It’s hard enough to experience vaginal irritation, itching, soreness or painful sex and urination. But the stress of not knowing whether it’s a yeast infection or a sexually transmitted infection (STI) can feel even worse. 

If you’re having any of these symptoms, you should schedule an appointment with a doctor who gets you. 

In the meantime, here’s a quick guide to point you in the right direction. 

Symptoms of a yeast infection

Yeast infections are more common than you may think. Three out of four women will experience one at some point in their lifetime. 

It’s healthy and normal for every woman to have some yeast. An infection happens when there is overgrowth of a yeast called Candida in the vagina.

If you are experiencing any of these symptoms and are wondering what’s going on down there, it could be a yeast infection:

• Itching and irritation in the vagina and vulva.
• A burning sensation, especially during intercourse or while urinating.
• Redness and swelling of the vulva.
• Vaginal pain and soreness.
• Vaginal rash.
• Thick, white, odor-free vaginal discharge with a cottage cheese appearance.
• Watery vaginal discharge.

Some yeast infections can go away with over-the-counter medication. Others require treatment from a doctor.  

What if it’s not a yeast infection?

If your doctor has ruled out a yeast infection and you’re still experiencing symptoms, it may be one or more of the following conditions.

Bacterial vaginosis 

Symptoms can include burning and itching of the vagina, as well as a grayish discharge that gives off a fishy smell. Bacterial vaginosis is not an STI. It happens when the “unhealthy or bad” bacteria in your vagina outweighs the “good” bacteria. Bacterial Vaginosis should be treated with a prescription from your doctor.

Chlamydia 

Chlamydia is caused by the bacterium Chlamydia trachomatis. It can cause white, green, or yellow discharge, burning with urination, painful sex, and inflammation. Sometimes, Chlamydia does not cause any symptoms.

Unlike yeast infections, there is no cottage cheese-like consistency to the discharge. Symptoms usually don’t appear until a few weeks after the initial infection. 

Sometimes, the infection moves upward to the uterus and fallopian tubes, causing pelvic inflammatory disease (PID). This can be serious, so it’s important to treat Chlamydia as soon as possible.

Chlamydia should be treated with a prescription from your doctor. Your sexual partner(s) should also be treated as well. Your HealthTap doctor can also order urine testing to check for chlamydia.

Gonorrhea 

Gonorrhea is also a bacterial STI. Like Chlamydia, the vaginal discharge caused by Gonorrhea  white, yellow or green and can cause inflammation. Unlike yeast infections, there is no cottage-cheese-like consistency to the discharge. 

Symptoms don’t always occur, or if they do, they may seem very mild. However, you may notice rectal symptoms like itching or soreness, heavier bleeding during periods, burning with urination, and pain during sex. 

Gonorrhea is caused by the bacterium Neisseria gonorrhoeae. It should be treated with a prescription from your doctor. Your sexual partner(s) should also be treated as well. Your HealthTap doctor can also order urine testing to check for gonorrhea.

Herpes 

Vaginal herpes causes itching and burning in the vagina, but no discharge. The biggest difference between a yeast infection and herpe is that it causes sores. 

Herpes is not curable, but your doctor can prescribe antiviral medications that control the outbreaks and help with pain.

Hemorrhoids 

These occur when a blood clot develops in or around the anus. This often leads to visible bumps or swelling. Hemorrhoids often cause vulvar or peri-anal itching and pain. This can happen during exercise, bowel movements, or childbirth. 

Your doctor can develop a treatment plan to help with hemorrhoids.

Trichomoniasis 

Trichomoniasis does not often come with symptoms, but when it does, you can expect many of the symptoms described above—burning, itching, painful sex, and thin discharge that is clear, white, yellow, or green that can have a bad odor. 

It is caused by infection with a protozoan parasite called Trichomonas vaginalis. This should be treated with a prescription from your doctor. Your sexual partner(s) should also be treated as well.

"But it’s awkward …"

It’s OK to feel awkward about talking to someone about these issues.

What’s not OK is suffering silently with discomfort, or letting a small issue become a larger problem.

HealthTap doctors can speak to you over a video call from the comfort of your own home and recommend next steps. That can make the process of investigating some of these symptoms a lot easier. However, if symptoms don’t resolve, an in-person exam may be necessary. 

Use your HealthTap subscription to choose a doctor that gets you — one you can trust to determine and develop a treatment plan for you!

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