The Three Most Common Vaginal Problems

Recognizing Yeast Infections, Trichomoniasis, and Bacterial Vaginosis

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Whether it's persistent itching, an abnormal discharge, or irritation, when things aren't right in your vaginal area, you know it. Most women experience vaginal problems at some point in their lives, and the three most common issues that occur are yeast infections, trichomoniasis, and bacterial vaginosis. While these concerns do have some similar symptoms, their causes are completely different. The treatment for each is different too, so knowing exactly which one you have is crucial to getting rid of the infection quickly and effectively, and avoiding potential complications.

Yeast Infections

An overabundance of yeast is the most common cause of vaginal infection. A yeast infection is caused by a fungus called Candida that may normally be found in your vagina in small amounts without causing any problems. When the conditions are right—such as when you're on an antibiotic, you're pregnant, you use birth control, you have diabetes, or you have a weak immune system (even if just from stress)—Candida can multiply, causing a yeast infection that affects the vagina and surrounding area. Without intervention, yeast thrives due to the vagina's wet, warm accommodations.

Three out of four women have at least one vaginal yeast infection during their lifetimes and nearly half of women have two or more. They nearly always occur during your fertile years, after the onset of puberty and before menopause, likely because of the dramatic shift in hormones at these times. 

When you have a yeast infection, you will likely have some or all of the following symptoms involving the vagina and/or vulva (the lips that surround the vagina's opening). These can range from mild to severe:

  • Itching
  • A thick, white discharge that may look like cottage cheese
  • Pain during sexual intercourse
  • Redness
  • Burning
  • Soreness
  • Swelling
  • General irritation

Some women experience frequent yeast infections, so they are familiar with the symptoms and the course of treatment. You can buy an over-the-counter antifungal cream, suppository, or tablet that you put in your vagina for anywhere from one to seven days, depending on what you choose. Your doctor can also give you a prescription for a pill called Diflucan (fluconazole) that you take by mouth once to treat the infection.

However, if this is the first time you're having these symptoms, it's important to see your doctor in order to get a formal diagnosis and rule out other possibilities, especially because research shows that two in three women who buy antifungal medicine for a yeast infection don't actually have one. The treatment for a yeast infection won't cure an STI or bacterial vaginosis, either of which you may have instead, putting you at risk for complications from those conditions. Additionally, your body may become more resistant to antifungal medication if you use it when you don't have a yeast infection, which can lead to difficulty getting rid of a yeast infection in the future.

Trichomoniasis

Trichomoniasis is caused by a parasite and spread through unprotected sex. It's the most common curable sexually transmitted infection (STI) and can be spread even when you have no symptoms. Men can get it too, though it's more common in women. The time between exposure to trichomoniasis and the onset of symptoms can be anywhere from five to 28 days .

While most women don't experience any symptoms, others have symptoms such as:

  • A yellowish-greenish vaginal discharge
  • A foul vaginal odor
  • Pain during sexual intercourse
  • Pain during urination
  • Vaginal itching and general irritation
  • Pelvic pain, though this is rare

If you suspect you may have trichomoniasis, you should refrain from sexual intercourse and see your doctor immediately. If your doctor diagnoses trichomoniasis, your sexual partner(s) should be diagnosed and receive treatment if necessary as well. You shouldn't resume sex until both you and your partner are treated and symptom-free. Treatment for trichomoniasis involves one of two antibiotics: Flagyl (metronidazole) or Tindamax (tinidazole).

If trichomoniasis is left untreated, you're at a higher risk of getting human immunodeficiency virus (HIV) if you're exposed. If you have HIV, untreated trichomoniasis makes it more likely for you to pass HIV on to your sexual partners, which is why the Centers for Disease Control and Prevention (CDC) recommends that you get tested for trichomoniasis every year if you're HIV-positive.

Bacterial Vaginosis (BV)

Bacterial vaginosis (BV) is the most common cause of vaginal discharge in women during their reproductive years. It's not an infection; rather, BV develops when the normal balance of Lactobacillus bacteria that colonize in the vagina gets thrown off by an overgrowth of other bacteria.

While there is not a definitive answer about what causes BV, a few factors are known to raise your risk of contracting it, including having a new or multiple sexual partners, being pregnant, using vaginal douches, having an intrauterine device (IUD), and not using a condom during every act of sexual intercourse.

Though many women don't have noticeable symptoms, the ones who do may notice the following:

  • A fish-like vaginal odor
  • An abnormal vaginal discharge that's white or gray and that can be either watery or foamy
  • Vaginal itching and/or irritation
  • A burning feeling when urinating

BV is treated with antibiotics and doesn't respond to antifungal medication for yeast infections, though the symptoms are similar. You should refrain from sex until your treatment is complete.

If your partner is male, he won't need treatment, but if you have a female partner, she may have BV as well and should see a doctor too. If it's left untreated, BV can raise your risk of contracting STIs and HIV, as well as lead to premature birth or a baby with low birth weight if you're pregnant.

Prevention

Normally, your vagina has a healthy balance of yeast and bacteria, but certain factors can throw that balance off. If you're prone to vaginal infections, consider the following tips to help keep the environment in your vagina balanced:

  • Wear underwear with a cotton crotch
  • Avoid tight pantyhose, leggings, or jeans
  • Stay away from vaginal douches
  • Don't use scented feminine products or toilet paper
  • Make sure you change tampons, liners, and pads frequently
  • Change out of wet clothes as soon as possible
  • Always wipe from front to back

A Word From Verywell

Be sure to discuss any vaginal discomfort and symptoms with your doctor at your regular checkups, even if they're minor. For any irritating or clearly abnormal symptoms, see your doctor right away to ensure you get the correct treatment promptly. While the above is the most common vaginal problems, there are others that can have some overlapping symptoms, such as urinary tract infections (UTIs), vaginitis, and vulvodynia.

View Article Sources
  • Office on Women's Health. Bacterial vaginosis. U.S. Department of Health and Human Services. Updated April 24, 2018. https://www.womenshealth.gov/a-z-topics/bacterial-vaginosis
  • Office on Women's Health. Trichomoniasis. U.S. Department of Health and Human Services. Updated May 22, 2018. https://www.womenshealth.gov/a-z-topics/trichomoniasis
  • Office on Women's Health. Vaginal yeast infections. U.S. Department of Health and Human Services. Updated May 24, 2018. https://www.womenshealth.gov/a-z-topics/vaginal-yeast-infections