Yeast infection, UTI or something else? How to spot the difference

Dealing with irritation or an infection that impacts the vagina can not only be painful or frustrating, if left untreated it could become a more serious issue.

Often many people will assume any kind of vaginal problem is a yeast infection when in reality, it could be a host of other things, said Dr. Sanya Kostov, an assistant professor at the University of Alberta in the department of family medicine who specializes in reproductive and sexual health.

Understanding the differences between a yeast infection, bacterial vaginosis and a urinary tract infection (UTI) is important so you can clearly describe symptoms to a doctor if these issues do not clear up on their own, said Kostov.

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“What I’d always recommend to patients is that if it’s persistent or if it’s bothering you or if it’s the first time you’ve ever had it that’s a great time to go see their family doctor,” she said. “This is all stuff that is very commonly treated by family doctors.”

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It can be hard to tell on your own what the issue is which is why contacting a doctor in these cases and identifying your symptoms can help speed up the recovery process by linking you to the care you might need, she explained. 

What is the difference?

Yeast infections 

It’s not uncommon for yeast to be in your vagina or bowel, but sometimes it gets out of balance, causing an inflammatory response for some, said Dr. Amanda Selk, an obstetrician and gynecologist at Mount Sinai Hospital in Toronto and an associate professor with the University of Toronto.

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A yeast infection occurs when a fungus called candida builds up and causes irritation, she said. Common symptoms include itching, burning and a thick discharge that is irritating, she said.

However, simply having yeast or having yeast show up on pap test results doesn’t mean anything is necessarily wrong or that an infection is present, Selk said.

“All yeast is not an infection — it’s only an infection if it’s causing symptoms like redness, burning, swelling, itching and an abnormal discharge,” she said. “People get very worried about it … but it just happens to be there, it’s not dangerous.”

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Yeast infections are common and most individuals with vaginas will get one in their lifetime, while some get them more often than others, said Selk.

“Some people are more prone, for example, diabetic people potentially, when their sugars are out of control they get more yeast infections. We see them more often in pregnant women,” she said.

Bacterial vaginosis 

Yeast infections are not the most common type of vaginal infection — bacterial vaginosis is actually more prevalent, said Kostov.

Bacterial vaginosis occurs when there’s an overgrowth of bacteria that’s naturally found in the vagina, creating inflammation. This type of infection may feel similar to a yeast infection, which is why it’s important to see a doctor to get a clear diagnosis, Kostov explained. 

“It’s a little bit different. You’ll still have a change in vaginal discharge … that’s more thin. Sometimes it can be green,” she said. The discharge may have a strange smell, which likely won’t happen with a yeast infection, she said.

Both yeast infections and bacterial vaginosis make up about 75 to 80 per cent of all vulva and vagina infections that happen, she said. 

It’s crucial to understand that neither of these issues are sexually transmitted infections, you can’t transmit these through sexual intercourse, she said. 

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There are bacteria that are already in and around our bodies, and if your immune system is low, or if you’re on antibiotics or if you have other conditions like diabetes, you are more likely to have these issues more frequently, she explained. 

Urinary tract infections

(UTIs can technically be anywhere in the urinary tract and can also be considered a bladder infection, said Selk. 

UTIs happen when bacteria from your gut or bowel crosses your vagina and enters the urethra, and into the bladder, she explained. 

Symptoms include feeling like you need to pee frequently, burning or pain when you urinate, and blood in your urine, said Selk. If the infection spreads to your kidneys, you can experience back pain along with a fever, and you could potentially become very sick if untreated, she said.

The most common reason a person would experience a UTI is if they have a female reproductive system, as the anus is closer to the urethra and the urethra is shorter, said Kostov. Sexual intercourse can also cause gut bacteria and other bacteria into the area where the urethra is, and sex will potentially push these bugs up the urethra, she explained. 

How are these issues treated?

A large percentage of patients will be able to clear yeast infections on their own without additional treatment, said Kostov. If they go see a doctor and describe these symptoms, the doctor may do a test but it’s likely they’d determine the symptoms are synonymous with a yeast infection, she explained.

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Over-the-counter treatments for yeast infections are found in most pharmacies and drug stores, which can help, she said. 

For bacterial vaginosis, about half of all cases are asymptomatic where patients don’t feel serious symptoms and the infection will go away on its own. The same can happen for people who are experiencing clear symptoms, like unusual discharge, said Kostov.

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If it’s persistent and bothering you, seeing your family doctor would be helpful and the doctor may consider doing a swab to determine what the issue is. Treatment for bacterial vaginosis would be an antibiotic. 

Patients that are coming in every one to two months with new symptoms, by that point doctors would have done more tests and examine underlying causes and whether a more rare fungus might be present. That patient may have an immune disorder they don’t know about yet that could be causing frequent yeast infections, she said. 

As for UTIs, about half of patients find these can resolve on their own, especially if they have a healthy immune system, she explained. 

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But if you’re getting persistent symptoms for a UTI, that is a good sign you should see your family doctor. To prevent antibiotic resistance, they may send your urine to a lab to determine which bug caused the infection so they can choose the right medication to target that exact bacteria, instead of guesswork, she explained.

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There’s also no evidence that cranberry juice is actually effective at treating UTIs, she said. 

Can I do anything to prevent these issues from happening?

Making sure to stay hydrated and to urinate after sex are the best ways to prevent a UTI from happening, along with wiping front to back, said Kostov. Some patients who are prone to UTIs may be given an antibiotic that they take specifically on days they have sexual intercourse to prevent the infection, she said. 

As for yeast infections, there’s really no actions you can take to prevent them from happening and they are common, said Selk.

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If your symptoms don’t resolve, or if you are unsure, it is important to see a doctor especially during the pandemic when patients may be more hesitant, Kostov added. 

“It also could be a sexually-transmitted infection,” she said. Some infections, like chlamydia and gonorrhea may mimic many of these symptoms, like pain when urinating, and you’d need a doctor to identify those issues, she explained.

 “It’s really important to see or call your family doctor because there’s so many different things it could be,” she said. 

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