II. Causes

  1. Infection
    1. Candida Vulvovaginitis
    2. Bacterial Vaginosis
    3. TrichomonasVaginitis
    4. Viral
      1. Cytomegalovirus
      2. Herpes Simplex Virus
  2. Reactive changes
    1. Inflammation
    2. Atrophy
    3. Radiation
    4. Intrauterine Device (IUD)
    5. DES effect

III. Management

  1. Treat infection if present
  2. Repeat Pap Smear in 3-6 months
    1. Normal Pap Smear: Repeat every 6-12 month
    2. Abnormal Pap Smear: Colposcopy

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