Trichomoniasis vs Yeast Infection: Symptoms, Discharge, and Diagnosis

When something doesn’t feel right "down there," it’s natural to worry and wonder what might be causing the discomfort. Two common infections that can cause vaginal discomfort are yeast infections and trichomoniasis. 

While they might have similar(ish) symptoms, they are distinct issues that require different treatments. Understanding the differences between these two can help you identify what’s going on and get the right care. 

Keep reading to learn the difference between trichomoniasis and yeast infections, and how to tell them apart.

Trichomoniasis vs yeast infections

While trichomoniasis and yeast infections can present similar symptoms, like abnormal discharge, itching, and discomfort, they are fundamentally different conditions.​ Understanding the distinctions between these two conditions is crucial for accurate diagnosis and effective treatment.

What is a yeast infection and symptoms

A vaginal yeast infection, also known as vaginal candidiasis, is a type of fungal infection that occurs when there is a Candida overgrowth. Candida is a type of fungus that is naturally present in the body but can overgrow under certain conditions, such as after taking antibiotics, during pregnancy, or when the immune system is weakened. 

Common symptoms of a yeast infection include: 

• Vulvar and vaginal irritation or itching
• Thick, white vaginal discharge that looks like cottage cheese and is odorless
• Pain during sex 
• A burning sensation when you pee. 

Although uncomfortable, yeast infections are generally not serious and can be treated effectively.

What is trichomoniasis and symptoms

Trichomoniasis, on the other hand, is a sexually transmitted infection (STI) caused by a parasite called Trichomonas vaginalis. Unlike a yeast infection, trichomoniasis is transmitted through sexual contact, and it’s one of the most common sexually transmitted infections. It affects both men and women, but women are more likely to experience symptoms. Left untreated, trichomoniasis can lead to complications such as an increased risk of pelvic inflammatory disease (PID) and other STIs.

Trichomoniasis rarely causes noticeable symptoms. Around 70% of women with trichomoniasis don't experience any signs or symptoms, according to the Centers for Disease Control and Prevention (CDC). But when symptoms do appear, they often include: 

• Itching or irritation inside and/or around your vulva and vagina
• Green, grey, frothy, and/or thin vaginal discharge that has a foul or fishy smell
• Pain or burning when peeing
• The frequent need to pee
• Spotting or bleeding between periods
• Pain during sex.

Trichomoniasis vs yeast infection vaginal discharge

Vaginal discharge is a common symptom of both vaginal yeast infections and trich, and can be a helpful clue in telling the difference between the two:

• Yeast infection discharge is typically thick, white, and odorless, often described as looking like cottage cheese. 
• Trichomoniasis discharge is usually thin, frothy, and yellow-green with a distinct foul odor. 

Paying attention to these differences can provide valuable insight into which condition you might be dealing with. That said, other vaginal infections — such as bacterial vaginosis (BV), aerobic vaginitis (AV), cytolytic vaginosis (CV) — and STIs can cause discharge similar to trich or yeast infections. If you notice any drastic changes to the color, consistency, or smell of your vaginal discharge, you should see your healthcare provider or take an Evvy Vaginal Health Test.

Trichomoniasis vs yeast infection smell

One of the noticeable differences between trichomoniasis and a yeast infection is the smell (or lack thereof). Yeast infections typically don’t have much of an odor. The discharge may be thick and white, but it’s usually odorless — at most, it might have a mild, yeasty smell. 

Trichomoniasis, on the other hand, often causes a strong, unpleasant, fishy or musty smell. This is due to the presence of the parasite Trichomonas vaginalis, which disrupts the vaginal microbiome in a different way than yeast. If you notice a persistent foul odor along with other symptoms, it’s a good idea to get tested. 

How to know if you have a yeast infection or trichomoniasis

Because yeast infections and trichomoniasis can cause similar symptoms (like itching, irritation, and unusual discharge, it’s easy to confuse one for the other. But despite how alike they may feel, they’re caused by entirely different organisms: yeast infections by Candida (a fungus), and trichomoniasis by a parasite called Trichomonas vaginalis. That means they require completely different treatments, and guessing wrong could leave you feeling worse, not better.

That’s why getting a proper diagnosis is so important. A healthcare provider may perform a pelvic exam, take a swab of your vaginal discharge, or send a sample for lab testing to determine what’s really going on. Self-diagnosing based on symptoms alone can often lead to the wrong treatment and unnecessary frustration, especially if symptoms keep coming back.

For those who want more clarity without waiting for a doctor’s appointment, Evvy’s at-home Vaginal Health Test + Expanded PCR Panel is a helpful option. It uses advanced metagenomic sequencing to detect and quantify the microbes in your vaginal microbiome — including Candida species and Trichomonas vaginalis. This kind of insight can help you better understand what's driving your symptoms and guide more targeted conversations with your healthcare provider.

Knowing exactly what you're dealing with means you can treat it effectively the first time, without the guesswork, unnecessary medications, or lingering discomfort.

Treatment options for yeast infection and trichomoniasis

Getting the right treatment matters, not just to feel better, but to avoid bigger issues down the line. Even though yeast infections and trichomoniasis can have some similar symptoms, they’re totally different and need different treatments. Using the wrong remedy can drag things out or make things worse. Plus, if left untreated, trich can lead to more serious health problems or even spread to a partner. So if something feels off, it’s always best to check in with a healthcare provider, get a proper diagnosis, and treat it the right way from the start.

How to treat trichomoniasis

If you think you might have trichomoniasis, it’s crucial to visit a healthcare provider for proper diagnosis and treatment. They can prescribe oral antibiotics to clear the infection. The two main medications used are metronidazole and tinidazole, typically taken in smaller doses twice daily for seven days. Be sure to finish the full course of treatment!

It’s also important that your sexual partners receive treatment for trichomoniasis, even if they don’t show any symptoms. Men often don’t have symptoms of trichomoniasis, but they can still carry the infection and may pass it back to you or others if untreated.

How to treat a yeast infection

Most yeast infections can be treated with over-the-counter antifungal medications available in creams, ointments, or suppositories. These treatments are effective for most mild to moderate infections. 

If over-the-counter treatments don’t work, or if you have frequent vaginal yeast infections, your healthcare provider may prescribe a stronger antifungal medication. It’s important to complete the entire course of treatment, even if symptoms improve, to ensure the infection is fully eradicated.

Your doctor will recommend treatment based on the severity of your infection and how frequently it recurs, if at all.

If standard treatments aren't effective, your doctor may suggest other medications such as boric acid, nystatin, or flucytosine, which are typically administered as vaginal suppositories.

If you suspect you have either trichomoniasis or a yeast infection, an Evvy test can help you get to the bottom of your symptoms. Evvy’s Vaginal Health Test + Extended PCR Panel can test for both yeast and trich (along with hundreds of other bacteria and four of the most common STIs) — all in one swab. Eligible users can also receive personalized prescription treatment developed by a provider.

FAQ

How to tell the difference between yeast infection and trichomoniasis? 

To tell the difference between a yeast infection and trichomoniasis, pay attention to the symptoms and the type of discharge. Yeast infections usually come with intense itching, irritation, and a thick, white, odorless discharge that looks like cottage cheese. On the other hand, trichomoniasis often causes a frothy, yellow-green discharge with a strong, unpleasant smell, along with itching, burning, and discomfort when you pee or have sex. Both can be uncomfortable, but the different types of discharge and odor are the key clues for telling them apart. If you're experiencing any of these symptoms, it's best to see a healthcare provider for the right diagnosis and treatment or take an at-home Evvy Vaginal Health Test.

Can a yeast infection be misdiagnosed as trich? 

Technically, yes, a yeast infection can sometimes be misdiagnosed as trichomoniasis, especially if the symptoms are not clear-cut. Both conditions can cause vaginal itching, irritation, and discomfort, which can lead to confusion. However, the type of discharge usually differs — yeast infections typically produce a thick, white, odorless discharge, while trichomoniasis often causes a frothy, yellow-green discharge with a strong odor. Sometimes, trichomoniasis symptoms are so mild they can overlap with those of a yeast infection, making it possible to misdiagnose one for the other, especially if you’re self-diagnosing. Trichomoniasis can also be confused with bacterial vaginosis because their symptoms are very similar. For an accurate diagnosis, healthcare providers often rely on lab tests, such as a vaginal swab, to identify the specific cause of the symptoms. You can also take an Evvy Vaginal Health Test + Extended PCR Panel to know for sure.

Does trichomoniasis smell like yeast?

No, trichomoniasis doesn’t smell like a yeast infection. Trichomoniasis discharge typically has a strong, unpleasant, and often fishy odor. A yeast infection usually causes a thick, white discharge that is generally odorless or has a mild, yeasty smell. The distinct foul smell is a key symptom that helps differentiate trichomoniasis from a yeast infection. If you notice an unusual odor and other symptoms like itching or discomfort, it's important to consult a healthcare provider for an accurate diagnosis.

How do I know if it’s a yeast infection or STD?

It can be tricky to tell the difference between a yeast infection and a sexually transmitted disease (STD) just based on symptoms, since they can overlap quite a bit. Both can cause itching, burning, and unusual discharge, and both can make things uncomfortable during sex or while peeing. The only way to really know what you're dealing with is to get tested. Evvy’s Vaginal Health Test can be a helpful tool here. It analyzes your vaginal microbiome and can detect high levels of Candida as well as Trichomonas vaginalis. Having this kind of detailed insight can give you a much clearer picture of what’s going on, so you and your healthcare provider can choose the right treatment and avoid unnecessary back-and-forth. If you're not getting relief from typical yeast infection treatments or if your symptoms keep returning, it’s a sign that testing is the next best step.