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Does Everything That Itches Equal Yeast? Vaginal Infections

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When anything feels off down there, our mind usually goes to one place: yeast infection. No matter what the actual symptoms are, any discomfort seems to signal yeast. For whatever reason, for most of us vaginal discomfort reflexively equals yeast. And while some of us will call our GYN to get their take on what’s going on down there, most of us simply head over to the local Duane Reade or CVS for some sort of topical relief.

Whether you pick the one-day, the three-day, or the extended seven-day course, you leave with something to stop the itch, the burn, and the overall discomfort. It isn’t until your symptoms outlast the one-, three-, or seven-day regimen that you pick up the phone and call your doctor. It is usually here that you find out that not all burning, discharge, or itching is yeast—a.k.a. Monistat works, just not on a bacterial or urinary tract infection.

Here are some tips on how to know if yeast is really the culprit…

  1. Discharge: While most of us associate vaginal discharge with some sort of problem or infection, news flash: a healthy vagina also secretes vaginal discharge. However, the latter is usually odorless, fairly clear, and doesn’t make you think or wipe twice! An infection, be it yeast, bacteria, or something else, will cause the discharge to change color, content, and quantity. While yeast is routinely associated with white, clumped (cottage cheese-like) discharge, discharge that is green or yellow is more commonly seen in bacterial infections (e.g., bacterial vaginosis or Trichomoniasis). And taking it one step further, urinary tract infections (which are often misdiagnosed as a yeast infection) will likely cause no change in the quantity or quality of the vaginal discharge. Bottom line, what the discharge looks like may “color” our diagnosis of what is causing your vaginal discomfort.
  2. Odor: Nobody wants to smell bad…especially down there! So, when something smells off, it should signal you that something is not right. However, that “not right” does not mean a yeast infection. Here’s the deal. A normal vaginal pH is about 3.8 to 4.5. Infections can alter the pH and change the vaginal odor. Select bacteria (think bacterial vaginosis, a.k.a. BV) can result in foul-smelling vaginal discharge. And although yeast can alter the pH, it doesn’t usually have a significant impact on vaginal odor. Therefore, when the odor seems way off you are likely dealing with something else.
  3. Itching: Vaginal itching and yeast infections sort of go hand in hand. In fact, this is the symptom that sends most of us straight to the drugstore. But while yeast is the infection that is most likely to cause an itching sensation, the vaginal mucosa, just like your skin, is sensitive to changes in body washes, soaps, and detergents. The same sort of itching that can occur on your arms, legs, stomach, and face when you change detergent or add a new skin care product can happen to your vagina. Before prescribing yourself Monistat, think about what has changed in your hygiene routine, and make sure that it is not what’s making you itch!
  4. Abdominal Pain: Most vaginal infections are limited to the vulva and the vagina. They rarely make their way to the cervix, the uterus, the tubes, and into the pelvis/abdomen. However, some sexually transmitted diseases (think chlamydia and gonorrhea) can move. They are frequent trespassers in the pelvis and pelvic organs. Therefore, when abdominal pain is accompanying your vaginal discharge the culprit is more likely to be a bug that can do damage on the inside as well as the outside rather than your garden-variety yeast. However, the pathogens that can move can do some major damage (e.g., infertility) if they are not treated.
  5. Fever: While most vaginal infections are super annoying, that won’t make you super sick. Therefore, when a woman reports a fever as well as vaginal discharge we start to think of things like gonorrhea, chlamydia, and even an infection in the kidneys. If your temperature goes up, you should get up and go right to your doctor!
  6. Pain with Urination: Although vaginal discomfort can make urinating super uncomfortable, pain with urination is usually the tell-tale sign of a urinary tract infection. Add to that urinary frequency and urgency (a.k.a. I have to go right now!), and urinary discomfort is more likely to be from a urinary tract infection rather than a vaginal infection.

So, while we all love to play Dr. Google not everything can be solved without a visit to a doctor. Not everything that itches, burns, or makes you feel uncomfortable is a yeast infection. Make sure you take note of everything that you are feeling. If your discharge comes with any one of the above, Monistat is not going to make it go away. Go and see your GYN!

 

The Enemy: Vaginitis

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Vaginal discharge and its friends—itching, odor, and irritation—need no introduction. When they arrive, you know they’re there. They are some of the most unwelcome guests, and you’ll pretty much do anything to boot them from your bottom. As complaints go, they’re the cause of many calls and visits to the GYN and overall can leave you miserable.

Vaginal discharge usually indicates vaginitis (the medical way of saying “inflammation” or “infection”). Vaginitis is the umbrella term used to describe all the lovely symptoms listed above. And when they’re present, it’s a sure sign that something is off in the vagina. Let us share what these things usually are.

For starters, the vagina is an acidic place (a.k.a. the pH of the vagina is usually about 4.0 to 4.5). Acidity is important because it assists in keeping the bugs away—bacteria and fungus are more fans of a basic environment. When the pH is off and things are skewing in the basic direction, bugs start to flourish.

Anything from menstrual cycle phase to a foreign body to sex to antibiotics can throw things off (a.k.a. the pH) and set the stage for vaginitis. In come the bacteria or the fungus, and out goes your comfort (bacterial vaginosis, candida vulvovaginitis, and trichomoniasis are the most common culprits). When it comes to symptoms, the most common symptoms women with vaginitis complain of are vaginal discharge, itching, burning, redness, pain with intercourse, pain with urination, and even spotting.

It’s important to call your doctor when you get that “things don’t feel right down there” sensation. You should trek to their office for a chat (a good history can tell you more than any test), a pelvic exam, a vaginal plus or minus cervical culture, a pH test, and a close look at the discharge under the microscope. While there are some classic features of different bugs (trichomonas usually present with a greenish-yellow discharge, candidiasis with a thick, white, cottage-cheese-like discharge, and bacterial vaginosis with a thin, fishy-smelling gray discharge), it’s best to make the diagnosis before initiating any treatment.

If the tests come up without a clear diagnosis (which happens in about 25–35% of cases), your doctor will start delving deeper into some of the more unlikely causes (low estrogen, medications, hygienic practices, allergies). Whatever the cause, we may have ways to treat you and end your torture. Whether it is an oral medication or a vaginal cream, we can find the right medication to return the vagina and its pH back to normal.

Vaginitis can be super annoying. It can sideline you from doing a lot of fun things (no explanation needed) as well as some not-so-fun things (a.k.a. working). But you don’t have to suffer in silence. And you shouldn’t rely on self-diagnosis. While your intuition is probably pretty spot on, without a microscope and a pH test, you can’t be certain. Although it is usually bacteria or a fungus causing the problem, it’s important to confirm which one. This will ensure that you get the right treatment and get right back into the swing of things.