Vulvovaginal Atrophy, Genital Menopause Syndrome: Or something else? Differential Diagnosis

Since the differential diagnoses according to the ICD-10 are partly not recorded, e.g. burning sensation, pruritus or only unclear, and clinically not practicable to present, a differential diagnosis under clinically relevant aspects according to symptoms is explained under the item “Further”, whereby a strict separation between vulva and vagina is not possible and also not useful. Endocrine, nutritional, and metabolic diseases (E00-E90).

Infectious and parasitic diseases (A00-B99).

  • Mycoses
  • Molluscum cotagiosum
  • Pemphigus vulgaris
  • Phthiriasis (crabs)
  • Scabies
  • Staphylococcus aureus
  • Streptococcus group A, B

Musculoskeletal system and connective tissue (M00-M99).

  • Behçet’s disease (synonym: Adamantiades-Behçet’s disease; Behçet’s disease; Behçet’s aphthae) – multisystem disease of the rheumatic type associated with recurrent, chronic vasculitis (vascular inflammation) of the small and large arteries and mucosal inflammation; The triad (the occurrence of three symptoms) of aphthae (painful, erosive mucosal lesions) in the mouth and aphthous genital ulcers (ulcers in the genital region), as well as uveitis (inflammation of the middle eye skin, which consists of the choroid (choroid), the corpus ciliary (corpus ciliare) and the iris) is stated as typical for the disease; a defect in cellular immunity is suspected

Neoplasms – tumor diseases (C00-D48).

  • Vaginal carcinoma
  • Vulvar carcinoma

Psyche – nervous system (F00-F99; G00-G99)

  • Depression
  • Partner conflict
  • Psychosomatic disorders – especially in sexual conflicts (sexual disorder).

Genitourinary system (kidneys, urinary tract – sex organs) (N00-N99).

  • Infections caused by:
    • Bacteria
    • Parasites
    • Fungi
    • Protozoa
    • Viruses

Injuries, poisonings and other consequences of external causes (S00-T98).

  • Foreign body colpitis
  • Sexual abuse
  • Special sexual practices
  • Allergic, toxic effects of soaps, detergents, etc.

Differential diagnoses according to symptoms

Burning

  • Infections
    • Genital herpes
    • Herpes zoster
    • Streptococcus group A
    • Trichomonads
    • Vulvitis plasmacellularis
  • Dermatoses (skin diseases)
    • Behçet’s disease
    • Lichen ruber/planus erosivus
    • Pemphigus vulgaris
  • Other

Areal redness

  • Infections
    • Fungi
    • Streptococcus group A
    • Trichomonads
    • Vulvitis plasmacellularis
  • Dermatoses
    • Lichen ruber/planus erosivus
    • Lichen sclerosus (scratch marks)
    • Pemphigus vulgaris
    • Psoriasis
  • Other

Flora vaginalis (vaginal discharge).

  • Bacterial vaginosis
  • Chlamydia
  • Foreign body
  • Gonorrhea
  • Carcinoma
  • Parasites
  • Fungi
  • Trichomonads

Pruritus (itching)

  • Infections
    • Candida
    • Lice (vulva)
    • Scabies (scabies) (vulva)
    • Trichomonads
  • Dermatoses
    • Lichen sclerosus (vulva)
    • Lichen ruber/planus
    • Lichen simplex (vulva)
    • Psoriasis
  • Other

Pain

  • Infections
    • Acne inversa (vulva)
    • Abscess
      • Bartholinian pseudoabscess (vulva)
    • Folliculitis (vulva)
    • Genital herpes
  • Dermatoses (skin diseases)
    • Behçet’s disease
  • Other
    • Skin lesion/scratch marks (vulva).
    • Irritative (allergic) dermatitis
    • Toxic contact dermatitis (e.g., drugs, detergents, insecticides, cosmetics, oils, rinses, washovers, detergents).