By Maureen O. Khoo, MD, FACOG
Vaginal itching, discharge, or discomfort can be incredibly frustrating—and a little scary. The good news is that most vaginal infections are common, treatable, and manageable with the right care.
At the offices of Maureen O. Khoo, MD, FACOG, we help women every day with concerns like abnormal discharge, odor, or burning. Understanding the most common vaginal infections can help you recognize when something isn’t quite right and know when to call your gynecologist.
What Is Vaginitis?
Many vaginal infections fall under the umbrella term vaginitis, which simply means inflammation or infection of the vagina. Common symptoms include:
- Unusual vaginal discharge (change in color, texture, or amount)
- Odor (especially a “fishy” smell)
- Itching or irritation
- Burning, especially with urination
- Discomfort or pain during sex
The three most common causes of infectious vaginitis are:
- Bacterial vaginosis (BV)
- Vulvovaginal candidiasis (yeast infections)
- Trichomoniasis (a sexually transmitted infection) AAFP+1
Noninfectious causes such as allergic reactions, hormone changes (like menopause), or irritants (scented soaps, douches) can also cause similar symptoms. ACOG+1
1. Bacterial Vaginosis (BV)
Bacterial vaginosis is the most common vaginal condition in women of reproductive age. It occurs when the normal balance of bacteria in the vagina is disrupted, allowing certain bacteria to overgrow. CDC+2Government of Indiana+2
Common Symptoms of BV
- Thin, gray or white vaginal discharge
- “Fishy” odor, often stronger after intercourse
- Mild irritation or none at all (some women have no symptoms) CDC+1
How BV Is Treated
BV is typically treated with prescription antibiotics, either as oral medication or vaginal gel/cream. It’s important to complete the full course even if symptoms improve early. CDC
Why BV Matters
Untreated BV can:
- Increase the risk of sexually transmitted infections (STIs)
- Be associated with complications during pregnancy, such as preterm birth
- Increase the risk of pelvic inflammatory disease in some cases CDC+1
Regular gynecologic care and proper diagnosis are key, especially if symptoms keep returning.
2. Vulvovaginal Candidiasis (Yeast Infections)
Yeast infections are the second most common cause of vaginitis. They’re caused by an overgrowth of Candida—a type of fungus that normally lives in the vagina in small amounts. CDC+2AAFP+2
Common Symptoms of a Yeast Infection
- Thick, white, “cottage cheese–like” discharge (often odorless)
- Intense itching and irritation of the vulva and vagina
- Redness, swelling, or small cracks in the skin
- Burning, especially with urination or intercourse ACOG+1
Treatment Options
Treatment usually includes:
- Antifungal creams or suppositories placed in the vagina
- Oral antifungal medication in some cases
Most uncomplicated infections respond well to short-course therapy, but recurrent or severe infections may require longer treatment and evaluation for underlying issues such as diabetes or immune system problems. CDC+1
3. Trichomoniasis
Trichomoniasis (“trich”) is a common, curable sexually transmitted infection caused by a parasite called Trichomonas vaginalis. Many people with trichomoniasis have no symptoms, which means it can easily be passed between partners without anyone realizing it. CDC+2CDC Stacks+2
Common Symptoms of Trichomoniasis
When symptoms do occur, they may include:
- Frothy, yellow-green discharge
- Strong or unpleasant vaginal odor
- Vaginal itching, burning, or irritation
- Discomfort during urination or sex
Treatment
Trichomoniasis is treated with oral antibiotics, usually a single-dose or short-course regimen. Both partners need treatment, and sexual activity should be avoided until treatment is complete and symptoms have resolved. CDC+1
When Is Vaginal Discharge Normal?
Not all discharge is a problem. It’s normal for discharge to:
- Vary throughout the menstrual cycle
- Be clear to white
- Be mild in odor or nearly odorless
Signs it’s not normal include:
- Sudden change in color (gray, green, yellow, or very thick and clumpy)
- Strong or fishy odor
- Accompanying itching, burning, or pain
If you’re ever unsure, it’s always best to schedule an appointment rather than guess.
Risk Factors for Common Vaginal Infections
Several things can upset the natural balance of the vagina and increase the risk of infection:
- Douching or using scented washes or feminine sprays
- New or multiple sexual partners
- Recent antibiotic use
- Uncontrolled diabetes
- Tight, non-breathable clothing or staying in wet swimsuits for long periods
- Hormonal changes (pregnancy, birth control, menopause) CDC+2Indian Health Service+2
Your provider can help identify personal risk factors and ways to reduce them.
How Are Vaginal Infections Diagnosed?
At Maureen O. Khoo, MD, FACOG, diagnosis usually begins with:
- A discussion of your symptoms and medical history
- A pelvic exam
- Simple in-office tests, such as:
- Checking the vaginal pH
- Looking at discharge under the microscope
- Specialized swabs or cultures when needed ACOG+2AAFP+2
- Checking the vaginal pH
These tests help distinguish between BV, yeast, trichomoniasis, and noninfectious causes, so you get the right treatment the first time.
How to Help Prevent Vaginal Infections
Healthy daily habits can support your vaginal health:
- Avoid douching and scented feminine products
- Use mild, unscented soap on the vulva (not inside the vagina)
- Wear breathable cotton underwear and avoid staying in damp clothing
- Practice safer sex: use condoms and limit number of partners
- Wipe front to back after using the bathroom
- Manage chronic conditions like diabetes
Even with perfect habits, infections can still happen—and that’s okay. What matters most is getting evaluated promptly.
Common Vaginal Infections: Q&A
Q: Can I treat a vaginal infection with over-the-counter products alone?
A: Some mild yeast infections may improve with over-the-counter antifungal creams or suppositories. However, BV and trichomoniasis require prescription treatment, and repeated self-treatment without a diagnosis can delay proper care or mask a more serious problem. If this is your first time with symptoms, symptoms are severe, or they keep coming back, you should see a gynecologist. ACOG+2AAFP+2
Q: How do I know if I have BV or a yeast infection?
A: BV more often causes a thin, gray or white discharge with a fishy odor, while yeast infections typically cause thick, white, clumpy discharge and intense itching. That said, symptoms often overlap and can be misleading—only testing can reliably tell them apart. If you notice a change in discharge, odor, or irritation, schedule an exam for an accurate diagnosis. Cleveland Clinic+3CDC+3CDC+3
Q: Can bacterial vaginosis or trichomoniasis affect my fertility or pregnancy?
A: Yes, they can have important health implications. BV has been associated with increased risk of certain pregnancy complications, such as preterm birth, and can increase the risk of acquiring other STIs. Trichomoniasis has also been linked to pregnancy complications and greater risk of HIV acquisition and transmission. Getting timely treatment and regular gynecologic care is an important part of protecting your reproductive health. CDC Stacks+3CDC+3CDC+3
Q: Are these infections sexually transmitted?
A:
- Trichomoniasis is a sexually transmitted infection.
- BV is not traditionally classified as an STI, but it is strongly associated with sexual activity and new or multiple partners, and recent research suggests it may be passed by male partners and that treating both partners may reduce recurrence. CDC+2Indian Health Service+2
- Yeast infections are usually not considered STIs, though they can occasionally be passed between partners.
If you’re unsure whether you or your partner need evaluation, your gynecologist can advise you.
Q: How soon should I see a doctor for symptoms?
A: You should schedule an appointment if you:
- Notice a new or unusual discharge or odor
- Have significant itching, burning, or pain
- Have pain during sex
- Have symptoms that don’t improve with over-the-counter treatment
- Are pregnant and notice any vaginal symptoms
Prompt care helps relieve discomfort faster and reduces the risk of complications.
Q: What happens if vaginal infections keep coming back?
A: Recurrent infections are common and can be frustrating, but they are manageable. Your provider may:
- Confirm the diagnosis with more specific testing
- Evaluate for underlying conditions (like diabetes or immune issues)
- Recommend a longer course of treatment or maintenance therapy
- Review lifestyle and hygiene habits that might be contributing CDC+2Guideline Central+2
Working with a gynecologist who knows your history—like Dr. Khoo—can make a big difference.
When to Call Maureen O. Khoo, MD, FACOG
You should contact our office if you:
- Have new vaginal symptoms that last more than a day or two
- Experience recurrent yeast infections or BV
- Are pregnant and notice discharge, odor, or irritation
- Have pain, bleeding after intercourse, or pelvic pain
We provide compassionate, confidential gynecologic care for women at every stage of life, from adolescence through menopause and beyond.
Locations & Contact Information
📍 Los Gatos Office
Maureen O. Khoo, MD, FACOG
320 Dardanelli Lane, Ste 20
Los Gatos, CA 95032
Phone: (408) 364-2440
📍 Mountain View Office
Maureen O. Khoo, MD, FACOG
2490 Hospital Drive, Ste 209 – Melchor Pavilion
Mountain View, CA 94040
Phone: (408) 364-2440
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