Is it a Yeast Infection, BV, Trich, or UTI? Know the Difference

When you experience vaginal redness, itching, and abnormal discharge, it can be tricky to determine the cause. Knowing whether you have a yeast infection, bacterial vaginosis, or trichomoniasis is critical to properly treat the infection and find quick relief. These conditions all have different causes and require different treatments, so knowing the underlying cause of symptoms is important.

While many of the symptoms of yeast infections, bacterial vaginosis, and trichomoniasis are the same, there are key differences, including how the conditions affect vaginal pH. At-home vaginal pH testing can help you distinguish between the three types of vaginal infections.

What Is a Yeast Infection?

Yeast infections, also called vaginal candidiasis, is a fungal infection of the vagina and vulva. These common infections are caused by an overgrowth of a microorganism called candida albicans which is a normal part of the microbiome of the vagina and doesn't cause any health issues. Typically, healthy bacteria such as lactobacillus prevent candida from proliferating too much. However, the balance can be thrown off due to issues like antibiotic use, pregnancy, uncontrolled diabetes, or a suppressed immune system.

When candida proliferates in the vagina and vulva, it can cause itching, redness, and soreness. In addition, a yeast infection can cause excessive vaginal discharge that is odorless and may be the consistency of cottage cheese.

Most yeast infections can be treated with over-the-counter anti-fungal treatments.

What Is Bacterial Vaginosis?

Bacterial vaginosis (BV) occurs when some normal bacteria in the vagina overgrow. The vagina typically contains a combination of bacteria types, including anaerobes and lactobacilli. When anaerobes overpopulate the vagina, it leads to an imbalance that causes BV.

BV is not considered a sexually transmitted infection, but it is more common among sexually active people. Experts believe sexual intercourse may affect the microbiome in the vagina for some people. BV is not contagious, and you cannot pass it on to sexual partners.

The main symptom of BV is vaginal discharge with a distinct odor. The discharge associated with BV may be off-white, grey, or even greenish and often has a fishy smell. Discharge may increase after sexual intercourse. BV may also cause vaginal irritation or soreness and pain when urinating.

The treatment for bacterial vaginosis is antibiotic gel inserted into the vagina or an oral antibiotic. Learn about BV treatment and prevention strategies in this article.

What Is Trichomoniasis?

Trichomoniasis is a parasitic infection. It is caused by a one-celled protozoan called Trichomonas vaginalis. It can grow in the vagina, vulva, and cervix. It can infect the urethra, so people of any gender are susceptible to trichomoniasis.

Trichomoniasis is a sexually transmitted infection. It can be passed through any genital contact, including oral, anal, and genital sex. Symptoms of trichomoniasis don't appear until 28 days after exposure. However, you can pass the infection to a partner during that time.

When you have a vaginal trichomoniasis infection, you may notice excessive vaginal discharge that has a strong odor. The discharge associated with trichomoniasis may be thin and frothy and ranges in color from yellow to greenish. It often has a foul, moldy smell. Other symptoms include redness, burning, and itching around the vagina and vulva, pain with urination or sex, and lower abdominal discomfort.

Trichomoniasis can be treated with oral antibiotics.    

Urinary Tract Infections

Urinary tract infections (UTIs) can also cause symptoms similar to vaginal infections. A UTI is an infection in your bladder, ureters, urethra, or kidneys. It can cause abdominal pain, painful urination, frequent urination, and blood in the urine. There is no vaginal discharge or discomfort of the vagina and vulva with a UTI.

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How to differentiate between different infections?

Look into following physical symptoms to differentiate between different infections.

Discharge - Texture, Color, and Smell

Discharge is a common symptom of many vaginal conditions. You can get clues to the underlying cause by paying attention to the look and smell of your discharge.

The discharge associated with a yeast infection is typically thick, white, and curdy without a strong odor. Keep in mind, however, that you can experience thick white discharge that is not due to a yeast infection, so you will need to look at the other symptoms you have as well. 

The discharges typical in BV and trich differ in color, texture and odor. The discharge associated with BV may be off-white, grey, or even greenish and often has a fishy smell.

The discharge with trichomoniasis may be thin and frothy and ranges in color from yellow to greenish. It often has a foul, moldy smell. About 70% of people with trich have no symptoms at all, so discharge alone is not a reliable indicator. 

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Other Physical Symptoms

Aside from discharge, there are some other symptoms that are commonly present with yeast infections, BV, and trich. Comparing symptoms can be helpful in determining whether it's a trichomoniasis, BV or yeast infection. All three may present with itching, soreness, and redness, although these symptoms are less common with BV. Trich sometimes causes pain with urination, which is not a symptom of BV or a yeast infection. 

Yeast Infection vs UTI

Symptoms can help you tell the difference between a UTI and a yeast infection. If you experience no discharge but a burning sensation with urination, you may have a urinary tract infection or UTI. Burning upon urination can occur with either yeast infection or UTI, but accompanying discharge is usually associated with a yeast infection.

UTI vs BV

If you're unsure if you have BV or a UTI, consider your symptoms. Both can cause painful urination. However, only BV causes vaginal discharge; discharge with a strong, foul odor, particularly after sex, is a strong indicator of BV.

BV vs Yeast Infection 

When comparing bacterial vaginosis and a yeast infection, look for texture and odor of vaginal discharge. An odorless, cottage cheese-like discharge is associated with a yeast infection. On the other hand, discharge with a strong foul odor, particularly after sex, is a strong indicator of BV.