How do I know if I have thrush or a UTI?

Is it vaginal thrush or is it a UTI – Urinary Tract Infection? You feel discomfort in your nether regions (around your vulva, vagina & urethral opening). So sometimes it can hard to distinguish where you feel the burning sensation. Is it the vagina, vulva or urethra or urethral opening? Or is it a combination?

Just a little female anatomy reminder: you have your urethra first (which is the tube that goes from the bladder to the opening where your wee comes out), vagina is next and then lastly you have your anus.

And sometimes it can be difficult to differentiate between the two (thrush and UTI) with some similarities, but technically there are differences in symptoms. Let’s talk about the difference between the two.

For those of you that don’t know me, my name is Michelle Cooke, Period & Hormone Naturopath, Natural Fertility Educator & Naturopathic Emotional Release Practitioner. I’m the Founder and Director of Reproductive Wellness, a clinic located in Melbourne. I see patients online and face-to-face.

Vaginal Thrush


What is thrush? 

Thrush can occur in various parts of the body: vagina, skin, gastrointestinal system (gut, throat, mouth). But today we are going to talk about vaginal thrush otherwise known as Vulvovaginal Candidiasis.

Vulvovaginal candidiasis is where there is thrush or a yeast overgrowth / infection of candida. Candida is a yeast or fungus. Candida albicans is usually the most common type of vulvovaginal candidiasis (approx. 85-95%), the rest is due to Candida glabrata. Which is another species. There is inflammation of the vulva (entrance to the vagina and / or vagina) known as Vaginitis.

It is healthy and normal to have candida albicans in our body, it is normally it is found in the vagina, skin, gastrointestinal system (gut, throat, mouth). However, it is known as an opportunistic organism, which means that given the opportunity in the right circumstances for the yeast, it will take advantage and try to dominate arising in overgrowth.


Signs & Symptoms of thrush

  • Itchy vulva and / or vagina

  • Unusual vaginal secretion: thick white, or yellowish cheese like (bit like cottage cheese) or watery

  • Burning vulva and / or vagina

  • Sore vulva and / or vagina

  • Swelling or redness of vulva and / or vagina

  • Painful urination / stinging when you wee (Dysuria)

  • Painful sex (Dyspareunia)

  • Vulva splits in skin tissue

How can you get thrush?


Risk factors:

  • High oestrogen situations: pregnancy, PCOS, Endometriosis

Oestrogen increases glycogen which is a type of sugar in the vagina which is idea for candida to thrive & overgrow.

  • Medications arising in high oestrogen: oral contraceptives like the combined oral contraceptive pill, oestrogen therapy (including vaginal oestrogen cream for menopause)

  • Other medications:

  • Immunosuppressant (suppress the immune system)

  • Antibiotics: Antibiotics are effective at addressing bacterial infections caused by bad bacteria, but they disrupt the normal healthy balance of your good bacteria which prevents candida from overgrowing

  • Medical conditions / Issues:

  • Diabetes Mellitus – poorly controlled > high blood sugar levels > high sugar levels in vagina which is the perfect food source for candida. Also, those with diabetes tend to have poor immunity due to the high blood sugar levels.

  • Obesity

  • Low iron

  • Poor Immunity or immune system disorders (there is nothing to keep things in check)

  • Stressed and run down > poor immunity

  • Topical Vaginal products:

  • Douches –

This disrupts the pH of the vagina which should be acidic. This acidic environment has a very important purpose to protect your vagina from infections. If you make the pH too alkaline this will create the ideal environment for fungal infections like candida to flourish. Your vagina is self-cleansing so no need to “clean” it with something like this, if there is an unusual odour or sensation go to a GP to get assessed

  • Intimate washes or wipes –

These also disrupt pH of the vagina. Same as above. No need to use these because vagina will clean itself.

  • Spermicides –

For the same reasons as above.



How is thrush diagnosed?

It is usually by your GP with a vaginal swab which is sent off to the lab for investigation. Along with physical observation of your vagina and vulva.


Urinary Tract Infection (UTI)

What is a UTI?

A urinary tract infection or UTI is an infection that takes place anywhere in the urinary system. The urinary system consists of the:

  • Bladder

  • Kidneys

  • Urethra: this is the tube where the urine comes out of the body

  • Ureters: these are the two tubes that join the kidneys to the bladder

The most common type of urinary tract infection is cystitis (which occurs in the bladder) but it can also occur in the urethra (urethritis), kidneys (pyelonephritis) or a combination. It is important to get treatment ASAP because kidney infection is very serious.

Signs & Symptoms of a UTI

(You may not have all of these)

  • Pain in lower back or sides (kidneys)

  • Uncomfortable feeling in lower tummy area (bladder)

  • Your wee is smelly or strong odour

  • Your wee is cloudy or a dark yellow

  • Blood in your wee (bladder)

  • When you do a wee it burns or stings (bladder, urethra)

  • Fever (kidneys)

  • Vomiting (kidneys)

  • Nausea

  • After you have done a wee you feel like the bladder is still full

  • You have the urge to wee often (bladder)

  • When you do wee it is only small amounts

What is the cause of a UTI?

It is due to bacteria entering into the urethra (the tube that goes from outside your body to your bladder). Women are more likely to get a UTI because the urethra is smaller than the males and the urethral entrance is a lot closer to the anus (where bacteria like to hang out).

Infection of the bladder:

Usually caused by E.Coli which is a type of bacteria that is found in your gastrointestinal system. But other bacteria can result in infection of the bladder too. Because the urethra is close to the anus bacteria can easily travel from anus to urethra and up to the bladder.

Infection of the urethra:

This can occur due to two reasons:

  1. When bacteria from the gastrointestinal system spreads from the anus to the urethra

  2. Due to sexually transmitted infections: gonorrhoea, herpes, mycoplasma or chlamydia. This can occur because the urethra is close to the vagina.

Risk factors of UTI

  • Diabetes Mellitus: poor immunity more susceptible to infection

  • Menopause: decline in oestrogen levels

  • Sexually active: because the urethra is close to the vagina so more prone to infection

  • Poor immunity: Diabetes mellitus or other medical conditions can lower body’s defence against nasties

  • Contraceptive use: diaphragms, spermicidals

  • Use of feminine hygiene products: douches, deodorants, wipes etc.

  • Holding when you need to wee:

In some cases, it can cause a UTI as it causes bacteria to multiply in the bladder


  • Not drinking enough water:

Bladder is not sending a message to the brain to wee as often as it should. So, this can lead to bacteria multiplying in the urinary tract > infection


How is a UTI diagnosed?

It is diagnosed by a GP via a wee test (assessing your urine) midstream urine. The urine sample will also be sent off to a lab where it is examined under microscope where they will look for bacteria or white blood cells in the urine which mean that you have an infection.


Similarities of UTI & vaginal thrush

Some of the symptoms of urinary tract infection and vaginal thrush can be the same. It can be confusing to separate them. And it is totally possible to have both at the same time (fun times!). Furthermore, if you are given antibiotics for a urinary tract infection this can increase the risk of getting vaginal thrush.

Same symptoms:

  • Painful urination / stinging when you wee (Dysuria)

  • That burning sensation around the gential region (can be hard to distinguish – is it urethra, vulva or vagina? or a combo?)

You may have to do the vaginal swab and urinary test if the doctor wants to double check which infection/s you have. Generally, they will do that anyway to check for what is causing your infection.

Differences between UTI & thrush

They are totally different infections:

Vaginal thrush is a fungal infection of vulva and / or vagina

Urinary tract infection (UTI) is a bacterial infection of urinary system (bladder – commonly, urethra, ureters or kidneys)

Apart from the common symptoms above, the rest of the symptoms are different.

What would I recommend doing if you are not sure if you have a UTI or thrush?

I would recommend booking an appointment with a GP to rule out which infection you have (or whether you are lucky enough to have both!). This will also establish if you have one of them or both. The treatment is very different with vaginal thrush being an infection of the vulva and vagina whereas UTI is infection of the urinary system (most commonly bladder, but can also be urethra, ureters or kidneys).

A Naturopath can definitely help you with a UTI or thrush there is plenty of herbal medicine, nutritional medicine, diet and lifestyle advice to help support your vaginal, urinary tract health and immune system. If it is addressed soon enough, you may not need antibiotics for your urinary tract infection.

However, acting fast is crucial particularly if you have a urinary tract infection. If you leave it too long to get help, it can be too severe for natural treatment, and it will require antibiotics to prevent kidney infection which is serious. Keep in mind though you can actually do both natural and medical treatments together to prevent reinfection & recurrence and to support your body.

If you get recurrent UTIs and / or thrush a Naturopath can do wonders here to prevent it recurring for you so make sure you book an appointment to get to the bottom of why it is happening for you and address the core reason/s.

If you need help with your urinary or vaginal health (or both), I would love to help you, go ahead and book a FREE 15 min discovery call to find out more about how we would work together and if we are a good fit.

Thank you so much for watching, if you have any questions or comments please pop them in the comments box below 🙂