If you’re experiencing vaginal itching, burning or unusual discharge, you might assume it’s a yeast infection - but that’s not always the case.
Many vaginal conditions can cause similar symptoms but require different treatment, so it’s important to understand the possible causes.
“A vaginal yeast infection is a common fungal infection that causes burning, itching, a thick, white, cottage cheese-like discharge and discomfort in the genital area,” said Jennifer Nelson, DO, an internal medicine-pediatric specialist with Banner – University Medicine. “Although it’s common in women, many other vaginal conditions can mimic a yeast infection but require different treatment. This is why it’s always important to discuss symptoms with your doctor to ensure that you are receiving the correct treatment.”
What does a yeast infection feel like?
A vaginal yeast infection typically causes:
- Itching and irritation
- Burning
- A thick, white discharge
- Discomfort in the genital area
However, these symptoms can overlap with other conditions.
Conditions that can be mistaken for a yeast infection
Several vaginal health conditions can cause similar symptoms but have different causes and treatments.
Sexually transmitted infections (STIs)
STIs can cause symptoms that look similar to a yeast infection.
“Sexually transmitted infections can often mimic yeast infections in that they may cause vaginitis, an irritation of your vagina or vulva,” Dr. Nelson said. “Common symptoms can include vaginal discharge, itching, burning, pain with sexual activity, bleeding and vaginal odor.”
The most common STIs that may cause these symptoms include:
- Trichomoniasis: Often has no symptoms, but may cause itching, burning, discharge or pain with sex
- Gonorrhea and chlamydia: May cause discharge, burning or lower abdominal pain
- Mycoplasma genitalium (MG): May cause discharge, bleeding or pain with sex
Depending on sexual practices, symptoms may also appear in the rectal or oral areas.
Treatment: STIs are typically treated with antibiotics. Because many can be asymptomatic, regular screenings and pelvic exams are important.
Bacterial vaginosis (BV)
Bacterial vaginosis is one of the most common causes of vaginal discharge and is often mistaken for a yeast infection.
“BV occurs when there is a shift in the bacteria that contributes to vaginal health,” Dr. Nelson said. “This imbalance can lead to symptoms.”
Symptoms may include:
- Thin, off-white discharge
- A strong, fishy odor
While BV is not technically an STI, sexual activity and multiple partners can increase your risk.
Treatment: BV is typically treated with antibiotics such as metronidazole.
Allergic reactions or irritation (noninfectious vaginitis)
Your vaginal area is sensitive and may react to products you use.
“As with other parts of the body, the vulvar and vaginal areas can develop a contact dermatitis reaction to detergents, lotions, soaps and creams,” Dr. Nelson said. “These products can also alter vaginal pH and increase the risk of infections.”
Symptoms may include:
- Itching
- Burning
- Discharge
Treatment: Identifying and avoiding the irritant is key. In some cases, short courses of topical steroids may help.
Skin conditions that affect the vulva
Certain skin conditions can mimic yeast infection symptoms.
Conditions may include:
- Eczema
- Psoriasis
- Lichen sclerosus
Lichen sclerosus often causes severe itching and is more common after menopause.
Treatment: Treatment depends on the condition. Lichen sclerosus is usually treated with corticosteroid ointments and requires monitoring.
How to tell if it’s a yeast infection or something else
Because symptoms overlap, it can be hard to tell the difference on your own.
In general:
- Yeast infections: Thick, white discharge and intense itching
- BV: Thin discharge with a fishy odor
- STIs: May include pain, bleeding or unusual discharge
A health care provider can confirm the diagnosis and recommend the right treatment.
Frequently asked questions about vaginal symptoms
Can you mistake BV for a yeast infection?
Yes. Symptoms can overlap, but BV usually has a distinct odor and thinner discharge.
Do STIs feel like a yeast infection?
Some STIs can cause similar symptoms, which is why testing is important.
When should I see a doctor for vaginal symptoms?
If symptoms persist, worsen or keep coming back, you should seek care.
Can you treat these conditions at home?
Some conditions require prescription treatment, so it’s best to get an accurate diagnosis.
The bottom line
If you have vaginal itching, burning or unusual discharge, it’s important to see a health care provider to determine the cause and get the right treatment.
Because some conditions - especially STIs - can lead to serious complications if left untreated, don’t wait to seek care.
Find a Banner Health provider near you.
