Any owner of a vulva/vagina (two different, non-interchangeable parts of the female anatomy!) knows that things get funky down there from time to time. Occasionally, you’ll know why something’s amiss—unprotected sex with a new (STI-tested) partner, a sugar/starch binge (just me?), some type of sweat situation, PMS, etc. Other times, the origins of said funk can be mysterious.

Regardless, Alyssa Dweck, MD, a board-certified OB/GYN in New York, tells me the go-to diagnosis for most women with unexplained funky nethers tends to be “yeast infection.” This, she says, is often a miss.

“Many women consider every vaginal itch or discharge a ‘yeast infection’ when in actuality, they may have a bacterial imbalance or infection [such as] BV or bacterial vaginosis, a sensitivity to an external irritant such as body wash or a bath bomb, a skin condition like eczema, or even an STI,” Dr. Dweck says.

Part of the problems is that the symptoms of a yeast infection—like itching and burning, unusual discharge, and redness or swelling—are similar to what pops up from other conditions. “Yeast can be the great imposter sometimes, because if a yeast infection goes unchecked, you can get little cuts and fissures on the external genitals as well as all the usual fun symptoms inside the vagina like discharge and itching and all of that,” says Dr. Dweck. “It’s easy to confuse different syndromes.”

“Yeast can be the great imposter sometimes… It’s easy to confuse different syndromes.” —Alyssa Dweck, MD, OB/GYN

Dr. Dweck adds that women often just want to treat themselves, and that the proliferation of over-the-counter meds offering quick fixes for yeast infections has made doing so easier and more appealing than ever before. “Women want to just take care of themselves and not have to race off to the doctor all the time, so they’ll just treat everything as if it’s yeast,” she says. (It’s not just patients who misdiagnose vaginal infections, either; Dr. Dweck tells me physicians are guilty of this, too.)

But that’s obviously an issue. By not getting a proper diagnosis, people are potentially delaying critical treatment of infections or STIs, which could make them worsen (and thus harder to treat) or make them unknowingly pass the infection to their partner. For example, trichomoniasis—which is a very common STI caused by a parasite—can cause itching and redness like a yeast infection. If left untreated, trichomoniasis can make it easier to contract other STIs; in pregnant women, it can increase the risk of pre-term births.

Thankfully, Dr. Dweck says there are clear ways to tell if something is not yeast-related. “If there’s a foul fishy odor, that’s typically not yeast, or if there’s an open sore or something that looks like a blister on a red base, that’s typically not yeast,” she explains.

Some people likely know the tell-tale signs of a yeast infection pretty well. “I would say there’s a group of women who know what yeast is, they’ve gotten yeast infections before and they know how to treat themselves over-the counter or with an oral tablet,” Dr. Dweck says. However, she always recommends you get checked even if you’re *pretty* sure it’s just yeast, especially if you’ve never had a vaginal infection before. If it’s not your first rodeo and you decide to try a course of over-the-counter yeast treatment but your symptoms remain, you should also make a doc appointment ASAP.

Bottom line: “If there’s any uncertainty, check it out with your gyno,” Dr. Dweck advises. If your doc thinks it’s yeast and you don’t, insist on tests. After all, while most funk is just that—funk—occasionally symptoms may point to more serious conditions that no amount of Monistat can treat.

Here’s how to support better menstrual health with the foods you eat: 

Certain it’s yeast, but not down with drugstore cures? Here’s a guide to alternative treatments. Plus, 6 ways to avoid a yeast infection altogether, the next time around.