Candidiasis (Vaginal Yeast Infection): This is the most common cause of a white, cottage cheese-like vaginal discharge. It is characterized by the overgrowth of Candida albicans in the vagina, often due to changes in the vaginal environment, antibiotic use, or immunosuppression.

Bacterial Vaginosis (BV): Although BV typically presents with a thin, grayish-white discharge and a fishy odor, some cases can have a thicker, cottage cheese-like appearance. It's caused by an imbalance of the normal vaginal flora.
Trichomoniasis: This sexually transmitted infection can cause a frothy, yellow-green or gray vaginal discharge, but in some cases, it might appear white and cottage cheese-like. It's accompanied by other symptoms like itching, burning, and redness, but these might be absent in mild cases.
Atrophic Vaginitis: This condition, common in postmenopausal women, can cause a thin, white or yellowish discharge due to the thinning and drying of the vaginal walls. However, it's less likely to have a cottage cheese appearance.

Cervical Cancer: Although extremely rare to present solely with a change in vaginal discharge, advanced cervical cancer can cause abnormal vaginal discharge. It's crucial to not miss this diagnosis due to its severe implications.
Gonorrhea and Chlamydia: These sexually transmitted infections can cause changes in vaginal discharge, although they typically present with other symptoms like pelvic pain and abnormal bleeding. They are critical to diagnose and treat to prevent long-term complications.

Desquamative Inflammatory Vaginitis (DIV): A rare condition characterized by a purulent, greenish-yellow discharge, but in some cases, it might appear white. It's associated with significant inflammation and can mimic other conditions.
Vaginal Tuberculosis: A rare condition in many parts of the world, vaginal TB can cause a variety of symptoms including abnormal vaginal discharge. It's essential to consider in endemic areas or in individuals with risk factors for TB.