Educational Interventions for Vulvovaginal Discharge Literacy among Adolescent Girls: A Critical Narrative Review of Knowledge, Hygiene, and Care-Seeking

Abstract

Vulvovaginal discharge is a common concern during adolescence, yet educational messages often fail to distinguish normal pubertal physiology from symptoms that warrant clinical assessment. This distinction matters because normal discharge can be misread as disease, while malodour, pruritus, burning, dysuria, pain, bleeding, or persistent changes may require evaluation for vulvovaginitis, bacterial vaginosis, candidiasis, sexually transmitted infection, or other causes. This critical narrative review examined educational interventions relevant to vulvovaginal discharge among adolescent girls, with emphasis on discharge-specific programmes and transferable evidence from puberty, menstrual health, and sexual and reproductive health education. Literature published from 1 January 2000 to 20 July 2026 was identified through live searches of openly accessible scholarly databases and regional sources, then appraised for design, comparator quality, outcome validity, follow-up, clinical verification, implementation detail, and generalisability. The direct intervention literature is small and geographically concentrated, particularly in Indonesia, with additional relevant evidence from India. Most discharge-specific studies report improved knowledge, attitudes, or self-reported hygiene behaviour after counselling, leaflets, self-learning modules, or remote education. Confidence in causal and clinical effectiveness remains limited because several studies use single-group pre–post designs, short follow-up, questionnaire outcomes of uncertain validity, and no microbiological or clinician-confirmed endpoint. Broader school-based reproductive and sexual health interventions provide stronger evidence that interactive, skills-based, culturally adapted, and multi-component education can improve knowledge, attitudes, self-efficacy, and some behaviours, but these gains cannot be assumed to reduce pathological discharge or genital infection. The central knowledge gap is therefore not whether education can raise test scores, but whether it can improve symptom discrimination, reduce stigma and unnecessary self-treatment, prompt timely confidential care, and support clinically appropriate management. Future evaluations should use validated discharge-literacy measures, controlled designs with longer follow-up, service linkage, equity-sensitive implementation outcomes, and, where ethical and feasible, clinical confirmation of symptomatic episodes.