Itching, Odor or Burning?

Sort out BV, yeast infections, UTIs, irritation and lichen sclerosus.

Itching, odor, burning and discharge can come from very different things, and many people guess wrong. Use the sorter to see which conditions usually look like what you're feeling, compare them side by side, then dig into the research behind each one.

1 in 3women who bought a yeast treatment actually had a yeast infection alone
5common causes of vulvar and vaginal discomfort, each with its own page

Which one is it? Sort by what you're feeling

Itching, odor, burning and discharge can come from very different things. Tap what you've noticed and we'll show which conditions usually look like that, then where to read more. This isn't a diagnosis: only a test from your clinician can tell you for sure, and you can have more than one at once.

Vulva and vagina

When you pee

See a clinician today. Fever, chills or pain in your back or side with urinary symptoms can mean a kidney infection, which needs prompt treatment.

Bacterial vaginosis (BV)

An imbalance of vaginal bacteria. Thin gray discharge and a fishy odor, often stronger after sex. Itching is less common.

Read about BV

Yeast infection

An overgrowth of Candida. Itching, redness and thick white discharge, usually without a strong odor.

Read about yeast infections

Urinary tract infection (UTI)

Bacteria in the bladder or urethra. Burning inside as you pee, needing to go often, cloudy urine. Little or no discharge.

Read about UTIs

Irritation and dryness

Not an infection. A worn skin barrier from soaps, friction or falling estrogen. Dryness, stinging and pain with sex.

Read about irritation and dryness

Lichen sclerosus

A long-term skin condition, not an infection. Intense itching with white, thin patches and skin that tears easily. Needs a clinician.

Read about lichen sclerosus

How are BV, yeast infections, UTIs, irritation and lichen sclerosus different?

Here they are side by side. The most useful clues are the discharge and the odor, and whether the burning is inside when you pee or on the skin outside.

BV Yeast infection UTI Irritation & dryness Lichen sclerosus
What it is Too few lactobacilli, too many other bacteria such as Gardnerella Overgrowth of Candida yeast Bacteria, most often E. coli, in the bladder or urethra A worn skin barrier, not an infection A long-term inflammatory skin condition, not an infection
Where Vagina Vagina and vulva Urinary tract Vulva and vaginal opening Vulva and skin around the anus
Discharge Thin, gray or white Thick, white, clumpy Little or none Usually none, or less lubrication None
Odor Fishy, often stronger after sex Usually none Urine may smell strong None None
Itching Sometimes Common and often intense Not typical Common Common and often severe
Burning Sometimes, when peeing On the skin, when urine touches it Inside, as you pee On the skin, stinging Soreness, tears after sex
Peeing Usually normal Usually normal Often and urgent, cloudy or bloody urine Usually normal Usually normal
Vaginal pH Above 4.5 Normal (4.5 or below) Not affected Can rise after menopause Not affected
Usual treatment Antibiotics from a clinician Antifungals, over the counter or prescribed Antibiotics from a clinician Gentle care, moisturizers; see a clinician if it lasts Strong steroid ointment from a clinician, kept up long term

Want the longer version for the two most often mixed up? Read UTI vs yeast infection: what's the difference?

When should I see a clinician?

See a clinician if it's your first time with these symptoms, if you're pregnant, if symptoms don't settle within a week, if they keep coming back, or if you have a fever, back pain, sores or blisters. Many people guess wrong: in one study of women who bought a yeast treatment over the counter, only about a third had a yeast infection alone (Ferris 2002). A quick test saves weeks of the wrong treatment.

Sources

  1. CDC. About Bacterial Vaginosis (BV). cdc.gov/bacterial-vaginosis.
  2. CDC. Vaginal Candidiasis. cdc.gov/candidiasis.
  3. CDC. Urinary Tract Infection Basics. cdc.gov/uti.
  4. Ferris DG et al. Over-the-counter antifungal drug misuse associated with patient-diagnosed vulvovaginal candidiasis. Obstet Gynecol. 2002;99(3):419–425.
  5. British Association of Dermatologists. Lichen sclerosus in females: patient information leaflet. 2022.
  6. The Menopause Society. The 2020 genitourinary syndrome of menopause position statement. Menopause. 2020;27(9):976–992.

Reviewed by the Momotaro Apotheca medical team, including OB-GYNs and naturopathic doctors. Educational information, not medical advice. All ingredient research