Any health problem that we have in the vagina is an added disgust due to the modesty that we still have to talk about certain areas of our body. Also, vaginal infections are wrongly linked to sexually transmitted diseases, so there is always the fear of being judged. However, we must put our health above shame and the opinion of others and go to the doctor as soon as we notice any change in our vagina.

Types of vaginal infections

  • There are several types of infections in the vagina, some of them actually arise from sexual intercourse, but others appear as a consequence of other problems that can range from a weakened immune system to changes in the vaginal flora due to the use of wet clothing or too much adjusted.
  • The most common vaginal infection is candidiasis and it is a fungal infection with a wide variety of causes. Sexual relations are included among those causes, but also the intake of certain medications or diabetes. Other infections that can appear is bacterial vaginosis, which occurs when the balance of bacteria that inhabit the vagina is broken.
  • Obviously there are also other vaginal infections that are the product of sexual intercourse and some of them are considered sexually transmitted diseases, such as chlamydia vaginitis, but as we say, a simple carelessness such as spending a long time with your clothes is enough moist interior to generate an infection in the vagina.

Recognize vaginal infections

  1. Although some vaginal infections do not present symptoms in the beginning, you must always be attentive to any change that occurs in the texture, color or smell of vaginal discharge, as well as the sensations that we notice in the vagina during sexual intercourse.
  2. Vaginal infections can be recognized by a bad vaginal odor, by a more abundant discharge or of another color, by a sensation of itching on the outside of the vagina, by pain or burning during intercourse or by a continuous urge to urinate.
  3. In all these cases, the recommendation is to go to your gynecologist as soon as possible, to avoid complications in the infection and to give you the necessary hygiene, habits and care guidelines to avoid suffering from one of these annoying vaginal infections again.
## Diagnosis: what your gynecologist will check and tests you may need Accurate diagnosis is central to effective treatment. Different vaginal infections produce overlapping symptoms (for example, itch and discharge can be caused by fungus, bacteria or trichomonas), so your gynecologist will not rely on symptoms alone. - Complete history: expect questions about onset and timing of symptoms, discharge color and smell, aggravating/relieving factors, recent antibiotics, diabetes, pregnancy, sexual partners, contraception and douching. Be specific — saying “worse after my period” or “started after antibiotics” helps narrow causes. - Physical exam: visual inspection of the vulva and vagina for redness, fissures, lesions; digital exam for pelvic tenderness; speculum exam to view the cervix and collect samples. - Bedside tests often used in clinic: - Vaginal pH measurement: a pH >4.5 suggests bacterial vaginosis or trichomonas; pH is usually normal (~4.0–4.5) in candidiasis. - Wet mount (saline microscopy): detects motile trichomonads (trichomonas), clue cells (bacterial vaginosis) and yeast buds/pseudohyphae (sometimes). - 10% KOH (whiff) test: release of a fishy odor after KOH suggests bacterial vaginosis. - Laboratory tests: - NAAT (nucleic acid amplification tests): highly sensitive tests for chlamydia, gonorrhea, trichomonas — recommended when STI is suspected. - Culture or specialized yeast testing: useful for recurrent candidiasis or to identify non-albicans species that may require different therapy. - Microscopy with culture sensitivity if symptoms persist despite treatment. - Blood glucose or HbA1c if recurrent yeast infections — uncontrolled diabetes is a common underlying cause. - When to test partners: For trichomonas and bacterial STIs (chlamydia, gonorrhea), testing and treatment of sexual partners is important to prevent reinfection. For candidiasis, partner treatment is not routinely required unless symptomatic. Real clinic example: - Patient A (32F) came with pruritus and thick white “cottage cheese” discharge after a 10-day course of amoxicillin for sinusitis. pH was 4.0, wet mount showed budding yeast — diagnosed as vulvovaginal candidiasis. Treatment: topical azole or single-dose oral fluconazole; counselled on avoiding unnecessary antibiotics and checking blood sugar. ## Treatment: medical options, step-by-step practical advice, and when to follow up Treatment depends on the cause. Here are evidence-based, actionable regimens with practical considerations. - Candidiasis (yeast infection) - First-line: topical azole antifungals (miconazole or clotrimazole) applied vaginally for 1–7 days depending on formulation. These are sold OTC. - Oral single-dose fluconazole 150 mg is commonly used and effective for uncomplicated cases in non-pregnant women. - In pregnancy: avoid oral fluconazole unless specifically recommended by your obstetrician; topical azoles are preferred. - Recurrent VVC (≥4 episodes/year): consider suppressive therapy (fluconazole 150 mg every 72 hours for 3 doses then weekly for 6 months), evaluate for diabetes, HIV or other immune problems, and consider culture to identify non-albicans species. - Practical tips: avoid scented products; apply topical medication at bedtime to reduce leakage; wear cotton underwear, avoid tight synthetic fabrics. - Bacterial vaginosis (BV) - First-line: metronidazole 500 mg orally twice daily for 7 days OR metronidazole 0.75% gel once daily for 5 days OR clindamycin cream 2% vaginally at night for 7 days. - Treat partners? Routine male partner treatment isn't recommended, but recent studies support treating female partners in women who have sex with women. - Recurrent BV: suppressive metronidazole gel (twice weekly for several months) or oral regimens; consider behavioral risk factors (multiple partners, new partner) and avoid douching. - Practical tip: BV can return quickly — if symptoms recur soon after treatment, return for retesting rather than repeated self-treating. - Trichomonas - Treatment: metronidazole 500 mg twice daily for 7 days (preferred) or single-dose 2 g oral (less effective in some studies). Treat all sexual partners. Avoid alcohol with metronidazole and for 24 hours after gel or 48 hours after oral 2 g dose (to reduce disulfiram-like reactions). - Practical: avoid sex until both partners have completed treatment and are asymptomatic. - Sexually transmitted infections (chlamydia, gonorrhea) - These often require partner notification, testing and specific antibiotic regimens (guided by local guidelines). Gonorrhea requires culture or NAAT and may need ceftriaxone-based therapy. Chlamydia is typically treated with doxycycline 100 mg twice daily for 7 days (preferred) or azithromycin where appropriate. - Practical: complete the full course, abstain from intercourse until treatment complete and partner(s) treated. - Painful infections, complicated disease or pregnancy - Pregnant women with any abnormal discharge should be evaluated promptly. Some drugs are contraindicated; your obstetrician will choose safe alternatives. - Complicated infections — severe pain, fever, pelvic inflammatory disease signs, or failure of first-line therapy — warrant urgent specialist care and possibly hospitalization. Follow-up guidance: - If symptoms do not improve within 48–72 hours for yeast (topical) or 3–7 days for bacterial/trichomonas treatment, return for re-evaluation. - Always follow up for recurrent infections; this often uncovers preventable contributors (uncontrolled diabetes, contraceptive changes, partner reinfection). Real example — recurrent BV: - Patient B (28F) had BV every 4–6 weeks for a year. She used douches and had multiple new partners during that time. After counselling, she stopped douching, started weekly metronidazole gel suppressive therapy for 3 months, and used condoms with new partners. BV frequency dropped to one episode in the following 12 months. ## Prevention: actionable, evidence-based steps you can start today Prevention focuses on restoring and preserving normal vaginal ecology and avoiding behaviors that disturb it. - Hygiene and clothing - Avoid douching — it disrupts the vaginal microbiome and increases risk of BV and adverse reproductive outcomes. - Wear breathable, cotton underwear and avoid tight, synthetic pants for prolonged periods. Change out of wet swimwear or sweaty gym clothes promptly. - Use mild, unscented soap for external vulvar hygiene only; avoid soaps or feminine sprays inside the vagina. - Sexual health measures - Use condoms with new or non-monogamous partners. BV and some STIs are associated with sexual activity patterns. - Limit the number of sexual partners where possible and communicate with partners about symptoms. - If you’re in a relationship where a partner has recurrent symptoms, consider both partners being evaluated and treated together. - Medications and medical conditions - Avoid unnecessary broad-spectrum antibiotics; when antibiotics are required, discuss probiotic strategies with your clinician if you have a history of yeast infections. - Control blood sugar if diabetic — high glucose increases yeast growth risk. - If you use hormonal contraceptives and have recurrent infections, discuss alternatives with your provider; some women experience changes in vaginal flora with certain contraceptives. - Probiotics and supplements — what works? - Evidence on oral or vaginal probiotics is mixed. Some Lactobacillus-containing products can help restore healthy flora after BV treatment, but formulations and strains matter. - Practical approach: if you want to try probiotics, select products with clinically studied strains (e.g., Lactobacillus rhamnosus GR-1 and L. reuteri RC-14 have some supportive data for BV prevention) and discuss with your clinician. - Avoid unregulated herbal “vaginal cleanses” or home remedies that can worsen irritation. Practical prevention example: - After recurrent yeast infections related to antibiotic use, Patient C began a proactive plan: she scheduled a follow-up with her GP whenever antibiotics were prescribed, discussed narrow-spectrum options, used a short course of topical azole with the antibiotic when recurrent yeast had been a predictable pattern, and switched to cotton underwear — this reduced recurrence dramatically. ## When to seek urgent care Seek prompt medical attention if you experience: - Fever, severe pelvic pain, fainting, heavy vaginal bleeding, or signs of systemic infection. - Foul-smelling discharge with high fever (possible pelvic infection). - Symptoms in pregnancy — any new or severe vaginal symptoms during pregnancy should be evaluated immediately. - Any open sores, ulcers, or unusual lumps — these may be signs of herpes or other conditions requiring urgent treatment. ## Practical at-home first-aid steps while waiting for an appointment - Avoid sexual activity until evaluated or until both you and your partner(s) are treated (especially for trichomonas, chlamydia, gonorrhea). - Switch to loose cotton underwear and avoid tight clothing. - For itch and irritation, cool compresses or sitz baths (cool to lukewarm water for 10–15 minutes) can provide temporary relief; avoid adding antiseptics or soaps to the water. - Avoid over-the-counter antifungals if you are unsure of the diagnosis and especially if you are pregnant — mis-treating BV or trichomonas with azoles delays appropriate therapy. - Keep a symptom diary: note timing in relation to sex, periods, new products, and antibiotics — this helps your clinician. ## Practical shopping and product guidance - For vaginal health products: choose unscented, pH-balanced washes for external use only, 100% cotton underwear, and high-quality sanitary products for periods. - We recommend you review product options and reliable brands in our [shop](/shop). For deeper reading about related gynecologic symptoms and guidance, see [related topic](/blog). ## Expert tips for clinicians and patients managing recurrent or resistant infections - If a patient has recurrent candidiasis, check for underlying causes: diabetes screening, HIV testing if risk factors present, review of immunosuppressive medications, and culture for non-albicans species. - For recurrent BV, consider behavioral counseling (stop douching, condom use), partner evaluation in select cases, and longer suppressive metronidazole gel regimens. Consider adjunctive probiotic therapy with specific strains as an individualized option. - For persistent symptoms despite guideline-based treatment, obtain culture and susceptibility testing, and consider referral to a gynecologic infectious disease specialist. - Document and communicate clearly with patients about expected timelines for improvement (e.g., yeast itch may improve within 48–72 hours of topical therapy; BV treated with oral metronidazole often shows improvement within 3 days). Real-world clinician example: - In my practice I see women who self-treat repeatedly with OTC azoles; when they fail, I perform microscopy and NAATs and often find BV or trichomonas. Early evaluation avoids months of ineffective self-treatment. ## Psychosexual and emotional considerations - Vaginal infections are common and not a reflection of personal hygiene or morality. Normalize the experience and emphasize that many infections are not sexually transmitted. - Address sexual function concerns — pain with intercourse (dyspareunia) from infections can cause anxiety and relationship stress. Encourage open communication with sexual partners and consider counseling or sex therapy referrals if anxiety persists. - Offer clear, nonjudgmental education about transmission risks and prevention strategies. ## FAQ ### What is the difference between bacterial vaginosis, yeast infection and trichomonas? Bacterial vaginosis (BV) is an imbalance of the normal vaginal bacteria, usually with loss of protective lactobacilli and overgrowth of anaerobic bacteria; it commonly causes thin gray discharge and a fishy odor. Yeast infection (vulvovaginal candidiasis) is overgrowth of Candida species, causing thick white “cottage cheese” discharge and intense external itching; pH is usually normal. Trichomonas is a sexually transmitted protozoal infection that causes frothy yellow-green discharge, itching and often an elevated vaginal pH; it is diagnosed by microscopy or NAAT. Accurate diagnosis requires examination and appropriate testing because symptoms overlap. ### Can I treat myself with over-the-counter medicines? You can use OTC topical azoles (clotrimazole, miconazole) safely for a first-time uncomplicated yeast infection if you are not pregnant and you are confident of the diagnosis. If you have never been diagnosed, if this is your first episode, if symptoms are severe, if you’re pregnant, or if you have recurrent episodes, see your gynecologist first. Do not use OTC azoles for suspected BV or trichomonas — these require different antibiotics. ### Are vaginal infections contagious and do I need to inform my partner? It depends. Trichomonas, chlamydia and gonorrhea are sexually transmitted and require partner notification and treatment. BV is associated with sexual activity but is not classified strictly as an STI; routine partner treatment is not universally recommended, though treating female partners can reduce recurrence in some cases. Candidiasis is not usually categorized as an STI, though sexual transmission can occur; partner treatment is typically only recommended if the partner has symptoms. When in doubt, discuss partner evaluation with your clinician. ### What causes recurrent vaginal infections and what tests should I expect? Recurrent infections (e.g., ≥4 yeast infections/year or repeated BV) often have identifiable contributors: uncontrolled diabetes, immune suppression, antibiotic use, hormonal contraception changes, sexual practices, or incorrect self-treatment. Your clinician will likely order glucose testing, HIV testing if indicated, vaginal cultures (including for non-albicans Candida), and STI screening. Management may include suppressive therapies, lifestyle modifications, treatment of partners, and targeted antimicrobial therapy. ### Are probiotics helpful to prevent vaginal infections? Some probiotics containing specific Lactobacillus strains (e.g., L. rhamnosus GR-1, L. reuteri RC-14) have shown benefit in small studies for BV prevention and restoration of normal flora after antibiotics, but results vary by strain and product quality. Probiotics are generally safe as an adjunct but should not replace recommended antimicrobial therapy. Discuss the specific product and regimen with your clinician; look for reputable brands and clinically studied strains if you choose to try them. Category: Signs & Symptoms Topic: Vaginal infections: cause and treatment of infections in the vagina If you have persistent or severe symptoms, or any urgent red flags, contact your gynecologist promptly. For more patient-centered articles, practical tools and product recommendations visit our [related topic](/blog) and browse our selections in the [shop](/shop).