Yeast Infection, STD, or Something Else?

If you suspect that you have a vaginal yeast infection, you’re most likely in a hurry to get rid of it. Yeast infections are uncomfortable, and are usually accompanied by itching, burning, and thick discharge. 

Before you run to the pharmacy, though, it’s important to determine if what you’re experiencing is indeed a yeast infection or something else. Other causes of vaginal pain and discomfort include bacterial infections, sexually transmitted diseases (STDs), skin irritation, and more. While the symptoms are similar, the causes and treatments are very different. 

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What Is a Yeast Infection? 

A yeast infection is common, and most women will experience at least one in their lifetimes. A yeast infection occurs when the Candida yeast in the vagina overgrows and leads to an infection. It usually causes burning and itching in the vagina and the surrounding area called the vulva. Vaginal yeast infections are common in girls and women, with about 75% of women experiencing at least one. The infection is rare before puberty and after menopause. 

Symptoms of a Yeast Infection

The most common symptoms of a yeast infection include:

  • Itching
  • Burning
  • Thick, white discharge that has a cottage cheese consistency

Other symptoms to keep in mind may include redness and swelling, pain with urination, and pain with sexual intercourse.

Yeast Infection Treatments

Most yeast infections can be treated at home with over-the-counter products. The infection requires an antifungal medication that may come in the form of a cream, ointment, or vaginal suppository. 

While yeast infections are usually easy to treat, it’s still helpful to check in with your doctor. Other types of infections can be mistaken for a yeast infection, and it’s estimated that up to two-thirds of women who buy over-the-counter yeast infection treatments do not have a yeast infection. In addition, using an antifungal treatment when you do not have a yeast infection can cause your body to become resistant to the medication. The antifungal may not be effective the next time you need it for a true yeast infection. 

If you seek treatment from your doctor, they may be able to prescribe you a one-time dose of oral Diflucan (fluconazole) to treat the infection. If you notice that you have been experiencing frequent yeast infections, talk with your doctor about possible causes and a more long-term antifungal prescription. 

Take the following measure to prevent a yeast infection: 

  • Choose underwear made from a breathable cotton fabric
  • Make sure your clothing and underwear are not too tight
  • Frequently change pads and tampons
  • Change out of wet clothing or a bathing suit right away
  • Never douche or use soap inside your vagina
  • Avoid soaps that are scented or contain artificial dyes
  • Wipe from front to back after using the bathroom
  • Avoid too much time in hot tubs or very hot bathwater

Yeast Infection or STD?

Many STDs share the same symptoms as yeast infections, and it can be difficult to tell what the cause of your symptoms is. While yeast infections are not considered a sexually transmitted disease, it’s possible to get one from your partner during sex.

Trichomoniasis

Trichomoniasis is a relatively common sexually transmitted disease, but many have never heard of it. This may be due to the fact that 70% of people who have it show no symptoms. It is caused by a parasite called Trichomonas vaginalis, and the Centers for Disease Control and Prevention (CDC) estimates that there were two million infections in the United States in 2018. 

Most people do not experience symptoms, but if you do, they could include vaginal itching, burning, and soreness. The color of your vaginal discharge may be yellow, white, or green and fishy-smelling. Trichomoniasis is curable and requires antibiotics. 

Herpes

Genital herpes is a sexually transmitted disease caused by the herpes simplex virus type 1 (HSV-1) or herpes simplex virus type 2 (HSV-2). While most people with herpes don’t experience symptoms, possible symptoms include painful genital sores. The sores usually start out as blisters, then break open and leave a sore. People with oral herpes may experience cold sores or fever blisters around their mouth. 

Herpes does not cause a change in vaginal discharge. There is no cure for herpes, but it is still important to see your doctor to be diagnosed and treated for the blisters. 

Genital Warts

Genital warts are caused by the human papillomavirus (HPV), the most common STD in the United States. Most cases of HPV resolve on their own, but when they don’t, the virus can lead to genital warts or even cancer. Most people with HPV do not develop symptoms.

HPV is frequently discovered when a woman's doctor performs a routine Pap smear with HPV testing. However, the CDC does not recommend testing for HPV in women with genital warts because the test results will not help determine the appropriate treatment.

Gonorrhea

Gonorrhea is a common STD that usually does not cause any symptoms in women. If you do experience symptoms, you may notice pain or burning with urination, increased vaginal discharge, and vaginal bleeding or spotting between periods. Your vaginal discharge may appear white or green.

Your doctor can test your urine for gonorrhea and prescribe antibiotics to cure it. Untreated gonorrhea can lead to serious health problems, including pelvic inflammatory disease and infertility. 

Chlamydia

Chlamydia is another common sexually transmitted disease that can lead to a change in vaginal discharge and pain with urination. The discharge may appear white, green, or yellow. 

Chlamydia can be diagnosed by a urine test or vaginal swab. Chlamydia is curable with prescription medication from your doctor. Untreated chlamydia can lead to pelvic inflammatory disease, infertility, and ectopic pregnancy. 

Yeast Infection
  • Vaginal pain

  • Burning

  • Thick, white, cottage cheese-like discharge

  • Does not cause bleeding

STD
  • May cause pain

  • May cause burning with urination

  • Discharge may be green, white, or yellow, and may have a foul odor

  • May cause abnormal bleeding or spotting

Other Possible Causes

In addition to yeast infections and sexually transmitted diseases, there are other infections and conditions that can cause vaginal pain and discomfort. It’s important to be able to recognize them so that you can receive the right treatment as soon as possible. 

Bacterial Vaginosis 

Bacterial vaginosis occurs when the normal bacteria in the vagina overgrow, causing an imbalance of bacteria and yeast. While it is not considered a sexually transmitted disease, it can put you at higher risk of contracting one. Bacterial vaginosis is the most common vaginal health issue in women between the ages of 15 and 44. It causes a thin gray or white discharge, along with pain, itching, and burning. You may also notice a strong fish-like odor. Bacterial vaginosis sometimes goes away on its own, but check in with your doctor as you may require antibiotics. 

Contact Dermatitis 

Contact dermatitis on and around the vulva can cause stinging and burning due to micro-cracks in the skin. Contact dermatitis usually happens as a result of the skin being irritated from an allergen or irritant. Examples include soap, laundry detergent, douches, spermicides, perfumes, and deodorants. This condition does not cause a change in vaginal discharge. 

Treatment requires gentle skincare since the skin is already irritated. Your doctor may recommend a corticosteroid cream to help with the redness and itching. Resisting the urge to scratch is essential to healing, so your doctor may recommend taking an antihistamine at bedtime to relieve the itching. 

Dipping Estrogen Levels

Estrogen levels dip as we age, which can lead to vaginal dryness and irritation. Other risk factors for low estrogen levels include family history, pituitary gland problems, extreme dieting, eating disorders, and excessive exercise. Symptoms can include vaginal dryness, irritation, and pain with sex.

Low estrogen also has several other signs like hot flashes, night sweats, insomnia, amenorrhea, headaches, fatigue, depression, and more. If you believe you may have a low estrogen level, talk with your doctor about the possible causes and treatment. 

Hemorrhoids

Hemorrhoids refer to swollen veins in and around your rectum and anus. Symptoms of external hemorrhoids include pain, itching, swelling, and bleeding. Internal hemorrhoids, which are located inside your rectum, can present with bleeding with bowel movements. Hemorrhoids can often be treated with lifestyle changes like adding more fiber-rich foods to your diet, soaking in a warm bath, and using over-the-counter pain medication as needed. See your doctor if the symptoms are not improving. 

Skin Conditions

Skin conditions like eczema and psoriasis can present on the skin surrounding the vagina, leading you to believe that you have a yeast infection. Psoriasis occurs when the cells in your skin reproduce too quickly, leading to thick patches of rough skin made up of old skin cells. When these patches occur on the vulva, they usually appear as pink patches with defined edges. If the skin cracks open, it can become infected. This requires a trip to the doctor for a prescription topical steroid cream that is gentle enough for the vulva area.

Other skin conditions that can cause vaginal irritation include lichen planus and lichen sclerosis. Lichen planus is caused by an overactive immune system, and leads to burning and soreness of the vulva. It can also lead to a thick yellow vaginal discharge and pain with intercourse. Lichen sclerosis is an inflammatory condition that is more common in postmenopausal women. Symptoms include itching and scaly, white patches of skin. It is usually treated with corticosteroid ointment and requires monitoring as these patches are at risk of turning into skin cancer. 

Small Cuts

Small cuts or tears in and around the vagina can lead to pain, burning, and itching. Larger tears are usually a result of childbirth, but small ones can occur because of vaginal dryness, sex without adequate lubrication, and pubic hair removal. The most common symptoms include pain, stinging or burning with urination, spotting, itching, and burning. Most small cuts will heal on their own. See your doctor if you develop bleeding, foul-smelling discharge, fever, numbness, or worsening symptoms. 

When To See a Doctor

It’s important to see your doctor any time you are concerned about new vaginal pain or discomfort. Your doctor will be able to help you determine the cause and how to treat it. Because many STDs have serious complications if left untreated, don’t hesitate to see your doctor. Other signs that it’s time to get checked out include a fever, abnormal bleeding, uncontrolled pain, and worsening symptoms.

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Article Sources
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