UTI, Yeast Infection, Vulvodynia or PFD? The Guessing Game No One Wants to Play

Are you having pain down there? You might find yourself asking… is it a UTI or something else? Urinary tract infections, yeast infections, vulvodynia, and pelvic floor disorders are not only uncomfortable. They are also confusing, since symptoms can present similarly. The body can be a really good liar. Because of that, we have to be really smart when trying to understand it.

Understanding Common Infections: UTIs and Yeast Infections

Let’s start with everyone’s favorite: infections. UTIs are a fairly regular occurrence for women, but yes, men also get them. UTIs usually occur when bacteria enters the urethra. Yeast infections, true to their name, are usually caused by Candida albicans, a type of yeast.

Both UTIs and yeast infections can lead to pain when you urinate, also known as dysuria. Both can also cause discharge. That being said, yeast infection discharge can be “thick, white and clumpy,” according to OB/GYN Jill Purdie, M.D., quoted in Prevention. This type of discharge is not as likely with UTIs. With UTIs, discharge can also originate from the urethra when it is involved in the infection. With yeast infections, you commonly see vaginal discharge.

Key Clues That May Help You Tell the Difference

The presence or lack of itching or vaginal swelling can be a major clue. A lack of itching often points toward a UTI. The presence of itching or swelling more often suggests a yeast infection.

With a UTI, You may also have, in addition to painful urination with a UTI, fever and urinary urgency.

Putting on Your Detective Hat

When you start wondering which is which, it’s time to put on your detective hat. With UTIs, not drinking enough water and not urinating regularly can set you up for trouble. (six to eight glasses) of water matter more than you think.

So ask yourself: were you recently laser-focused on a Netflix show and forgot to drink water or get up to urinate . . . or both? If so, a UTI becomes more likely.

Yeast infections, on the other hand, sometimes happen after antibiotic use. Think back on your recent history. Another reason not to take antibiotics you don’t really need? Antibiotic resistance.

What to Do If You Suspect a UTI

If you suspect a UTI, a home test can be a helpful starting point, even though it isn’t perfect. From there, call your doctor to discuss next steps. They may order a urinalysis and a clean-catch urine sample.

What does that mean? According to Healthline, vaginal skin naturally has bacteria on it. You don’t want that bacteria to show up in the culture. If it does, it can taint the results and lead to inaccuracy.

When It’s Not an Infection: Pelvic Floor Dysfunction and Vulvodynia

Here comes the curveball, my friends. Pelvic floor dysfunction and vulvodynia can mimic UTIs and yeast infections.

With pelvic floor dysfunction, you can have frequent urination or back pain, similar to a UTI. You won’t have a fever, though. With vulvodynia, itching can absolutely be present.

Why Antibiotics Can Be Confusing

Here’s another layer of confusion. Antibiotics can sometimes make you feel better even if you don’t have a UTI. Yes, it’s true. I have seen people get some relief from antibiotics even when they don’t actually have a UTI at all.

This has been observed in people with CPPS, or chronic pelvic pain syndrome. In some cases, the relief may come from an undetected UTI. According to emedicine,  “Some patients with CPPS are maintained on long-term, low-dose regimens, such as one tablet of trimethoprim-sulfamethoxazole (Septra DS) daily. In some cases, patients experience symptomatic relief while on these regimens. Whether this is a reflection of the strong placebo effect associated with treatment of this condition or the result of suppression of an undetected pathogen is purely a matter of speculation. Studies suggest that, beyond the placebo effect, certain antibiotics may actually be providing an objective anti-inflammatory and/or analgesic benefit to these patients.”

If you don’t feel better after taking antibiotics for a UTI, that’s something to talk to your doctor about. The treatment may be ineffective at best. At worst, it can contribute to antibiotic resistance.

Trusting Your Body and Seeking the Right Care

Ultimately, you don’t want to spin your wheels longer than you have to. Doing so can leave you feeling worse than necessary. It can also allow something like a UTI to escalate.

Trying to figure out what’s going on can feel time-consuming and exhausting. Still, you don’t want to delay seeing a doctor for a UTI because you thought you could ease symptoms with yogurt. Knowing your body and communicating clearly can only help your provider at the end of the day.

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