Susan has made an appointment to see you on the way home from work. She is now 55-years-old and has attended you for many years. Today she says her complaint is a severe itch in her genital area and she has noticed a discharge on her underwear getting worse over the last 4 days. She denies any other symptoms.

She still works full time as a book-keeper in a retail store. She has had the same job for years but says she has been thinking of cutting back or stopping altogether as she is finding the travelling by car and the long hours seem to be too much in recent months. Her husband wants her to retire. When she gets home she is looking forward to a sleep which is unusual for her.