Burning, itching and unusual discharge can come from a urinary tract infection, bacterial vaginosis or thrush. Here is how they differ, what treats each one and when to see a doctor.
The short answer
A UTI mainly affects peeing: burning, needing to go often and urgently, and cloudy or strong-smelling urine. Bacterial vaginosis (BV) causes thin, grey-white discharge with a fishy smell, often without itching. A yeast infection (thrush) causes itching, soreness and thick, white, cottage-cheese-like discharge with little smell. Each needs a different treatment, so guessing wrong can delay relief.
Side by side
| UTI | BV | Yeast infection | |
|---|---|---|---|
| Main symptom | Burning when peeing, urgency | Fishy-smelling discharge | Itching and soreness |
| Discharge | Usually none | Thin, grey-white, watery | Thick, white, clumpy |
| Smell | Strong-smelling urine | Fishy, stronger after sex | Little or none |
| Cause | Bacteria in the bladder | Imbalance of vaginal bacteria | Overgrowth of Candida yeast |
| Usual treatment | Antibiotics | Antibiotics (tablets or gel) | Antifungal cream, pessary or tablet |
Urinary tract infection
Look for burning or stinging when peeing, needing to go often with little coming out, lower belly pain, and cloudy, dark or bloody urine. Drink water, but most UTIs in women need antibiotics. In several Canadian provinces, including BC, pharmacists can assess and prescribe for uncomplicated UTIs. Seek care the same day for fever, shivering, back or side pain, vomiting, or if you are pregnant, as these can mean a kidney infection.
The short version
Bacterial vaginosis
BV is the most common cause of unusual discharge in women of reproductive age. It is not a sexually transmitted infection, but sex, new partners, douching and scented products raise the risk. It is treated with metronidazole or clindamycin. BV often comes back; if it returns frequently, ask about longer treatment plans. Treat it in pregnancy, as it is linked to complications.
Yeast infection
Thrush causes itching, burning and redness around the vagina and vulva, pain during sex and thick white discharge. Antibiotics, pregnancy, diabetes and a weakened immune system raise the risk. Over-the-counter clotrimazole or miconazole creams and pessaries, or a single fluconazole tablet, usually work. If it is your first time, symptoms aren’t clear, or you have four or more episodes a year, see a doctor first.
When to get checked rather than self-treat
- First time with these symptoms, or you are not sure which it is
- Pregnant, or under 16
- Fever, pelvic or back pain, sores, blisters or bleeding
- A new partner or possible STI exposure, as chlamydia, gonorrhoea and trichomoniasis can look similar
- Symptoms not better after treatment, or coming back often
Prevention
Wash the vulva with water only, avoid douches and scented products, pee after sex, stay hydrated and wear breathable underwear.
Frequently asked questions
How do I know if I have a UTI or a yeast infection?
A UTI mainly causes burning and urgency when peeing. A yeast infection mainly causes itching and thick white discharge.
Does BV go away on its own?
Sometimes, but it often needs antibiotics, and it should be treated if you are pregnant or have symptoms.
Can a pharmacist treat a UTI in BC?
Yes. BC pharmacists can assess and prescribe treatment for uncomplicated UTIs in women.
Is BV an STI?
No, but sex and new partners can increase the risk.