Yeast Infections Vs Bacterial Vaginosis (BV): How to Tell the Difference

When something is wrong with your vagina, there are a million places that your brain may go: STI, pregnancy, cancer. And it doesn’t help when many of the symptoms that people experience when something is off in their vagina are shared between hundreds of vaginal infections and conditions. Whilst we can’t tell you exactly what is going on when your vagina isn’t feeling the best version of itself, we can give you a comprehensive comparison between two annoyingly similar and common infections: yeast infections and bacterial vaginosis (BV). 

These two infections are easily confused and treated at home because of their similar symptoms. Both are uncomfortable and can cause discharge, itching, and irritation. However, understanding the differences between yeast infections and BV is very important since they both require different treatments in order to go away. Whilst common and very low risk to overall pelvic health, when left untreated or not dealt with properly, these infections can become even more of a nuisance and prevent you from getting back to the more important things. We hope this comparative guide distinguishes between the two and allows you to feel more informed the next time one of them pops up. 

What is a Yeast Infection?

A yeast infection, also known as vaginal candidiasis, is caused by an overgrowth of yeast, a type of fungus that naturally lives in small numbers in the vagina. When something disrupts the normal balance of bacteria and yeast, it can lead to an increase in yeast cells, resulting in infection. The condition is very common, affecting approximately 3 out of 4 individuals with uteruses at some point in their lives. 

Yeast infections often arise due to factors that upset this natural balance. 

Common triggers include:

• Antibiotic use can decrease beneficial bacteria.
• High estrogen levels from pregnancy or hormone therapy.
• Uncontrolled diabetes provides excess sugar that yeast thrives on.
• Wearing wet clothing for too long, like a swimsuit, or lifestyle factors such as stress and lack of sleep 

The symptoms of a yeast infection are typically easy to recognize. They often include:

• Intense itching and irritation around the vagina and vulva.
• A thick, white discharge that has a cottage cheese-like consistency and no odor.
• Pain or a burning sensation during urination or intercourse 

Yeast infections can often be treated with over-the-counter antifungal medications, like clotrimazole cream or fluconazole oral pills. However, some infections may require a doctor’s visit, especially if they recur frequently or if symptoms are severe. Complicated yeast infections—which may include swelling, sores, or tears—may need extended treatment. 

What is Bacterial Vaginosis?

Bacterial vaginosis is also caused by an overgrowth of bacteria in the vagina. Whilst a yeast infection is an overgrowth of a specific bacteria, BV is an overgrowth of a variety of pathogens such as Gardnerella spp, Prevotella spp., Mobilincus spp., Megaspahera spp., Sneathea spp., as well as mixed vaginal anaerobes species. While the vagina naturally contains a mix of different bacteria, an imbalance of certain strains can lead to BV. Certain behaviors increase the risk of BV, including douching, having multiple sexual partners, or using an intrauterine device (IUD) for birth control. BV is more common in sexually active individuals, though it’s not considered a sexually transmitted infection. 

BV symptoms include:

• A thin, off-white, gray, or greenish discharge.
• A strong, fishy odor, especially noticeable after intercourse.
• Itching and irritation, and sometimes a burning sensation when urinating

Unlike yeast infections, BV requires treatment with antibiotics, such as metronidazole or clindamycin. Over-the-counter remedies that work for yeast infections won’t address BV because they do not target bacteria. Therefore, seeing a healthcare provider is essential for proper treatment. It’s also worth noting that BV can increase the risk of contracting sexually transmitted infections (STIs) and can lead to pelvic inflammatory disease (PID) if left untreated, which can have serious consequences for reproductive health. 

How Are Yeast Infections and BV Similar?

Yeast infections and BV share some overlapping symptoms, such as itching, irritation, and discharge. This can make it hard to tell the difference between the two without a medical evaluation. However, there are key differences that can help. 

Discharge

Yeast infections tend to produce a thick, white, odorless discharge, while BV discharge is typically thin, grayish, and has a noticeable fishy smell.

Causes

Yeast infections result from fungal overgrowth, while BV is due to bacterial imbalance.

Risk Factors

Yeast infections can occur from various physical factors like high sugar levels in diabetes, whereas BV is more associated with sexual activity and other behaviors that alter the bacterial balance.

Why Is It Important to Know the Difference?

Proper diagnosis is crucial because the treatments for yeast infections and BV are completely different. Using antifungal treatments on BV won’t help, and antibiotics for BV won’t address a yeast infection. Untreated BV may lead to complications such as STIs and PID, which can impact fertility. Yeast infections, while uncomfortable, don’t typically pose long-term health risks, though recurrent infections may require further medical attention.

Prevention Tips for Yeast Infections and BV

Taking preventive steps can help reduce the risk of both yeast infections and BV.

Wear breathable clothing

Cotton underwear and avoiding tight-fitting clothes help maintain a healthy environment. If you're on your period, consider a good quality period underwear - like the ones from Aisle.

Practice good hygiene

Washing the vulva with plain water and wiping from front to back can prevent infections.

Limit antibiotic use

Only use antibiotics when necessary, as they can disrupt the bacterial balance.

Avoid douching and scented products

These products can alter the natural pH and bacteria in the vagina, increasing the risk of infection 

Protected Sex 

Consistent use of condoms by all sex partners can reduce the risk of BV 

Whilst we know our bodies best, it is also important that we take precautions when self-diagnosing and treating symptoms are shared with many different vaginal infections. When in doubt, go to a doctor. It may seem like an annoying and timely detour, but this will ensure that clearing those infections is effective and correct.