Thrush, BV and UTIs After Sex: What's Going On

You had a great weekend. Now it's Tuesday, and something's itching, or stinging, or it smells a bit off, and you're staring at the pharmacy shelf wondering which of these 14 boxes you need. Thrush, bacterial vaginosis (BV) and urinary tract infections (UTIs) are all very common, and all three can be set off by sex. They aren't a sign you're dirty, and thrush and UTIs aren't STIs. But they do feel different, and they need different treatment.

How to tell them apart

Thrush is an overgrowth of yeast. It usually causes itching and soreness, redness or swelling of the vulva, and a thick, white discharge that may look like cottage cheese. It doesn't tend to smell very much. It can sting when you pee or have sex. People with penises can get it too, with redness, itching or a rash on the head of the penis.

BV happens when the normal balance of vaginal bacteria changes. It often causes a thin, watery, grey or white discharge, with a strong fishy smell, particularly after sex. It usually doesn't itch much. Some people don't have any symptoms.

A UTI is an infection of the bladder or urinary system. It causes burning when you pee, needing to go all the time and only managing a little, cloudy or smelly urine, and aching low in your belly. It's usually got nothing to do with discharge.

STIs can cause similar symptoms, including unusual discharge, burning and sores. That's why it's worth having a test, particularly if you've got a new partner, or if the symptoms are unusual for you. Our STI testing guide explains how.

When to see a doctor

See a doctor if it's your first time with these symptoms, if you aren't sure what it is, if it keeps coming back, if you're pregnant or if over-the-counter treatment isn't working. A lot of people who think they've got thrush turn out to have something else, so a proper test can save you weeks of misery.

See someone urgently if you've got UTI symptoms along with a fever, chills, back or side pain, nausea or vomiting, as that can mean the infection's reached your kidneys. Men with UTI symptoms should also see a doctor, as it's less common and might need further investigation.

Treatment

• Thrush: Antifungal creams, pessaries or tablets, many of which you can get from the pharmacy. Tablets aren't suitable during pregnancy, so ask.
• BV: Usually antibiotics from your doctor. It often comes back, so tell them if it does. For women who have sex with women, your partner may need to be considered too. Newer Australian research has also found that treating male partners may help reduce recurrence, so ask your doctor.
• UTI: Usually antibiotics. In some Australian states, a pharmacist can provide treatment for simple UTIs without a doctor's appointment, in certain circumstances. Check what's available where you live.

Don't have sex until the symptoms have cleared up and you've finished your treatment. It'll hurt, and you might make things worse. Don't use anything inside your vagina that isn't medically recommended. That includes yoghurt, garlic, tea tree oil and whatever else that internet stranger suggested.

Why sex can trigger them

• Bacteria move around. Sex can push bacteria towards the urethra. That's why UTIs often show up a day or two after a big weekend.
• Semen and lube can change your pH. The vagina's normally acidic, and semen is alkaline. This can tip things out of balance, leading to BV.
• Friction. Dry sex can cause tiny tears. Use plenty of lube.
• Sugary or scented products. Some flavoured lubes, whipped cream and glycerin-based products can set off thrush.
• Going from bum to vagina. Bacteria from the bowel are the main cause of UTIs. Change your condom, wash your hands and clean your toys. Our hygiene guide tells you how.
• New partners. A new partner's a known risk factor for BV.

What actually helps prevent them

• Pee after sex. It may help flush bacteria out of your urethra. It won't prevent STIs or pregnancy, or all UTIs, but it's easy and worth doing.
• Use condoms. They can reduce your risk of BV and STIs, and they keep semen away from your vagina.
• Use a gentle lube. Wicked Simply Natural is pH balanced and fragrance free. Our lube ingredients guide tells you what to look out for.
• Wash gently, on the outside only. Use plain water. Don't douche, as it removes the good bacteria. No scented washes, wipes or sprays.
• Keep your toys clean, as they can pass things on. Here's how. Replace them if they've gone sticky or porous.
• Wear loose, breathable undies, and get out of wet swimmers and sweaty gym clothes. It's a big deal in an Aussie summer, and it can help with thrush.
• Drink plenty of water, and don't hold on when you need to pee.

If you keep getting these infections, talk to your doctor. Perimenopause and menopause can make UTIs and dryness more common, and vaginal oestrogen might help. Diabetes can make thrush more likely, and some contraceptives can also be a factor. You don't have to keep putting up with it.

This is general information, not medical advice. A doctor, pharmacist or sexual health clinic can tell you what's going on.