UTI, BV, STI or a yeast infection - how to spot the difference

A detailed guide to helping you find out what’s going on in your vagina

Only a visit to the doctor can give you clarity

When you feel pain or discomfort inside your vagina or in the vulva area in general, or when you notice any unusual discharge or odor that last for longer than a few days, it’s always a good idea to see a doctor. This is because there are several common as well as a couple of rarer vaginal health problems that have similar symptoms and thus are difficult to discern on your own. This is true even if you have previous experience with some of these infections.

However, if currently you are having problems and for whatever reason can’t get immediate medical support, this article will give you some guidance on how to figure out what your condition may be.

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How to tell if you have a yeast infection?

The first suspect always is a yeast infection. This is simply because yeast infections are so common — some 75% of women will have a vaginal yeast infection at least once. The culprit behind the infection is a fungus (candida albicans) that dwells in the frontal area of the vagina and normally is kept in check by bacteria there. If these bacteria are reduced (for example, because you’ve been taking antibiotics or you suffer from uncontrolled diabetes), the fungus faces no resistance anymore and will grow unchecked. A yeast infection can last anywhere from 2-3 days to two weeks, depending on how severe it is and what treatment you get. Normally OTC drugs and probiotics will be all it takes to defeat a yeast infection.

You may have a yeast infection if you notice the following symptoms:

  • Itching or burning sensation on your vulva, also while urinating
  • Thick (that’s important!), milky discharge but no unusual odor
  • Red, swollen tissue around the vagina entry area
  • Pain or a sore feeling inside your vagina

If in addition to these symptoms you are taking or have recently taken antibiotics, chances are high that your situation indeed is a yeast infection. The most significant evidence is the thick, milk-white discharge. If the discharge is thin, a bacterial vaginosis (BV) is more likely. 

How to tell if you have a bacterial vaginosis (BV)?

   
BV is the 2nd suspect on the list, especially if you are between 15 and 45 years of age. It’s the most often-seen vaginal infection for that age group. Essentially, BV is a bacterial imbalance, where bad bacteria outnumber the good ones. Surprisingly, even though it’s such a common condition, there’s no scientific conclusion on what causes BV. The only obvious correlation is that women only tend to get it once they started having sex. That doesn’t only mean male-female sex. In fact, there’s some evidence that female-female sex has an even higher risk of BV, perhaps because it may be orally transmitted to the vagina. BV requires treatment, as it rarely goes away on its own. 

You may have BV if you notice the following symptoms:

  • Itchiness or burning inside or outside the vagina (also when urinating)
  • Thin white, grayish or (less common) green discharge
  • A sharp fishy odor (particularly after sex)

If you experience any of the above symptoms, especially the thin discharge and fish-like odor, you may be dealing with a BV. The likelihood of this is higher if recently you’ve had a new sex partner (male or female) or if you are new to sex altogether. 

How to tell if you have a urinary tract infection (UTI)?

UTI also are a common form of vaginal infection. About half the women aged 35 or younger in the United States had at least one UTI in their life so far. Globally there are about 160 million cases a year. In its most common appearance UTI is a bladder infection (cystitis) that is caused by bad bacteria — typically E. coli — accidentally entering the vagina, most often because of poor hygiene (where the bacteria come from the woman’s own anus because of wrong wiping) or sexual intercourse. If untreated, an UTI can trigger a potentially fatal kidney infection. Therefore, it’s important that you seek proper medical treatment from a doctor or clinic, who will prescribe you antibiotics.   

You may have a UTI if you notice the following symptoms:

  • Urge to frequently urinate (even when no urine comes out anymore)
  • Burning feeling during urination (but not so much when you don’t urinate)
  • Dark, cloudy urine with an intense odor
  • Mild pain in the lower abdominal area
  • General feeling of tiredness 

As you can see, what makes UTI different from yeast infections and BV are that the burning sensation is most notable when you pee and that the smelly part is not the vaginal discharge but your urine. Another factor that stands out is the frequent urge to pee — you wouldn’t have that with a BV or yeast infection.    

How to tell if you have a sexual transmitted infection (STI)?

That’s a more difficult question, as the range of STI is so wide and their symptoms often go through several stages as the disease makes progress in the body. That’s why when in doubt only a doctor can give you peace of mind. A simple blood test will do the job.  

However, generally speaking, the first signs of STI tend to be skin conditions on the vulva or inside the vagina, such as rashes, itching, swellings, red blots, blisters, and sores. The color of urine and vaginal discharge doesn’t usually change, although at an advanced stage some STI will cause internal bleeding that mixes into the discharge and urine. Also, strong odor is not a common symptom, and most likely signals a BV or UTI instead. And the urge to frequently urinate is also not something commonly seen in STI. 

That said, only a visit to your doctor and proper testing can determine with certainty which infection you currently are suffering from.    
  

References

  1. Pujades-Rodriguez, Mar, et al. “Lower Urinary Tract Infections: Management, Outcomes and Risk Factors for Antibiotic Re-Prescription in Primary Care.” EClinicalMedicine, vol. 14, Sept. 2019, pp. 23–31, www.thelancet.com/journals/eclinm/article/PIIS2589-5370(19)30120-8/fulltext, 10.1016/j.eclinm.2019.07.012. Accessed 10 Feb. 2020.
  2. Huppert, Jill S., et al. “Urinary Symptoms in Adolescent Females: STI or UTI?” Journal of Adolescent Health, vol. 40, no. 5, May 2007, pp. 418–424, www.ncbi.nlm.nih.gov/pmc/articles/PMC1976261/, 10.1016/j.jadohealth.2006.12.010. Accessed 10 Feb. 2020.
  3. Sumati, AH, and NK Saritha. “Association of Urinary Tract Infection in Women with Bacterial Vaginosis.” Journal of Global Infectious Diseases, vol. 1, no. 2, 2009, p. 151, www.ncbi.nlm.nih.gov/pmc/articles/PMC2840952/, 10.4103/0974-777x.56254. Accessed 10 Feb. 2020.
  4. Jacob, Louis, et al. “Prevalence of Vulvovaginal Candidiasis in Gynecological Practices in Germany: A Retrospective Study of 954,186 Patients.” Current Medical Mycology, vol. 4, no. 1, 29 July 2018, www.ncbi.nlm.nih.gov/pmc/articles/PMC6101156/, 10.18502/cmm.4.1.27. Accessed 10 Feb. 2020.

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