Is it thrush? Infections that cause vulval itching

Vaginitis means inflammation of the vagina. Vulvovaginitis means the vulva is affected too. Infections are a common cause, but skin conditions, irritants and low oestrogen can cause very similar symptoms (see Why is my vulva dry, itchy or sore?).

Thrush

Thrush, also called a yeast infection, is usually caused by Candida albicans, a yeast that lives harmlessly in many people's vaginas. It causes itching and soreness, often with thick white discharge, like cottage cheese, that doesn't usually smell. Some people itch with little or no discharge. The skin can look red, swollen or cracked.

Thrush is more likely after antibiotics, during pregnancy, and with diabetes that isn't well controlled. It's less common after menopause, because low oestrogen makes the vagina less hospitable to yeast, unless you're using HRT. After menopause, itching is more often caused by genitourinary syndrome of menopause (GSM, previously called vaginal atrophy) or a skin condition.

Antifungal treatment is available from pharmacies. The NHS advises seeing a GP or sexual health clinic if it's your first time, you're pregnant, you're under 16 or over 60, treatment hasn't worked, or it keeps coming back (more than four times in a year).

Bacterial vaginosis (BV)

BV happens when the balance of vaginal bacteria shifts, with fewer lactobacilli and more of other types. The main sign is thin grey or white discharge with a strong fishy smell, often stronger after sex. It doesn't usually cause itching or soreness, and around half of people with BV have no symptoms. BV isn't a sexually transmitted infection, but sex can make it more likely. It's treated with antibiotics.

Trichomoniasis

Trichomoniasis is a sexually transmitted infection caused by a tiny parasite. It can cause itching, soreness, frothy yellow-green discharge with an unpleasant smell, and pain when peeing or during sex. Many people have no symptoms. It's treated with antibiotics, and sexual partners need treating too.

Genital herpes and warts

Genital herpes causes small blisters or sores, which may tingle, itch or burn before they appear. Genital warts are small growths that occasionally itch. Both are diagnosed at sexual health clinics.

When to get checked

See a GP or go to a sexual health clinic if you have unusual discharge, a strong smell, sores or blisters, or pain when peeing or during sex. The same applies if you might have a sexually transmitted infection, or if thrush treatment from the pharmacy hasn't worked. Sexual health clinics are free and confidential, and you don't need a referral.

References

NHS, "Thrush in men and women," (reviewed July 2023) https://www.nhs.uk/conditions/thrush-in-men-and-women/

NHS, "Bacterial vaginosis," (reviewed June 2026) https://www.nhs.uk/conditions/bacterial-vaginosis/

NHS, "Trichomoniasis," (reviewed July 2025) https://www.nhs.uk/conditions/trichomoniasis/

NHS, "Genital herpes," (reviewed June 2023) https://www.nhs.uk/conditions/genital-herpes/

NHS, "Genital warts," (reviewed July 2023) https://www.nhs.uk/conditions/genital-warts/