Do I Have a Vaginal Yeast Infection or Something Else?

Medically Reviewed by Zilpah Sheikh, MD on June 19, 2024
10 min read

Yeast infections can be uncomfortable, but they’re usually not serious. You may have itching or irritation in or around your vagina, as well as a thick, white discharge. In many cases, an antifungal treatment will clear up your symptoms.

If you’re not sure whether you have a yeast infection or something else, it’s important to see a doctor for the right diagnosis and treatment. If you don’t have a yeast infection, antifungals won’t help you get better. They can actually prolong the problem because the real cause will continue to get worse.

A yeast infection is a fungal infection of the vagina and vulva — the outside parts of the vagina. Anyone with a vagina can get a yeast infection. These infections are so common that up to 75% of people who were assigned female at birth (AFAB) will get at least one vaginal yeast infection in their lifetime. Around 45% will get two or more of these infections.

The fungus candida causes yeast infections. Candida naturally lives in the vagina. Normally, bacteria in the vagina keep the yeast in balance. But if the yeast gets out of balance with the bacteria and grows too much, you could get an infection. This imbalance can happen if you:

  • Take antibiotics, which kill bacteria
  • Have poorly controlled diabetes 
  • Are pregnant
  • Have a weak immune system
  • Take birth control pills or hormone therapy that increase estrogen levels in your body
  • Sit in a wet bathing suit or sweaty clothes
  • Wear scented tampons or use deodorant in your vagina

A yeast infection causes symptoms such as:

  • Itching, pain, and irritation in the vagina and vulva
  • Burning when you pee or have sex
  • Redness and swelling of the vulva
  • Thick white discharge from the vagina that may look like cottage cheese but doesn’t smell bad
  • Rash on the vagina

Many other conditions that affect the vagina and vulva cause symptoms like these. That’s why it’s important to see your doctor for a diagnosis, especially if you’ve never had a yeast infection before.

Yeast infections are not sexually transmitted diseases (STDs), but having sex could increase your risk for a yeast infection. That’s because sex sometimes creates breaks in the skin of the vagina where yeast can get inside and grow.

You might confuse an STD such as chlamydia, trichomoniasis, or gonorrhea for a yeast infection because they cause some of the same symptoms, including:

  • Itching and burning in the vagina and vulva
  • Burning when you pee or have sex
  • Thick discharge from the vagina 

The main difference is the type of germ that causes these infections. Bacteria or viruses cause most STDs, while a fungus causes yeast infections.

Because the symptoms are so similar, often the only way to know for sure which type of infection you have is to see a doctor. The doctor will examine you and take a sample of discharge from your vagina to confirm whether you have a yeast infection. To diagnose STDs, your doctor tests a sample of your pee.

Yeast infection vs. herpes

Herpes is a type of STD. Herpes simplex viruses (HSVs) such as HSV-1 and HSV-2 cause the infection. Herpes spreads through skin-to-skin contact during sex.

Like a yeast infection, herpes causes symptoms such as vaginal discharge and pain when you pee. But with herpes, you may also have small blisters around your vagina, anus, or mouth. Those blisters may break open and bleed or ooze liquid, and then form scabs as they heal.

Most yeast infections usually clear up after you take an antifungal medicine for a few days. You can treat herpes with an antiviral medicine, but it’s not curable. Symptoms may go away with medicine, only to return in the future.

Yeast infection vs. chlamydia

Chlamydia is a very common STD. The bacteria that cause chlamydia can spread from your partner to you during unprotected vaginal, oral, or anal sex. This infection causes symptoms such as white discharge and burning or pain when you pee or have sex, but most people with chlamydia don’t have any symptoms.

You can have chlamydia without showing symptoms; so, if you’re sexually active, ask your doctor if you should get screened. Your doctor will take a sample of your pee or fluid from your vagina. A lab will then test the sample for the bacteria that cause chlamydia.

Antibiotics should cure chlamydia in a week or two. It’s important to treat this infection. Untreated chlamydia can cause pelvic inflammatory disease (PID), which could damage your fallopian tubes and make it difficult or impossible for you to get pregnant.

It’s normal to have bacteria in your vagina. Usually “good” and “bad” bacteria balance each other out. But in bacterial vaginosis (BV), there is an overgrowth of “bad” bacteria, and they outnumber the “good” bacteria. This imbalance can sometimes happen if you douche or have unprotected sex.

Bacterial vaginosis can affect anyone with a vagina. About 1 in 3 people AFAB will get this infection.

Most people with BV don’t have symptoms. When it does cause symptoms, one of them might be discharge from the vagina and a burning feeling when you pee, similar to the symptoms of a yeast infection. The difference is that with BV, the discharge is off-white, gray, or green, and it has a fishy smell.

Your doctor can confirm whether you have BV with a pelvic exam and a test of fluid from your vagina. If you do have BV, you can’t treat it yourself like you might do with a yeast infection. Your doctor can prescribe an antibiotic that you take by mouth, such as metronidazole (Flagyl) or tinidazole (Tindamax). Some antibiotics come as a cream or gel that you insert into your vagina.

Another condition that’s easy to confuse with a yeast infection is a urinary tract infection (UTI). This infection is in your urinary tract, which includes the:

  • Bladder
  • Ureters
  • Kidney
  • Urethra

You get a UTI when bacteria travel up your urethra and multiply in your bladder, kidneys, or other parts of your urinary tract. You’re more likely to get a UTI after you have sex, during pregnancy, and as you get older. People who were AFAB are more likely to get UTIs than those assigned male because they have a shorter urethra.

A burning sensation when you pee is a symptom of both yeast infections and UTIs. With a UTI, you’ll also have symptoms such as:

  • The urge to pee, even when your bladder is empty
  • Red, pink, or brown pee — a sign that there’s blood in it
  • Smelly pee
  • Pain in your lower belly

If the infection travels to your kidneys, possible symptoms include:

  • Fever
  • Chills
  • Pain in your lower back or side
  • Nausea or throwing up

Your doctor can diagnose a UTI by testing your pee. They may send your pee sample to a lab for a urine culture to find out which type of bacteria caused your infection. Knowing the bacteria type will help your doctor know which antibiotic is most likely to work against it. You may need to take antibiotics for a week or longer to fully clear up the infection.

Redness and itching in your vulva might also be a sign of a skin condition called vulvar dermatitis. It includes:

  • Atopic dermatitis, a problem with your skin’s barrier that makes it more sensitive to allergens and irritating substances
  • Contact dermatitis, a reaction to something in your environment that causes an itchy rash

You can get vulvar dermatitis if you’re sensitive to products such as:

  • Soap and bubble bath
  • Laundry detergent and fabric softener dryer sheets
  • Underwear made from synthetic materials such as nylon
  • Douche, tampons, and feminine hygiene sprays
  • Scented toilet paper
  • Dyes

Pain during sex is a symptom of both a yeast infection and dermatitis. With dermatitis, you might also feel pain when you insert a tampon or get a pelvic exam from your OB/GYN.

Vulvar dermatitis also causes symptoms such as these in the vulva:

  • Itching, burning, or stinging 
  • Thick patches of skin 
  • Red or dark color to the skin 
  • Fluid oozing out of damaged skin

To get a diagnosis, your doctor will ask about your symptoms and examine you. They may test a sample of discharge from your vagina or do patch testing of your skin to see if you have any allergies.

Treatment starts with avoiding whatever substance is irritating your skin. Your doctor might prescribe a corticosteroid ointment or anti-itch medicine to relieve symptoms such as redness, swelling, itching, and burning.

Redness, swelling, itching, and discharge can also be symptoms of an allergic reaction of the vulva called vulvitis. Vulvitis isn’t an infection, but a reaction to products such as soap or laundry detergent. Sometimes an infection causes vulvitis.

With vulvitis, the itching is intense. Plus, you may have:

  • Small cracks in the skin of the vulva
  • Fluid-filled blisters that may break open, ooze, and crust over
  • Thick, white, and scaly patches of skin on your vulva

To diagnose vulvitis, your doctor will do a pelvic exam. They may do blood and urine tests and check you for STDs. You might also have a Pap test, which not only screens for cancer but also helps diagnose infections and inflammation.

To treat vulvitis, first avoid the irritating substance that caused it. Cortisone creams can ease itch and irritation. Sitting in a sitz bath helps with itching.

Hemorrhoids are swollen veins in the rectum or the skin around the anus. They sometimes cause itching, swelling, and pain in and around the vagina. But mainly, you’ll feel the itching and discomfort around the anus. With hemorrhoids, you can actually feel a swelling around your rectum and you may have some bleeding.

Yeast infections are less common as you get older. If you have symptoms such as vaginal irritation and you’re past menopause, they could be due to low estrogen.

As you get older, your level of estrogen goes down. This causes changes in your body, such as thinner skin in your vagina called vaginal atrophy. With atrophy, you can have symptoms that mimic an infection, such as vaginal burning or itching and pain during sex.

Other low estrogen symptoms are very different from those of a yeast infection. Look for signs like these to help you tell the two conditions apart:

  • Dry skin
  • Sore breasts
  • Moodiness
  • Trouble concentrating
  • Hot flashes and night sweats
  • Weight gain, especially in the belly
  • Tiredness
  • Trouble sleeping
  • Reduced sex drive

What does discharge look like with yeast infection and low estrogen?

Discharge from a yeast infection is thick and white, and it doesn’t smell. With low estrogen, the discharge is thin, watery, and yellow.

Because the symptoms of so many other conditions resemble a yeast infection, it’s better to see an OB/GYN or other doctor for a diagnosis and treatment, especially if you’ve never had one of these infections before. Your doctor can do tests to confirm which condition you have. Then if you do have a yeast infection, they can prescribe an antifungal medication that’s stronger than ones you can buy over the counter. 

While you can treat a yeast infection yourself if you’ve had them before and you know what medicine works for you, don’t use antifungal medicines if you’re pregnant. Some of these medicines can harm your growing baby.

If you get frequent yeast infections, a chronic condition such as diabetes might be behind them. Your doctor can diagnose the cause and recommend treatments to prevent these infections in the future.

Yeast infections are so common that most people who have a vagina will get at least one of them in their lifetime. These infections cause symptoms such as burning, itching, irritation, and vaginal discharge. Many other conditions also cause similar symptoms. So, see your primary care doctor or OB/GYN for a diagnosis and treatment if you have symptoms like these, especially if it’s your first yeast infection.

What is the fastest way to get rid of a yeast infection?

Take an over-the-counter or prescription antifungal medication. These medicines can clear up a yeast infection in 3-7 days.

Will a yeast infection go away on its own?

Some mild yeast infections do go away on their own, but not all. Most of these infections will clear up after you take an antifungal medicine for a few days. Others will need longer treatment.

Should I treat a yeast infection myself?

If you’ve had these infections before, you could try to treat them yourself using an over-the-counter antifungal medicine. But if this is your first yeast infection or your symptoms don’t improve with over-the-counter treatment, see a doctor.

How can I be sure I have a yeast infection?

The only way to know for sure that you have a yeast infection is to get a diagnosis from your doctor. The doctor will do a pelvic exam and test fluid from your vagina to make the diagnosis.

Can a yeast infection cause back pain?

Back pain isn’t a usual symptom of a yeast infection. The cause of back pain is more likely to be a muscle, ligament, or joint problem such as arthritis or a bulging disc.