Think You Have a Vaginal Infection? Here’s What You Need to Know.

Vaginal infections are common—I see them all the time as an ob-gyn. Unusual discharge and itching can tell you something’s not quite right down there.

The good news is that most vaginal infections are easily treatable, and sometimes preventable. Here’s what you should know about these infections.

Vaginal discharge can be healthy and normal.

First things first: It’s normal to have some vaginal discharge (liquid that comes out of the vagina). Normal discharge is clear or white and doesn’t have a strong odor.

You may notice your vaginal discharge becomes thicker and heavier in the weeks leading up to your period. This is also normal, and it’s due to the monthly fluctuation of hormones.

Why do we have discharge? The vagina is full of organisms, such as cells, healthy bacteria, and yeast. Discharge helps keep these organisms in balance. It’s how the vagina removes dead cells from the vagina and prevents yeast and bacteria from growing out of control. This keeps the vagina clean and healthy.

Unusual discharge is a sign of infection.

A vaginal infection can occur if anything disrupts the natural balance of organisms, or if unhealthy bacteria get into the vagina. This often leads to changes in your vaginal discharge. The discharge may change in color, texture, or smell.

Most vaginal infections are caused by a few usual suspects.

If you notice a change in your discharge, tell your ob-gyn. To figure out the cause, your ob-gyn will want to know a few key things. What does the discharge look like? Does it have a smell to it? Do you have any itching? How long has it been going on? Your ob-gyn may also do a pelvic exam and test a sample of the vaginal discharge.

Here are the most common culprits:

• Yeast infection—This is an overgrowth of yeast, a fungus normally found in our bodies. Also called vaginal candidiasis, it most often occurs when the balance of yeast and bacteria in your vagina has been disturbed. A yeast infection has a cottage cheese-like discharge. You may also feel itching or burning in your vagina and vulva.

• Bacterial vaginosis (BV)—This is not a true infection, but a condition that happens when there is too much unhealthy bacteria and not enough healthy bacteria present in the vagina. BV comes with clear, heavy discharge that often has a fishy smell.

• Trichomoniasis—This is a sexually transmitted infection (STI) that can cause yellowish or greenish discharge. It can also cause irritation, redness, and swelling in the vaginal area.

• Other STIs—Chlamydia and gonorrhea are also possibilities if you have yellowish discharge.

If you experience vaginal discomfort around the time of menopause, you may have a condition called genitourinary syndrome of menopause (GSM), also called vaginal atrophy. This is not an infection, but rather a result of decreasing hormone levels. Your ob-gyn can diagnose GSM and offer treatment to help you feel more comfortable.

Most vaginal infections are not contagious.

BV and yeast infections are more likely to occur in people who are sexually active. That’s because sexual activity can introduce new bacteria into the vagina. But they are not considered STIs, nor are they usually contagious. With BV or a yeast infection, your partner doesn’t need to be treated.

But if you are diagnosed with trichomoniasis or another STI, your partner must also be tested and treated. (Depending on your state’s laws, your ob-gyn may be able to prescribe medication for your partner too.)

That said, it’s wise to avoid sex for about a week while treating any vaginal infection. Not only can sex be uncomfortable, but it can interfere with treatments.

You can treat repeat yeast infections at home.

Once you’ve had a yeast infection, it’s usually easy to recognize, self-diagnose, and treat future infections at home. You can buy over-the-counter treatments containing the medication miconazole. These products come in the form of creams or suppositories that you insert into your vagina.

If you’re unsure whether you have a yeast infection or if your symptoms don’t improve within 72 hours, give your ob-gyn a call.

For other types of infections, you’re going to need a prescription antibiotic. These medications can be applied topically (in the vagina) or taken orally. Go-to antibiotics for vaginal infections include metronidazole and clindamycin. If one treatment doesn’t do the trick, there are other options you can try. (Note: Stay away from alcohol while taking metronidazole, as the combination of the two can cause severe nausea and vomiting.)

Some people are more prone to vaginal infections.

Some people are more likely to get vaginal infections, either because unhealthy bacteria or yeast grow more easily in their bodies, or their systems have a harder time fighting off infection. This includes people with diabetes mellitus, people who are obese, and people who have weakened immune systems.

If you have five or more cases of the same infection in a year, ask your ob-gyn about suppression treatment. Suppression treatment involves multiple doses of a cream, gel, or pill, depending on the type of infection. After a few months of such treatment, many people find their infections are reduced, if not eliminated.

You can take steps to prevent infections.

Preventing vaginal infections comes down to preserving the delicate balance of organisms in your vagina. Here are a few tips you can try.

• Keep your vaginal area dry. Towel-dry after every bath or shower. Change out of wet clothes promptly after swimming or working out.

• Wash your pubic area gently with warm water. Soap is not needed on your vulva and should never be used in your vagina.

• Wear cotton underwear. Cotton lets your vaginal area breathe more than synthetic fabrics.

• Use condoms during sex. This can prevent new organisms from entering your vagina.

• Clean reusable products like menstrual cups, diaphragms, cervical caps, and spermicide applicators after every use.

• Take probiotics or eat more yogurt. These can help boost the levels of healthy bacteria in your body. Look for yogurts that contain live and active cultures.

• Do not douche. Douching can throw off the balance of organisms in your vagina, allowing unhealthy bacteria and fungi to grow. Remember, your vagina is self-cleaning!

• Seek preventive treatment when taking antibiotics. Some people tend to get yeast infections while taking antibiotics for other types of infection. If this sounds like you, ask your ob-gyn about taking a preventive treatment at the same time. An antifungal medication can counteract the antibiotic’s effect on your vaginal health.

Despite your best efforts, you may not be able to prevent all vaginal infections. Most women will have at least one vaginal infection at some point in their life.

If you’re experiencing symptoms, get in touch with your ob-gyn. They’ll be ready to diagnose and treat the problem—so you can get back to feeling like yourself.

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This information is designed as an educational aid for the public. It offers current information and opinions related to women's health. It is not intended as a statement of the standard of care. It does not explain all of the proper treatments or methods of care. It is not a substitute for the advice of a physician. Read ACOG’s complete disclaimer.