Vaginal health problems are among the most common reasons women attend a gynaecologist, and among the most undertreated. Recurrent bacterial vaginosis, persistent thrush, vaginal dryness, vulvar discomfort, and changes in discharge are all conditions that respond well to specialist assessment but are often managed inadequately in primary care, either because appointments are too short, because the cause has not been properly identified, or because the same treatment is repeated without investigation into why it keeps returning.
At AristoGP, Dr Anastasia Mermigka offers a dedicated Vaginal Health consultation. The appointment is 45 minutes and includes a full clinical assessment, examination, and a personalised management plan. Swabs and screening can be arranged at the same visit. The consultation costs £200 and does not require a referral.
What the Consultation Covers
- Clinical history: A detailed history of your symptoms including their onset, pattern, and any previous treatments. Dr Mermigka reviews what has been tried before, whether it worked, and if not, why not. Recurrent infections are taken seriously and investigated rather than simply retreated.
- Examination: External examination of the vulva, and speculum examination where clinically indicated and consented. Examination allows Dr Mermigka to assess the appearance of the vaginal walls, identify signs of atrophy, inflammation, or skin changes, and take targeted swabs if needed.
- Microbiome and infection assessment: The balance of the vaginal microbiome is central to most vaginal health problems. Dr Mermigka assesses for bacterial vaginosis, candida (thrush), and other causes of altered discharge, odour, or discomfort, and discusses how to restore and maintain a healthy microbiome long-term.
- Vulvar skin assessment: Conditions affecting the vulvar skin, including lichen sclerosus, lichen planus, contact dermatitis, and skin changes associated with menopause, are assessed and documented with a management or referral plan where needed.
- Written management plan: A clear summary of findings and a personalised treatment and prevention plan, issued the same day.
Conditions Assessed
- Bacterial vaginosis (BV): The most common cause of altered vaginal discharge and odour. BV is frequently undertreated, and recurrent BV benefits from specialist assessment to understand why it keeps returning and how to break the cycle.
- Recurrent thrush (vulvovaginal candidiasis): More than four episodes per year warrants investigation. Dr Mermigka assesses for predisposing factors, considers long-term suppressive treatment, and reviews whether the diagnosis has been confirmed by swab or assumed.
- Vaginal dryness and atrophy (GSM): Genitourinary syndrome of menopause causes vaginal dryness, tightness, discomfort during sex, and urinary symptoms. It is very treatable with topical vaginal oestrogen and other options, but often goes unaddressed for years.
- Vulvar pain and vulvodynia: Persistent vulvar discomfort without an identifiable infection or skin condition requires a structured approach. Dr Mermigka assesses for provoked and unprovoked vulvodynia and outlines a management pathway.
- Lichen sclerosus and lichen planus: Chronic inflammatory skin conditions affecting the vulva that require accurate diagnosis and long-term management. Lichen sclerosus in particular needs regular monitoring to exclude malignant change.
- Changes in discharge: Altered discharge that is not explained by BV or thrush, including cytolytic vaginosis, aerobic vaginitis, and other less common conditions, is assessed using targeted swabs and clinical findings.
- STI screening: Where STI testing is appropriate, a full panel can be arranged at the same visit (see below).
Optional Swabs and Screening
Swabs and additional screening can be arranged at the same visit if Dr Mermigka recommends them. Options include high vaginal swab (HVS) for infection assessment, endocervical swab for chlamydia and gonorrhoea testing, and the full STI panel of seven tests including HIV, hepatitis B and C, syphilis, chlamydia, gonorrhoea, and trichomonas, priced at £290. Cervical screening (HPV test) can also be arranged at the same visit for £150 if you are due or overdue. Swab results are processed by TDL and reviewed by Dr Mermigka, who will contact you with results and management advice.
Who Is This Appointment For?
- Women with recurrent bacterial vaginosis or thrush who want specialist review rather than repeated prescriptions
- Women experiencing vaginal dryness, discomfort during sex, or changes associated with perimenopause or menopause
- Women with persistent vulvar itching, burning, or pain without a clear diagnosis
- Women who have noticed changes to the appearance of the vulvar skin and want a specialist assessment
- Women who want comprehensive STI screening in a confidential, clinical setting
- Women with unusual or persistent vaginal discharge that has not been adequately investigated
About Dr Anastasia Mermigka
Dr Mermigka is a female consultant gynaecologist with specialist expertise in vulvovaginal health, reproductive medicine, and women preventative care. She holds full GMC registration and sees patients at AristoGP, 1-5 Portpool Lane, London EC1N 7UU, near Chancery Lane.
Pricing and Booking
Vaginal Health Consultation — £200
45-minute consultation with Dr Mermigka including clinical history, examination, and written management plan. Swabs, STI screening, and cervical screening available as add-ons at the same visit. No referral needed.
Select A1 — F2F Gynaecology Consultation (45 min) when booking.
Book Vaginal Health Consultation — £200Frequently Asked Questions
Do I need a referral for a vaginal health consultation?
No. You can book directly at AristoGP without a referral. Select A1 when booking online.
Can I have STI testing at the same appointment?
Yes. The full STI panel of seven tests can be arranged at the same visit for £290. You do not need a separate appointment for screening. Swabs are taken by Dr Mermigka and results are reviewed and communicated to you directly.
I keep getting BV or thrush. Is there anything that can actually help?
Yes. Recurrent BV and thrush both have evidence-based long-term management approaches that go beyond short courses of treatment. Dr Mermigka will assess why the infections are recurring, confirm the diagnosis with swabs if not already done, and discuss long-term suppressive or preventative treatment options.
How much does a vaginal health consultation cost in London?
The AristoGP Vaginal Health Consultation costs £200. Swabs, STI screening (£290), and cervical screening (£150) can be added at the same visit. A pelvic ultrasound can be added if indicated for a total of £300.