Antibiotics
Recent antibiotic use can promote candidiasis.5,4 Mention recent treatments and similar past episodes.
Health education · Intimate healthSexual and reproductive health
Vaginitis, vaginosis and vulvar irritation: understanding the differences
Itching, burning, unusual discharge or a change in odour: these symptoms can have several causes. They do not automatically mean a yeast infection or a sexually transmitted infection.
Telling an infection apart from irritation or a hormonal change makes it possible to choose the right tests and treatment.4,2
The terms
Vaginitis, vaginosis, vulva: what are we talking about?
The vulva is the external genitals. The vagina is the canal inside the body.
Vaginitis is inflammation or infection of the vagina, with discharge, itching or odour.1 When the vulva is also affected, it is called vulvovaginitis.
Bacterial vaginosis is rather an imbalance of the vaginal microbiota: some bacteria become more abundant, while the lactobacilli usually present decrease.2
These terms therefore describe different situations, which do not all need the same treatment.
Vaginal discharge
Is vaginal discharge always abnormal?
No. Having vaginal discharge is normal.3 Its amount and appearance vary during the menstrual cycle: around ovulation, for example, it is often clear and stretchy.2
However, a change with itching, burning, pain or an unusual odour deserves an assessment.
There is no need to try to remove all secretions or odour with intimate hygiene products. These products can themselves irritate the area.2,7
Causes
What are the main causes?
The signs below are possible clues, not criteria for diagnosing yourself.
| Cause | What happens | Possible signs |
|---|---|---|
| Vulvovaginal candidiasis (yeast infection) | Yeasts of the Candida genus cause an infection. | Marked itching, burning, redness and sometimes thick, white or lumpy discharge.4,5 |
| Bacterial vaginosis | The balance of vaginal bacteria changes. | Thin, whitish or greyish discharge with a fishy odour. Often no symptoms, or only mild irritation.4,2 |
| Trichomoniasis | A sexually transmitted infection caused by a parasite. | Frothy, yellowish or greenish, foul-smelling discharge, itching, burning when urinating. 10 to 50% of infected women have no symptoms.4,1 |
| Irritation or contact reaction | The skin reacts to a product, friction or an allergen. | Redness, tingling, itching or burning, sometimes mostly on the outside.2 |
| Hormonal changes or skin disease | The tissues become thinner and more sensitive, or are affected by a skin condition such as lichen. | Dryness, irritation, itching, burning or pain during sex.6,2 |
Several causes can produce similar symptoms. The colour or smell of discharge is not enough to choose a treatment.4
Contributing factors
What can make these problems more likely?
Irritating products and friction
Scented soaps, wipes, intimate deodorants, douches, spermicides, detergents or some lubricants can irritate the vulva.2,7 Shaving can also cause small injuries.3
Hormonal changes
At menopause or during breastfeeding, lower estrogen can cause dryness, burning and irritation.6
Burning or persistent pain should therefore not automatically be blamed on an infection.
Sexually transmitted infections
Is it necessarily an STI?
Symptoms alone are not enough to conclude that it is an STI.
No. Candidiasis and bacterial vaginosis are not considered STIs.1,5
Trichomoniasis, however, is an STI.1 Other infections, such as chlamydia or gonorrhea, can affect the cervix and cause unusual discharge.4
An assessment may therefore include questions about sexual exposures and appropriate screening.
Assessment
How is the cause determined?
The assessment considers the symptoms, how long they have lasted, past episodes, medications, products used and the possibility of pregnancy.
Tests are chosen based on the causes being considered. A result must always be interpreted with the symptoms and the clinical exam.
Depending on the situation, it may include:4
- an examination of the vulva and vagina;
- a sample of vaginal secretions, with a pH measurement;
- tests to look for an infection;
- STI screening when relevant;
- a pregnancy test if pregnancy is possible.
Treatments
What treatments may be offered?
Treatment depends on the cause identified.
A yeast treatment does not treat every cause of itching or vaginal discharge.
Pregnancy and breastfeeding change the choice of medication: some treatments are avoided or replaced by a vaginal form.4 Some oil-based vaginal products can also reduce the effectiveness of latex condoms.4
- Candidiasis: an antifungal medication, vaginal or oral, may be indicated.4
- Bacterial vaginosis: an antibiotic may be offered depending on the situation.4
- Trichomoniasis or another STI: specific treatment and care for partners are needed.4,1
- Irritation: removing the irritating product or factor is part of the care.3
- Hormonal or skin cause: suitable treatment may be offered after the assessment, for example a vaginal moisturizer for dryness.6
Consequences
What can the consequences be?
Symptoms can affect comfort, sex and daily activities. Persistent irritation can also come with cracks or pain.
Some infections can come back or need special care during pregnancy. Trichomoniasis in pregnancy is associated with premature rupture of membranes, preterm birth and low birth weight.1 Bacterial vaginosis is associated with a higher risk of acquiring some STIs.1
Not all causes have the same consequences. Candidiasis, contact irritation and an STI do not carry the same risks.
When to seek care
When should you seek care?
Ask for an assessment in particular if:4,5
- the discharge is unusual or has lasted several days, or the cause is unclear;
- symptoms persist 48 to 72 hours after starting treatment, or get worse;
- infections come back often (for example, 4 or more episodes in 12 months);
- lesions, ulcers, blisters or growths appear on the genitals;
- you are pregnant, breastfeeding or have a weakened immune system.
When should you be assessed quickly?
Lower abdominal pain, deep pain during sex, or fever with a decline in general condition need prompt assessment.4 These signs can point to a complicated infection that goes beyond simple irritation or vaginitis.
If you are unsure how urgent it is, call Info-Santé at 811, option 1.
Day to day
What can help limit irritation?
Wash gently
The vulva with lukewarm water, no more than once a day, without rubbing. A mild unscented soap can be used around it.7,3
Don’t wash inside
Avoid scented products
Pat dry
Wear cotton
Cotton underwear and loose clothing. Change quickly out of wet swimwear or sportswear.7
Choose a suitable lubricant
Water- or silicone-based if friction causes discomfort. Oils can damage condoms.7,3
Washing more or using more products does not necessarily improve symptoms and can keep the irritation going.2
When to consult at the Clinique IPS du Palais?
A nurse practitioner can assess your symptoms, perform an exam and the necessary samples, offer STI screening when relevant and suggest suitable treatment, within the limits of her scope of practice.
Vaginal discharge (vaginitis, vaginosis) is also one of the examples of reasons for a teleconsultation at the clinic. Consultations are confidential.
Sources
- Public Health Agency of Canada. STI-associated syndromes guide: Vaginitis (French version). Accessed October 29, 2026. canada.ca
- Powell AM. Revue générale des vaginites, Merck Manual, professional version (in French). Reviewed and updated July 2026, accessed October 29, 2026. merckmanuals.com
- CHU de Québec–Université Laval. Soins de la vulve (information sheet, gynecology, in French). 2025, accessed October 29, 2026. chudequebec.ca
- Institut national d’excellence en santé et en services sociaux (INESSS). Protocole médical national : pertes vaginales inhabituelles (No. 628001, in French). January 2025, accessed October 29, 2026. inesss.qc.ca
- Goje O. Infection vaginale à levures (candidose), Merck Manual, consumer version (in French). Updated May 2026, accessed October 29, 2026. merckmanuals.com
- Centre de littératie en santé du CHUM. La sécheresse vaginale (in French). 2021, accessed October 29, 2026. chumontreal.qc.ca
- Government of Canada, National Defence. Hygiène vulvovaginale (French version). Modified October 27, 2025, accessed October 29, 2026. canada.ca
This sheet provides general information and does not replace an assessment by a health professional. Published October 29, 2026.