Thrush, BV or UTI? How to Tell the Difference

Itching, unusual discharge or a burning feeling down there can be uncomfortable and worrying. Three of the most common causes are vaginal thrush, bacterial vaginosis (BV) and urinary tract infections (UTIs). They can feel similar, but they have different causes and need different treatment. That’s why it’s worth getting the right diagnosis rather than guessing.

At a glance

Vaginal thrush

Thrush is caused by an overgrowth of Candida, a yeast that normally lives in small amounts in the vagina, gut and mouth. It’s most common in people who have regular periods and is uncommon before puberty and after menopause. Things that can make thrush more likely include:

• taking antibiotics
• pregnancy and other times of higher oestrogen levels
• diabetes or a weakened immune system
• menopausal hormone therapy

Thrush is usually treated with antifungal treatment, which is available from a pharmacy. According to healthdirect, you should see a doctor if:

• it’s the first time you’ve had symptoms
• over-the-counter treatment isn’t working
• you get thrush 4 or more times a year
• you’re pregnant or breastfeeding
• you have lower tummy pain or abnormal bleeding
• you’re worried you may have an STI

More on our thrush treatment page.

Bacterial vaginosis (BV)

BV happens when the balance of bacteria in the vagina changes. It isn’t caused by poor hygiene. You’re more likely to get BV if you have a new sexual partner, have sex without condoms, use douches or have a copper IUD (healthdirect). In about half of all cases there are no symptoms.

BV needs a doctor’s assessment, and a vaginal swab is often used to confirm it. You may be able to take the swab yourself. BV is usually treated with prescription treatment, and it often comes back. Australian guidance on managing BV has changed in recent years, including for some people with regular male partners, so it’s worth talking it through with your doctor. The Australian STI Management Guidelines set out the current approach. If you’re pregnant and think you might have BV, speak to a doctor.

Read more in our article Bacterial vaginosis (BV): symptoms, causes and treatment, or see our BV treatment page.

Urinary tract infections (UTIs)

A UTI is a bacterial infection, most often in the bladder (cystitis). The classic symptoms are stinging or burning when you wee, needing to go often or urgently, and cloudy or smelly urine. UTIs are more common in women because the urethra is shorter, but they can affect anyone. Older people with a UTI can sometimes become confused.

UTIs often need antibiotics, prescribed if clinically appropriate after a doctor’s assessment. A kidney infection is more serious and needs prompt treatment (healthdirect).

Read our guide to UTIs in women, or see our UTI treatment page.

Why the right diagnosis matters

• Different treatments. Antifungal treatment won’t clear BV or a UTI, and antibiotics can make thrush more likely.
• Some STIs can look similar. Chlamydia, gonorrhoea, trichomoniasis and herpes can also cause discharge, pain or stinging. If there’s any chance of an STI, testing is a good idea. See our STI testing and treatment page and our article on chlamydia.
• Repeated self-treatment can hide the real cause and delay the right care.

Getting tested

Depending on your symptoms, your doctor may suggest:

• a vaginal swab, often one you can take yourself at a pathology collection centre, to check for thrush, BV or an STI
• a urine test to check for a UTI and which antibiotic it responds to
• STI tests, such as a urine sample or swab for chlamydia and gonorrhoea

Tests are especially useful if this is your first episode, symptoms keep coming back, treatment hasn’t worked, or you’re pregnant.

When to get urgent help

See a doctor the same day, or go to an emergency department, if you have:

• fever, chills or shaking
• pain in your back or side, under the ribs
• nausea or vomiting
• symptoms while pregnant
• severe pelvic or tummy pain

These can be signs of a kidney infection or another condition that needs prompt in-person care.

How Teldoc can help

Our AHPRA-registered GPs can assess your symptoms by phone or video, usually within 15 minutes, 7 days a week. They can:

• arrange a swab or urine test through our pathology referrals if needed
• prescribe treatment if clinically appropriate, with eScripts sent to your phone or preferred pharmacy
• arrange STI testing if appropriate
• tell you if you need to be examined in person

Fees:

• Thrush and BV consultations are bulk billed for patients with a valid Medicare card.
• UTI consultations are $55 on weekdays and $75 on weekends and public holidays.
• See our fees page for full details.

Frequently asked questions

Can I have thrush and BV at the same time?

Yes, it’s possible to have more than one condition at once, which is one reason a swab can be helpful if symptoms don’t settle.

Does my partner need treatment?

Partners usually don’t need treatment for thrush or a UTI. For BV, current Australian guidance recommends treating regular male partners in some situations, so ask your doctor. If an STI is found, partners will need testing and treatment.

Can men get thrush or UTIs?

Yes. Men can get genital thrush and UTIs, although UTIs are less common in men. A UTI in a man should always be assessed by a doctor.

Can I treat these over the counter?

Thrush can often be treated with pharmacy products if you’ve had it before and the symptoms are the same. BV and UTIs usually need a doctor’s assessment and prescription treatment. If you’re not sure what you have, see a doctor before treating yourself.

Sources and further reading: healthdirect: Vaginal thrush; healthdirect: Bacterial vaginosis; healthdirect: Urinary tract infection; Australian STI Management Guidelines: Bacterial vaginosis.

This article is general health information and isn’t a substitute for advice from your own doctor. If you’re worried about your health, speak to a GP. In an emergency, call 000.

Medically reviewed by Dr Vafa Derakshan (MBBS, FRACGP), October 2026