Medical conditions causing irritation of the vagina and a woman's sensitive external genital tissues often cause similar symptoms, including pain, burning and itching. If you experience such symptoms, you may suspect a yeast infection or sexually transmitted disease, such as genital herpes. While similarities exist between these conditions, there are important differences.
Sores or Not
The presence of sores helps differentiate genital herpes from a yeast infection because sores typically do not occur with a vaginal yeast infection.The initial symptoms of genital herpes usually appear within a few days of infection, but may not appear for up to 12 days. Small red bumps in the genital or anal area, or on the inner thighs or buttocks are the most common symptom of a genital herpes outbreak. Within an initial herpes outbreak, there are usually multiple sores that erupt in crops for several days.
The initial bumps turn into blisters that rupture, leaving open sores that ooze and may bleed. Burning, itching and tingling are common in the area affected by the sores. Genital herpes sores eventually form scabs and heal. They may develop inside the vagina or rectum, where they usually go unnoticed. Additionally, many women infected with genital herpes experience no symptoms when initially infected.
Pain and Itching
Both a vaginal yeast infection and an initial genital herpes outbreak can cause pain and itching in the vaginal area. With a herpes outbreak, the sores are typically quite painful and tender. A vaginal yeast infection is characterized by overgrowth of fungus, known as Candida. This overgrowth inflames the skin, causing mild to moderate pain and burning. Both conditions frequently cause burning and pain when urinating.
With a vaginal yeast infection, overgrowth of Candida often causes intense itchiness in the entire genital area. Itchiness is also common during a herpes outbreak, but is most often caused by the sores and is more localized than what women with a yeast infection typically experience. A tingling sensation may occur with a genital herpes outbreak. This sensation generally does not occur with a yeast infection.
Abnormal Vaginal Discharge
Abnormal vaginal discharge is a common symptom of a vaginal yeast infection. Women typically notice a white, watery, odorless discharge with a cottage cheese-like consistency. A change in vaginal discharge is not common during an initial herpes outbreak, although women may notice a clear fluid or a small amount of bleeding when the blisters rupture. Spotting can occur if a woman has multiple herpes sores in her vagina.
Some women with an initial outbreak of genital herpes experience flu-like symptoms. A low-grade fever, swollen lymph glands, muscle aches and a headache are possible symptoms. For reasons that remain unclear, women are more likely to experience flu-like symptoms with an initial genital herpes outbreak than men are. These symptoms do not occur with a vaginal yeast infection.
Warnings and Precautions
The signs and symptoms of vaginal yeast infections, an initial herpes outbreak and other medical conditions affecting the female genital tissues are often similar. It is important to see your doctor if you experience vaginal symptoms to ensure an accurate diagnosis and appropriate treatment. Early diagnosis and treatment is particularly important if you have a weakened immune system due to illness or medical therapy, or you are pregnant.
Reviewed and revised by: Tina M. St. John, M.D.