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 (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)
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 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 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 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 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.
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 is a sexually transmitted infection (STI), caused by a parasite (tiny living cell) 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.