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Common vaginal infections


Expert reviewer Dr Adrian Raby, General Practitioner
Next review due July 2021

Vaginal infections can be caused by bacteria, fungi, parasites or viruses growing in and around your vulva and vagina. Infections of your vagina and vulva can cause symptoms such as soreness and itchiness around your vulva and vagina, and an unusual vaginal discharge.

Most vaginal infections can be treated quickly and easily. Getting medical advice as soon as you notice a problem can help to get rid of your infection quickly and prevent complications. If you think you could have a sexually transmitted infection (if you’ve had unprotected sex with a new partner, for instance), it’s best to get checked out at a sexual health clinic.

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Symptoms of common vaginal infections

Depending on the type of infection, you might have:

  • a white discharge from your vagina that looks like cottage cheese; alternatively you might have, or a thinner, white, green or yellow fishy-smelling discharge
  • itchiness or soreness in or around your vagina
  • pain when you have sex
  • pain when you pass urine
  • pain in your lower abdomen (tummy) or pelvis
  • bleeding between your periods or after you have sex
  • warts or ulcers around your vulva (the skin around the outside of your vagina)

 

It's normal and healthy for women to have some discharge from their vagina. The amount and colour of this discharge can change during your menstrual cycle, as you get older, when you take the contraceptive pill and when you’re pregnant. Sometimes, certain soaps, bath additives and vaginal douches (a type of prepared wash for your vagina) can cause inflammation of your vagina and changes in your discharge. But an abnormal unexplained change in the colour or smell of your vaginal discharge, along with other symptoms, can also be a sign of an infection. 

Some infections are best to get checked out at a sexual health clinic. If you think you could have a sexually transmitted infection (if you’ve had unprotected sex with a new partner, for instance) book a check-up at a sexual health clinic. If you think your symptoms are more likely to be due to thrush or bacterial vaginosis (see sections below), see your GP.

Diagnosis of common vaginal infections

Your doctor or nurse may be able to get a good idea of what’s wrong just by asking you about your symptoms. They may also ask to examine you. If so, they’ll first look at the outside of your vagina. They’ll then use an instrument called a speculum to gently open your vagina, allowing them to look and examine inside. They may take a sample of discharge or cells from your vagina using a small, round cotton bud called a swab. These samples may be tested or examined under a microscope in the clinic, and sent to a laboratory for testing. Your nurse or doctor may also ask to take a urine sample, which will be sent for testing. 

There are different ways to test for a vaginal infection. You may be asked to provide a sample of urine. A doctor or nurse at the clinic or surgery may ask to look inside your vagina using a speculum. This is an instrument to gently open your vagina; it is also used for smear tests. They’ll use a small, round cotton bud to take a swab of a sample of discharge or cells from your vagina. These samples may be tested or examined under a microscope in the clinic, and also sent to a laboratory for testing.

Bacterial vaginosis

Bacterial vaginosis (BV) is an infection caused by certain bacteria in your vagina growing more than usual. It’s the most common type of vaginal infection, although around half of women who get it don’t have any symptoms. If you do have symptoms, you’ll usually have a thin grey or white, fishy-smelling vaginal discharge. You won’t usually have any soreness, itching or irritation with this infection.

BV isn’t a sexually transmitted infection, but being sexually active – especially if you’ve had a recent change in partner – is thought to increase your risk. Other things that can trigger BV include:

  • perfumed soaps, feminine hygiene sprays or vaginal douching
  • having a copper intra-uterine system (IUS or coil)
  • smoking

BV usually clears up if you take antibiotics. These are usually tablets that you take by mouth, although they may come as a gel or cream that you apply to your vagina. If you have a male partner, they won’t need to be treated for BV.

It’s possible for the infection to go by itself, without treatment. But it can be associated with various complications in pregnancy. These include late miscarriage, premature birth and development of pelvic inflammatory disease after your pregnancy. So if you have symptoms, be sure to get them checked out.

Chlamydia

Chlamydia is the most commonly reported bacterial sexually transmitted infection (STI) in the UK. It’s caused by a bacterium called Chlamydia trachomatis.

Lots of women have chlamydia without knowing it. Seven in 10 women and half of men with chlamydia don't have any symptoms. If you do have symptoms, you may notice you have more vaginal discharge than normal, and you might have bleeding between your periods or after sex. You might get pain during sex or when you pass urine. 

Chlamydia can be treated with antibiotics. Your doctor will give you a course of antibiotic tablets to take for a week or two, or a one-off dose. You’ll be advised to go to a sexual health clinic, if you haven’t done so already. It’s important that any of your current or recent partners are tested and treated if necessary. The sexual health clinic can help with contacting them.

Your doctor may offer to re-test you three to six months after you’ve finished your treatment to check that you haven’t been re-infected. You can also buy kits to test for chlamydia yourself, at home.

If you don’t get treatment for chlamydia, it can lead to a number of complications. These include pelvic inflammatory disease (which can lead to infertility) and problems in pregnancy including premature birth.

Read our topic page on chlamydia for more information.

Genital herpes

Genital herpes is caused by the herpes simplex virus (HSV), which is usually passed on through sexual contact. Not everyone has symptoms, but it can cause painful blisters around your genital area, and you may feel unwell with a headache and fever.

There’s no cure for herpes; once you’re infected, the virus remains in your body. But you won’t have symptoms all the time. They tend to go and then may flare up again if the virus is reactivated. Various things may trigger a flare-up, including illness, stress, smoking and drinking alcohol.

Your doctor may be able to prescribe antiviral tablets for you. Although they won’t get rid of the virus, they can help to lessen your symptoms and get rid of them quicker. They can also reduce the number of flare-ups you have, and reduce your risk of complications.

Your doctor may also suggest using a local anaesthetic ointment on the affected area, to help with any pain.

Genital warts

Genital warts are caused by human papilloma virus (HPV). You usually catch genital warts by having sexual contact with someone who has them. Genital warts are one of the most common sexually transmitted infections (STIs) in the UK, but rates are dropping now that girls are routinely offered vaccination against HPV.

Genital warts appear as small growths on or around your vulva, cervix, vagina or anus. They can be painful and itchy, and might bleed. It’s possible that your warts may go away on their own, after a few months. But you’ll often need treatment at a sexual health clinic to get rid of them. You might be offered creams or ointments, cryotherapy (a procedure to freeze off your warts), surgery or electrocautery, which uses a heated electrode. Treatments help to remove the warts, but they can’t get rid of the virus.

Read our topic page about genital warts for more information.

Gonorrhoea

Gonorrhoea is a sexually transmitted infection (STI) caused by a bacterium called Neisseria gonorrhoeae. You can get it if you have unprotected sex with an infected person.

Half of women who get gonorrhoea don't have any symptoms. If you do have symptoms, they’ll usually appear within 10 days of getting infected. You may have more vaginal discharge than normal, and you might have pain around your lower abdomen. It might hurt when you pass urine, and you may get bleeding between your periods.

You’ll usually need to go to a sexual health clinic for treatment of gonorrhoea. Gonorrhoea is treated with antibiotics. This is usually with a single injection and single tablet to take by mouth. You’ll need to be tested again about a week after you finish your treatment to check the infection has gone completely. It’s important that any current or recent sexual partners are informed that they could have gonorrhoea. They will also need to be tested and treated if necessary. The sexual health clinic can help with contacting them.

Read our topic page on gonorrhoea for more information.

Thrush

Vaginal thrush (vaginal candidiasis) is a fungal infection, usually caused by a yeast called Candida albicans. Up to half of women have this yeast growing harmlessly in their vagina. Certain factors can trigger the yeast to grow more than usual, which then leads to thrush.

If you have thrush, you may have itching, soreness and irritation around your vulva. You may have a thick, white vaginal discharge (a bit like cottage cheese). It may also be painful to have sex or pass urine

Common triggers for thrush include:

  • taking some types of antibiotic
  • being pregnant
  • having diabetes that’s not well controlled

Using soaps, shower gels or ‘feminine hygiene’ products around your genital area, and wearing tight-fitting clothing may make you more likely to develop thrush. Any of these can also make your symptoms worse if you get thrush. Thrush isn’t a sexually transmitted infection, but it can be triggered by sex.

You can use antifungal creams or pessaries (which you put into your vagina) to get rid of thrush, or take antifungal tablets. You can get these from a pharmacist without a prescription. If you’re pregnant, see your GP before you take any medicines to treat thrush. If you have a male partner, they won’t need any treatment unless they have a rash or sore area on their penis.

See our topic page on vaginal thrush for more information.

Trichomoniasis

Trichomoniasis is a sexually transmitted infection (STI), caused by a parasite called Trichomonas vaginalis. You get it through having unprotected sex with an infected person. It’s common to have other STIs at the same time.

Up to half of women with trichomoniasis don't have any symptoms. If you do have symptoms, you’ll probably have a yellow or white, smelly and possibly frothy vaginal discharge. You may have some soreness and itching around your vulva and pain when you go for a wee.

You’ll usually need to take antibiotics to get rid of this infection and you’ll usually need to go to a sexual health clinic for treatment. Your doctor may prescribe a course of antibiotic tablets lasting five to seven days, or it may be a one-off larger dose. Your partner will also need to be treated, even if they don’t have symptoms of the infection. This is to stop you getting the infection again.

Prevention of common vaginal infections

Many common vaginal infections, including chlamydia, gonorrhoea, trichomoniasis, genital warts and herpes are passed on through sexual contact with an infected partner. Using a condom can provide good protection against many sexually transmitted infections (STIs).

You can reduce your risk of some vaginal infections, like thrush, by avoiding strong soaps, disinfectant bath additives and feminine hygiene products. This is because these products can irritate your vagina. It’s also important not to douche (wash out your vagina) because this can affect the natural bacteria that live in your vagina and keep it healthy.

 

Frequently asked questions

  • Things you can do to ease your symptoms and help you feel more comfortable when you have an infection such as vaginal thrush include the following.

    • Wear loose-fitting, cotton clothes rather than tight clothes or nylon underwear or tights.
    • Use plain water or a soap substitute to wash the area around your vulva and a simple emollient such as E45 to moisturise. Perfumed soaps, bath or shower products, antiseptics or vaginal deodorants can irritate your skin. You don’t need to wash the area more than once a day.

     

    If you have pain from genital herpes, the following measures can help. 

    • Take an over-the-counter painkiller, such as paracetamol or ibuprofen.
    • Clean the affected area with plain or salt water. 
    • Apply petroleum jelly or a mild anaesthetic gel to the infected area – you can buy these from a pharmacy.
    • If it stings when you pass urine, try urinating while sitting in the bath, or pour warm water over your vulva while you're on the toilet. Also increase your fluid intake to dilute your urine. 

  • The time it will take for the infection to clear up depends on the type of vaginal infection you have. Some infections may go away on their own without any treatment, but getting the right treatment will help you get rid of the infection more quickly. Vaginal infections caused by bacteria (such as bacterial vaginosis, trichomoniasis and chlamydia) are often treated with a course of antibiotics for around seven days. It may take a week or two for the symptoms of thrush to go. Genital herpes can last for three or four weeks, but treatment may help to get rid of symptoms sooner.

    It's important that you finish your course of treatment even if your symptoms start to improve. Always read the patient information leaflet that comes with your medicine. If you still have symptoms after you’ve finished your treatment or you get the infection again, talk to your sexual health clinic, pharmacist or GP.

    Vaginal infections such as genital herpes and genital warts can keep coming back. This is because they are caused by viruses and viruses are never completely cleared from your body. Other infections such as chlamydia and gonorrhoea normally only come back if you get infected again, which can happen if your partner doesn’t get treated.

  • It might be worth considering using live, natural probiotic yoghurt to help ease symptoms of thrush. You may find that applying it in and around your vagina helps to ease your symptoms. Or you may prefer to see if just eating the yoghurt helps.

    Thrush is thought to be caused by a disturbance in the healthy yeasts usually found in your vagina. There isn’t enough research to show whether or not using yoghurt does make a difference. However, it’s unlikely to be harmful, so it could be worth giving it a go.   

    Tea tree oil has not been shown to be helpful for thrush. In fact, you should avoid using tea tree oil because it may irritate your skin and make your symptoms worse.


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Related information

    • Sexual health and contraception. Oxford handbook of general practice. Oxford Medicine Online. oxfordmedicine.com, published April 2014
    •  Vaginitis. BMJ Best Practice. bestpractice.bmj.com, last updated May 2018
    • Assessment of vaginal discharge. BMJ Best Practice. bestpractice.bmj.com, last updated May 2018
    • Vaginal discharge. NICE Clinical Knowledge Summaries. cks.nice.org.uk, last revised May 2013
    •  Chlamydia – uncomplicated genital. NICE Clinical Knowledge Summaries. cks.nice.org.uk, last revised June 2016
    • Bacterial vaginosis. NICE Clinical Knowledge Summaries. cks.nice.org.uk, last revised July 2014
    • Herpes simplex – genital. NICE Clinical Knowledge Summaries. cks.nice.org.uk, last revised April 2017
    • Warts – anogenital. NICE Clinical Knowledge Summaries. cks.nice.org.uk, last revised April 2017
    • Gonorrhoea. NICE Clinical Knowledge Summaries. cks.nice.org.uk, last revised May 2017
    • Gonorrhoea. NICE Clinical Knowledge Summaries. cks.nice.org.uk, published September 2014
    • Gonorrhoea infection. BMJ Best Practice. www.bestpractice.bmj.com, published 21 September 2015
    • Candida – female genital. NICE Clinical Knowledge Summaries. cks.nice.org.uk, last revised May 2017
    • Trichomoniasis. NICE Clinical Knowledge Summaries. cks.nice.org.uk, last revised March 2015
  • Reviewed by Pippa Coulter, Freelance Health Editor, Bupa Health Content Team, July 2018
    Expert reviewer Dr Adrian Raby, General Practitioner
    Next review due July 2021



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