Trich, BV or Yeast Infection? How to Tell Them Apart
Quick answer
Yeast infections usually cause thick white discharge with itching and little smell. BV usually causes thin white or grey discharge with a strong fishy smell and little itching. Trich can cause thin, yellowish or greenish discharge, sometimes frothy and fishy-smelling, with itching or burning. The symptoms overlap, and the CDC says trich can't be diagnosed from symptoms alone, so only a test can tell them apart.
Which of these sounds like you?
Tick the field marks that match.
The first item leans toward a yeast infection, the second toward BV, and the third, fifth and sixth toward trich, though the fourth fits any of them. This is not a diagnosis. These conditions overlap a lot, and only a test can tell them apart.
Itching, an odd smell or a change in discharge could be a yeast infection, bacterial vaginosis (BV) or trichomoniasis (“trich”). They overlap so much that even people who’ve had a yeast infection before can guess wrong. Here is how they usually differ, and how to find out for sure.
How do I tell if it’s trich, BV or a yeast infection?
Start with the discharge and smell. These are patterns, not rules.
- Yeast infection (thrush). The NHS describes white discharge, often like cottage cheese, that does not usually smell, with itching and irritation around the vulva and vagina, and soreness or stinging during sex or when you pee.
- BV. The NHS describes a discharge that becomes greyish-white, thin and watery, with a strong fishy smell, particularly after sex. The CDC also lists a thin white or grey discharge and a strong fish-like odor. The NHS says BV does not usually cause soreness or itching, though the CDC lists pain, itching or burning as possible.
- Trich. The CDC lists a clear, white, yellowish or greenish discharge, thin or increased in volume, with a fishy smell, plus itching, burning, redness or soreness and discomfort when peeing. The NHS adds that it may look frothy.
If you want the details on trich alone, see trichomoniasis symptoms: discharge and smell.
Why can’t I just go by the symptoms?
Because they overlap. Both BV and trich can cause a fishy smell. Both trich and a yeast infection can cause itching and soreness. And the CDC states that it is not possible to diagnose trich based on symptoms alone.
There’s another problem. Many people have no symptoms at all: the CDC says about 70% of people with trich don’t have any, and it also says many people with BV don’t either. So a lack of symptoms doesn’t rule anything out.
Which one is an STI?
Trich is. It is a sexually transmitted infection, spread by sex without a condom with a partner who has it.
BV and yeast infections are not classed as STIs by the NHS. But sex can trigger or pass on BV, and the CDC says having BV can increase your chances of getting other STDs. So a partner situation doesn’t settle which one you have. For the partner angle, see BV, yeast or STD with partners.
Is BV treated with the same medicine as trich?
The NHS says both BV and trich are usually treated with antibiotics. Yeast infections are treated with antifungal medicine instead. But that doesn’t mean you can use one treatment for another. The right medicine depends on the right diagnosis.
One more difference: with trich, the CDC says all sex partners need treatment at the same time to prevent reinfection, and it recommends avoiding sex until everyone has been treated. With BV, the NHS says partners with a vagina may also need treatment.
What about trich vs chlamydia?
Both are STIs that can cause unusual vaginal discharge and burning when peeing, and both often cause no symptoms. A lab test is needed to separate them. See chlamydia: smell, discharge and itching for that side.
Should I treat it myself first?
If you have had a yeast infection diagnosed before and your symptoms are the same, the NHS says you can buy antifungal medicine from a pharmacy. For a first episode, the NHS advises seeing a GP.
It is also worth ordering an STD test online if you’ve had a new partner. Treating a yeast infection won’t help if the cause is BV or trich. See BV vs yeast infection for more on telling those two apart, and white, clumpy discharge with itching if that sounds like you.
Which test gives a real answer?
A doctor or clinician can examine you and test a sample of vaginal fluid for BV and yeast. The CDC says a provider can test a sample of vaginal fluid to find out if BV is present, and trich needs a test to confirm it. The CDC guidelines say the newer molecular tests (NAATs) are highly sensitive for trich. When you order a test online, check that trich is included. See which STD test do I need and at-home STD tests for options.
Get care today if
- You are pregnant and your discharge has changed
- You have a fever, pelvic or lower belly pain, or feel generally unwell
- The pain, itching or soreness is severe or getting worse quickly
- Symptoms keep coming back or haven't improved after treatment
Call 911 for a medical emergency. Otherwise, urgent care or your doctor can see you today.
When to test
- Before you treat it yourselfIf this is your first time with these symptoms, or you aren't sure, see a doctor or clinician first for BV and yeast, which are diagnosed from a sample of vaginal fluid. You can also order an STD test online that includes trich, since the same symptoms can come from any of them.
- If a store-bought treatment didn't workAn over-the-counter product only helps if it matches the cause. If symptoms haven't cleared, that is a good sign to see a clinician about BV and to order an STD test online.
- If a partner tests positive for trichOrder a trich test online even if you feel fine, as the CDC says people can pass trich on without any symptoms.
Common questions
Can I tell trich from a yeast infection by the discharge?
Sometimes the pattern points one way, but not reliably. A yeast infection typically gives thick white discharge that doesn't smell, while trich can be thin and yellow-green with a fishy smell. Still, the CDC says trich can't be diagnosed from symptoms alone, so a test is how you know.
Are BV and trich treated with the same medicine?
The NHS says both BV and trich are usually treated with antibiotics, whereas yeast infections are treated with antifungal medicine. Sharing a type of medicine doesn't mean you can treat one as the other, so get the right diagnosis first. Trich also needs partner treatment.
Is trich the same as chlamydia?
No. They are separate infections. Trich is caused by a parasite. Both can cause unusual vaginal discharge or burning when peeing, and both can have no symptoms, so a test is needed to tell them apart.
Can I have more than one at the same time?
It is possible. The CDC guidelines say women with BV are at higher risk for trich. That is another reason to test rather than guess, and to order a test online that checks more than one infection.
Sources
This guide is general information written by a patient advocate using public health sources. It is not a diagnosis. Only a clinician who examines you, or a lab test, can tell you what you have. Read how we write and check our guides.