At one time or another most women experience some type of vaginal infection. The vast majority of these are easily treatable and no big deal – if they are diagnosed correctly. There is a lot of information on the Internet and today, more than ever, people are diagnosing and treating themselves without consulting a health professional.

The top two vaginal infections are an example of why this is almost never a good idea. Bacterial vaginosis (BV) and yeast infections plague most women sooner or later. It is not typically possible to pinpoint exactly what causes BV, but it is known that having multiple sex partners, smoking, and douching all increase a woman’s chances of developing it. Yeast infections are generally caused by either douching, using antibiotics, or having diabetes, and being pregnant also makes a woman more susceptible.

These two infections can mimic each other’s symptoms and can sometimes be indistinguishable from each other without the proper tests. But they require completely different treatments. BV is caused by an overgrowth of harmful bacteria in the vagina and requires treatment with an antibiotic. Yeast infections are caused by fungi, and require antifungal medications to treat them. Antibiotics will have no effect on a yeast infection (except, possibly, to cause it or make it worse) and vice versa. So while you use the wrong medication, you are enduring discomfort for a much longer time than necessary and taking risks with your health.

While these two infections each have their own trademark symptoms (BV is more likely to produce a fishy odor; a yeast infection is more likely to produce a “cottage cheese” discharge), the symptoms can differ from woman to woman and day to day. And both infections can cause intense itching, pain (during intercourse or otherwise), redness, and burning during urination. You can get an idea of what your infection may be by evaluating the symptoms, but only a laboratory examination of the discharge (under a microscope, known as a wet mount) can confirm it.  Often, it is reported as an ancillary finding on a Pap test.

And confirming is extremely important, because if you are treating the wrong infection, you are wasting your time and money and possibly harming your health. Most cases of bacterial vaginosis do not spontaneously resolve, and bacterial vaginosis has been associated with both preterm births and cervical cancer.   For more information on this topic, read my healthbook “Inside Information for Women”.

Finally, evaluation by a doctor is important because it could be neither of these common infections; it could be something more serious or something requiring a different treatment, like an STI (sexually transmitted infection). So check with your doctor any time you have unusual vaginal symptoms to be sure you are properly diagnosed and using an effective treatment.

– Yvonne S. Thornton, M. D., M. P. H.