References UK clinical guidance from the NHS, the British HIV Association (BHIVA), and the British Association for Sexual Health and HIV (BASHH). Last updated: April 2026.
The vagina has its own natural microbiome — a balance of bacteria and yeast that helps keep it healthy. When this balance is disrupted, or when an STI is introduced, uncomfortable symptoms can follow. Some vaginal infections are transmitted sexually, while others happen spontaneously. All are treatable with the right approach.
Here’s a clear guide.
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Common Vaginal Infections
| Infection | Cause | STI? | Main Symptoms |
|---|---|---|---|
| Bacterial vaginosis | Overgrowth of certain bacteria | Not technically | Thin grey discharge, fishy smell |
| Vaginal thrush (candida) | Yeast overgrowth | No | Thick white discharge, itching |
| Chlamydia | Bacteria (Chlamydia trachomatis) | Yes | Often silent; sometimes discharge, bleeding |
| Gonorrhoea | Bacteria (Neisseria gonorrhoeae) | Yes | Often silent; discharge, bleeding |
| Trichomoniasis | Parasite (Trichomonas vaginalis) | Yes | Frothy yellow-green discharge, itching |
| Genital herpes | Herpes simplex virus | Yes | Painful blisters and ulcers |
| Genital warts | HPV | Yes | Small flesh-coloured growths |
Symptoms That Warrant Testing
- Unusual discharge (colour, smell, consistency)
- Itching, soreness or burning
- Pain during sex or urination
- Bleeding between periods or after sex
- Lumps, sores or ulcers
- Lower abdominal or pelvic pain
Testing
Most vaginal STIs and infections are diagnosed with:
- Self-swab or clinician swab — for chlamydia, gonorrhoea, trichomoniasis
- Urine test — some STIs can be detected this way
- Visual examination — for herpes, warts, thrush
- pH and microscopy — for BV and trichomoniasis
- Blood tests — for HIV, syphilis, hepatitis
Treatment
| Infection | Treatment |
|---|---|
| BV | Metronidazole or clindamycin |
| Thrush | Antifungal tablet or cream |
| Chlamydia | Doxycycline (7 days) |
| Gonorrhoea | Ceftriaxone injection |
| Trichomoniasis | Metronidazole |
| Herpes | Antiviral (aciclovir) |
| Warts | Topical treatment or cryotherapy |
Keeping Your Vagina Healthy
- Avoid douching — it disrupts the natural microbiome
- Don’t use scented products or feminine washes internally
- Wear cotton underwear and avoid tight synthetic fabrics
- Wipe from front to back after the toilet
- Practice safer sex
- Get regular STI screening if sexually active
Read more: Bacterial vaginosis | What is chlamydia? | Yeast infection smell
Frequently Asked Questions
Is BV an STI?
Not officially. It’s an imbalance of normal vaginal bacteria, though it’s associated with sexual activity. Your partner doesn’t usually need treatment (except for some same-sex couples).
Can I have more than one infection at once?
Yes, co-infections are common. This is one reason comprehensive STI testing is recommended rather than guessing based on symptoms.
Should I treat symptoms myself with over-the-counter products?
Mild yeast infections can be self-treated. Anything with unusual discharge, odour, bleeding or persistent symptoms should be seen by a professional.
Related reading
- Can You Test for STIs While on Your Period?
- Common STI Symptoms in Women
- Does a Vaginal Yeast Infection Smell?
- HIV Risk from Vaginal Sex: What You Need to Know
- How Different STIs Affect Vaginal Discharge
Sources
- NHS — Sexual health conditions
- BASHH — UK clinical guidelines for STI management
- British HIV Association (BHIVA) — HIV treatment guidelines
- Terrence Higgins Trust — sexual health information
- UK Health Security Agency — STI surveillance data
Steve Page is a recognised expert on Sexually Transmitted Diseases (STDs) and STD treatments, having published numerous articles in peer-reviewed journals and presented his research at conferences around the world. He has an in-depth understanding of the latest medical research on STDs, and is an advocate for the development of new treatments and protocols to improve the health of those affected. In addition to his research, he has dedicated his career to understanding the causes and symptoms of STDs, as well as how to best treat those impacted.
