The 3 Most Common Vaginal Problems

Recognizing Yeast Infections, Trichomoniasis, and Bacterial Vaginosis

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Three common issues that affect vaginal health are yeast infections, trichomoniasis, and bacterial vaginosis. They often have similar symptoms, such as persistent itching, an abnormal discharge, or pain with urination.

However, these three vaginal problems are different and so are their causes. It's important to get an accurate diagnosis for what's causing symptoms because the treatments are different, too. Your healthcare provider can ensure early and effective treatment to help you avoid complications.

This article discusses these three common vaginal conditions and their symptoms. It also offers some ideas about how to prevent these infections and disorders from occurring.

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Yeast Infections

A yeast infection is caused by an overgrowth of the fungus called Candida. It normally lives inside the body (in places such as the mouth, throat, gut, and vagina) and on the skin in small amounts without causing any problems.

However, some factors—such as antibiotics, pregnancy, uncontrolled diabetes, or a weakened immune system (even if just from stress)—can upset the balance of bacteria in the vagina, causing yeast to multiply. Without intervention, yeast thrives due to the vagina's wet, warm accommodations.

How Common Are Candida Infections?

Three out of four people who have vaginas will experience at least one vaginal yeast infection during their lifetime. About 8% will have recurring infections, three or more times per year. 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.

The most common symptom of yeast infection is extreme itchiness in and around the vagina. Other signs and symptoms you might experience include:

  • Burning, redness, and swelling of the vagina and the vulva (area around the vagina)
  • Pain or discomfort when urinating
  • Pain during sexual intercourse
  • Soreness
  • A thick, white vaginal discharge that looks like cottage cheese and does not have a bad smell

Most yeast infections are mild, but some people can develop severe infections involving redness, swelling, and cracks in the wall of the vagina.

Some people 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 healthcare provider can also give you a prescription for a pill called Diflucan (fluconazole) that you take by mouth once to treat the infection.

The treatment for a yeast infection won't cure a sexually transmitted infection (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.

If this is the first time you're having these symptoms, it's important to see your healthcare provider in order to get a formal diagnosis and rule out other possibilities, especially because research shows that two in three people who buy antifungal medicine for a vaginal yeast infection don't actually have one.

Trichomoniasis

Trichomoniasis is caused by a parasite and spread through unprotected sex. It's the most common curable STI and can be spread even when you have no trichomoniasis symptoms.People of both genders can get this infection, though it's more common in those who have a vagina.

The time between exposure to trichomoniasis and the onset of symptoms can be anywhere from five to 28 days. You may notice:

  • Itching, burning, redness, and soreness of the genitals
  • Thin or frothy discharge with an unusual fishy smell that can be clear, white, yellowish, or greenish
  • Discomfort during sexual intercourse
  • Pain or discomfort during urination
  • Pelvic pain, though this is rare

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.

Does Your Partner Need Treatment?

If you suspect you may have trichomoniasis, you should refrain from sexual intercourse and see your healthcare provider immediately. If your healthcare provider diagnoses trichomoniasis, your sexual partner(s) should be diagnosed and receive necessary treatment as well. You shouldn't resume sex until both you and your partner are treated and symptom-free.

Bacterial Vaginosis (BV)

Bacterial vaginosis (BV) is the most common cause of vaginal discharge during the reproductive years. BV typically occurs when there is more harmful than good bacteria in the vagina. Specifically, 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 new or multiple sexual partners
  • Being pregnant
  • Using vaginal douches
  • Having an intrauterine device (IUD)
  • Not using a condom during every act of sexual intercourse

Though many people don't have noticeable bacterial vaginosis 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 healthcare provider 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

Summary

Yeast infections, trichomoniasis, and bacterial vaginosis are the most common vaginal issues. They are all treatable conditions, but they need to be accurately diagnosed because they're managed in different ways.

Trichomoniasis, an STI caused by a parasitic infection, needs to be treated with antibiotics. So does bacterial vaginosis, but it's instead related to the balance of bacteria types in the vagina and may have more than one cause.

Antibiotics don't help a yeast infection at all (antifungal medications are needed) and sometimes may even lead to the infection. So be sure to contact your healthcare provider about your vaginal symptoms to ensure an accurate diagnosis.

A Word From Verywell

While the most common vaginal problems associated with vaginal discharge are discussed here, there are others that can have some overlapping symptoms, such as urinary tract infections (UTIs), vaginitis, and vulvodynia. Keep in mind that your symptoms can arise from a number of conditions.

9 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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By Tracee Cornforth
Tracee Cornforth is a freelance writer who covers menstruation, menstrual disorders, and other women's health issues.