Vaginas do a lot of great things: They aid in a pleasurable sex life, help bring new humans into the world, and self-clean with a natural balance of healthy bacteria. But there can be downsides to having a vagina, including the risk for conditions like bacterial vaginosis (BV) and yeast infections. Though these two vaginal infections are different, they share similar symptoms, so it can be tough to tell them apart.
To help you out, in this article I’ll explain the symptoms, causes, and treatments of bacterial vaginosis and yeast infections, as well as how to prevent both. Armed with this information, you’ll have a better idea of which women’s health condition you have and how to treat it yourself or with the help of a doctor.
What Is a Yeast Infection vs. Bacterial Vaginosis?
Anytime you’re dealing with an infection in an intimate area, it can cause embarrassment and stress. But rest assured: These conditions are common, and they do not reflect poorly on your hygiene.
Bacterial vaginosis and yeast infections are two different (and curable) types of vaginal infection. They’re caused by an overgrowth of microbes in the vaginal area, which disrupts the natural pH levels and causes inflammation (vaginitis). The major difference between BV and yeast infections is the specific microbe that causes them: BV is a bacterial infection, while a yeast infection is a fungal infection.
Neither one of these conditions is a sexually transmitted infection (STI), but you may need a prescription from a healthcare provider to help treat either one.
These two conditions share many symptoms, but they also have some distinct differences. Pay close attention to the look and smell of vaginal discharge to help you distinguish between the two.
Bacterial vaginosis symptoms include:
- White, gray, or green vaginal discharge with a fishy smell (the vaginal odor tends to be strongest after sex)
- Vaginal itching
- A stinging sensation with urination
Symptoms of a yeast infection include:
- Lumpy, white vaginal discharge (resembling cottage cheese) with no smell or minimal smell
- Whitish coating around the vaginal opening
- An itching or burning sensation around the vulva and vagina
- A stinging sensation while urinating
- Pain or discomfort during sex
Tips for identification
People with fairly mild cases of BV or vaginal yeast infection may not notice symptoms right away or at all. But in general, if you have white or gray vaginal discharge along with pain or discomfort, that’s a clue you might have an infection.
One easy way to distinguish between these two conditions is the smell or lack thereof. Discharge from BV has a distinctive fishy odor, while yeast infection discharge tends to be odorless. BV discharge is also fairly thin, while yeast infection discharge has a thick consistency often resembling cottage cheese.
How long does each infection typically last?
BV is unlikely to go away without the use of antibiotics, so always contact a doctor.
Mild yeast infections may go away on their own or with over-the-counter (OTC) medication after a few days. If a yeast infection persists or is getting progressively worse, seek medical advice.
A prescription treatment can quickly clear up BV or a yeast infection within a week (though a yeast infection sometimes takes longer). You may feel better sooner, but complete the full course of treatment as directed by your doctor to ensure the infection is gone.
What Causes Each Type of Infection?
The major thing that distinguishes BV from yeast infections is their different causes.
Bacterial vaginosis is a bacterial infection caused by an overgrowth of bacteria in the vagina (gardnerella is the most common culprit). Though it’s not sexually transmitted, having sex with multiple new partners increases the risk for BV, as does douching.
A yeast infection (candidiasis) is caused by an overgrowth of fungus called candida. Due to things like pregnancy, a course of antibiotics, a diabetes complication, hormonal changes of menopause, estrogen therapy, or a weakened immune system, the balance of good bacteria (lactobacilli) in the vagina gets out of whack. This allows the candida that naturally lives there to grow and multiply, resulting in a yeast infection.
When to See a Doctor
If any symptoms of BV or a yeast infection last longer than a few days, or if they impact your quality of life, talk to a doctor. BV and yeast infections are some of the most common vaginal conditions faced by women of reproductive age, and your provider will know how to distinguish between them.
To diagnose which condition you have and the best treatment, your doctor will ask about your health history and current symptoms.
If you’re seeing a provider in person, they’ll likely do a pelvic exam to look for signs of infection. They may also use a cotton swab to take a sample of your vaginal discharge. They’ll test this sample to confirm the diagnosis.
If you use telehealth, since you won’t have a physical exam, it helps to be as specific as possible about your symptoms. Try to share when they started, what they look and feel like, and how you’d rate your discomfort on a scale of 1 to 10.
Medication can treat BV and yeast infections, though different treatments work for each.
The most common treatment for BV is a round of oral or vaginal antibiotics. Metronidazole (Flagyl), clindamycin (Cleocin), and tinidazole (Tindamax) are three options frequently used for BV.
You need a prescription for these, which is why you need to see a doctor. Be sure to complete the full course of treatment to ensure the infection goes away.
For a mild yeast infection, you can try an over-the-counter vaginal cream like miconazole (Monistat) to see if that clears things up.
Otherwise, a doctor can prescribe an oral, cream, ointment, or suppository antifungal medication such as fluconazole (Diflucan).
Either way, you should start feeling better within a day or two and be totally symptom-free within about a week. If not, see your doctor again.
Can You Pass BV or a Yeast Infection to a Sexual Partner?
BV and yeast infections are easily confused for STIs, but neither is a sexually transmitted infection or sexually transmitted disease (STD). Still, it may be possible to transmit them to a sexual partner during vaginal, oral, or anal sexual activity.
People with vaginas are the only ones who can get bacterial vaginosis, so this infection may be passed between two sex partners with vaginas. People with penises cannot show symptoms of BV and do not require treatment, but it is unclear if they can spread the infection.
Around 15% of the time a person with a penis has unprotected sex with someone who has a yeast infection, a rash will show up on their penis a few days later. It’s rare, but if it happens, be sure to get it checked out by a doctor.
Outlook for Each Infection
Thankfully, both BV and yeast infections are easy to treat, and the vast majority of cases resolve in just a few days after treatment. If your symptoms do not improve, you could have a different condition. Contact your medical provider, who may try another treatment or do further testing.
Vaginal conditions are complex and caused by multiple factors, so there is no one foolproof way to prevent them. Instead, a mix of habits may lessen your likelihood of an infection or a recurrence.
- Use mild, unscented soaps and avoid any products with harsh chemicals or scents (including scented tampons).
- Avoid douching.
- Wear breathable, natural underwear (cotton is a good choice) and change it regularly.
- Clean your sex toys after each use.
- Limit your number of sex partners.
Get Treatment for Yeast Infection or BV Today with K Health
K Health provides a simple, accessible option for yeast infection or BV treatment. Chat with a doctor on your phone to determine whether you indeed have a yeast infection, and get a prescription sent straight to your pharmacy, all for just $23.