaginal discharge is added to a substance that promotes the growth of germs (such as bacteria, yeast, or trichomonads). This is
called a vaginal culture.
- The sex partners of women with
trichomoniasis are generally treated for the infection so they do not reinfect
their partners after treatment. Some doctors recommend treating the sex
partners of women with bacterial vaginosis, but most do not. Partners of women
who have vaginal yeast infections are not generally treated for yeast
infections. To learn more, see the topic
Tests for Bacterial Vaginosis.
- Infections
such as
chlamydia,
genital warts,
syphilis, herpes simplex, and
gonorrhea can also affect the vagina.
- A vaginal yeast infection can
occur after a woman is treated with antibiotics or in a woman whose
diabetes is poorly controlled. Recurring yeast
infections may be seen when a woman's
immune system is weakened. The immune system can be
weakened by old age, infections such as
AIDS, or treatment for cancer.
ReferencesCitations- Epstein A, Subir R (2010). Vulvovaginitis. In Management of Common Problems in Obstetrics and Gynecology, 5th ed., pp. 225-230. Chichester, UK: Wiley-Blackwell.
Other Works Consulted- Eckert LO, Lentz GM (2007). Infections of the lower genital tract. In VL Katz et al., eds., Comprehensive Gynecology, 5th ed., pp. 569-606. Philadelphia: Mosby Elsevier.
- Epstein A, Subir R (2010). Vulvovaginitis. In Management of Common Problems in Obstetrics and Gynecology, 5th ed., pp. 225-230. Chichester, UK: Wiley-Blackwell.
- Fischbach FT, Dunning MB III, eds. (2009). Manual of Laboratory and Diagnostic Tests, 8th ed. Philadelphia: Lippincott Williams and Wilkins.
CreditsByHealthwise Staff Primary Medical ReviewerSarah Marshall, MD - Family Medicine E. Gregory Thompson, MD - Internal Medicine Martin J. Gabica, MD - Family Medicine Specialist Medical ReviewerDeborah A. Penava, BA, MD, FRCSC, MPH - Obstetrics and Gynecology Current as ofOctober 13, 2016 Current as of:
October 13, 2016 Epstein A, Subir R (2010). Vulvovaginitis. In Management of Common Problems in Obstetrics and Gynecology, 5th ed., pp. 225-230. Chichester, UK: Wiley-Blackwell. Last modified on: 8 September 2017
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