A vaginal wet mount test, or vaginal smear, is a gynecological exam. The doctor takes a sample of discharge and sends it for testing. Results can show whether a person has vaginitis, which is a term for a range of infections and other issues.
A doctor may recommend a wet mount test if a person reports vaginal symptoms, including:
- unusual discharge
In this article, we explore the wet mount procedure and the issues it can help to diagnose. We also describe how to prepare, what to expect during the test, and what results can show. Finally, we look at treating and preventing various types of vaginitis.
A doctor will use this test when they suspect that a person has vaginitis.
Authors of a study from 2015 found wet mount testing to be more effective at diagnosing vaginosis than simpler and quicker methods, such as pH and standard culture testing.
The authors also concluded that results of vaginal fluid mount microscopy were better able to determine the best course of treatment and prevent recurrent infections.
Vaginitis causes inflammation of the vagina. This is often the result of infection or an imbalance of vaginal bacteria.
Other causes of vaginitis include:
- reduced estrogen levels after menopause
- hormone fluctuations during and after pregnancy
- contact irritants
- some skin conditions, including dermatitis
Symptoms of vaginitis include:
- itching, irritation, a burning sensation, or swelling in the vagina or vulva
- pain during sexual intercourse
- pain during urination
- mild vaginal bleeding, which is commonly called spotting
- changes in vaginal discharge
Changes to the amount, odor, or color of vaginal discharge can help a doctor to identify the type of vaginitis. Types and corresponding changes in discharge are described below.
This may also be called bacterial vaginosis (BV). It can cause grey or milky-colored vaginal discharge with a fishy odor.
The odor occurs when the vaginal pH level increases, and it is strongest after sexual intercourse.
However, some people have BV and no symptoms.
Also called candidiasis, a yeast infection leads to thick, white discharge that can resemble cottage cheese. The discharge does not have an odor.
A parasite causes this STI, which is commonly called trich. Symptoms include frothy, yellow-green vaginal discharge and an unpleasant smell.
The infection can also lead to red sores on the vaginal walls and cervix, which a doctor can see during a pelvic exam.
This refers to thinning of the vaginal walls, and it affects women who are entering menopause.
The atrophy can lead to atrophic vaginitis, which involves itching, irritation, vaginal dryness, and pain during sexual intercourse.
A doctor will take a medical history, review symptoms, and perform physical and pelvic exams. During the pelvic exam, the doctor will look for inflammation and abnormal discharge.
Doctors may also perform vaginal pH testing because elevated levels can indicate BV or trichomoniasis.
The test involves applying a sample of discharge to a pH strip. The paper will change color, and numbers assigned to the colors indicate the pH level.
The normal pH range of the vagina is from 3.8–4.5. A pH test is not conclusive. It should be performed alongside other tests, including the vaginal wet mount.
The pH test is also not used to diagnose yeast infections because people with these infections tend to have normal pH levels.
A person does not need to do anything significant to prepare. However, it is important not to use creams or other medications in the vagina for at least 2 days before the test.
A person also should not douche. Douching involves washing the vagina with water and other, sometimes medicated, fluid mixtures. Doctors do not recommend it, because it can lead to infection and irritation.
A person will undress from the waist down and lay on the exam table with their feet suspended in footrests.
The doctor will insert a tool called a speculum into the vagina. This holds it open and allows the doctor to see inside. The procedure is not painful, but the speculum may cause discomfort.
No risks are associated with the wet mount test.
The doctor will use a wet, sterile cotton swab to take a sample of vaginal discharge. They then remove the speculum, and the procedure is over.
What happens after the procedure?
The doctor’s office or clinic sends the sample of vaginal discharge to a lab for testing.
At the lab, the sample is mixed with a saline solution and placed on a slide. This is the wet mount. The sample is then examined under a microscope to check for evidence of an infection.
The test can detect the following types of infection:
- a yeast infection
If none of these are present, something other than an infection may be causing symptoms.
A person could also have vaginal atrophy.
The following are common treatments for different types of vaginitis:
Doctors often prescribe metronidazole to treat bacterial infections. It is available as a pill or a vaginal gel.
Another prescription medication for BV is clindamycin, a cream that can be applied to the vagina.
People can treat these infections with over-the-counter (OTC) antifungal creams, including miconazole (Monistat).
A doctor can also prescribe stronger creams, and the prescription antifungal fluconazole (Diflucan) is available as a pill.
Metronidazole (Flagyl) or tinidazole (Tindamax) are often used to treat this infection. Both drugs are available in pill form.
Because trichomoniasis is transmitted through sexual activity, all partners need to be treated to avoid reinfection.
Doctors treat vaginal atrophy with estrogen. The hormone can be supplemented by using:
- vaginal rings
Managing estrogen levels can reduce the symptoms of atrophic vaginitis.
When an infection is not responsible for vaginitis, doctors will work to determine the cause and recommend ways to avoid it.
Poor hygiene, soaps, laundry products, and scented sanitary napkins and tampons can all cause symptoms of vaginitis.
Practicing good hygiene can often prevent some types of vaginitis, including BV. A person may also be able to prevent noninfectious vaginitis by avoiding triggers and irritants. It is essential to thoroughly rinse soaps from the area and dry it well.
Practicing safe sex and using condoms can help to prevent trichomoniasis. Attend yearly gynecological examinations to catch issues early and ensure that reproductive and sexual organs are in good health.