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Posted by Alex Jordan

Bacterial vaginosis vs. yeast infection: How to tell the difference

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Medically reviewed by Dr. James Ryan
4 minute read

Vaginal health is important, but it can be confusing to tell the difference between bacterial vaginosis (BV) and yeast infections. Both are common vaginal infections, but they have different causes, symptoms, and treatments. This guide will help you understand how to spot the difference and what to do about it. 

Causes of vaginal infections 

The main differences between bacterial vaginosis (BV) and yeast infections are the causes, symptoms, and treatments: 

  • Bacterial vaginosis is caused by an overgrowth of bacteria in the vagina, typically Gardnerella vaginalis [1][2][3]. 
  • Yeast infections are caused by an overgrowth of the fungus Candida [1][2][3]. 

Symptoms of bacterial vaginosis and yeast infections 

Bacterial vaginosis symptoms 

  • Discharge: Thin, grey, yellow, or green with a fishy odour [1][2][3][4]. 
  • Itching and irritation: Usually absent, though some women might experience mild itching or irritation [2][3]. 

Yeast infection symptoms 

  • Discharge: Thick, white, and clumpy with no odour [1][2][3]. 
  • Itching and burning: Severe itching and burning around the vaginal area [1][2][3]. 
  • Redness and swelling: The vulva may appear red and swollen, sometimes feeling sore [1][2][3]. 

How bacterial vaginosis and yeast infections differ 

BV and yeast infections differ mainly in their causes, symptoms, and treatments: 

  • Causes: BV is bacterial, while yeast infections are fungal [1][2][3]. 
  • Symptoms: BV often has a fishy-smelling discharge without itching, whereas yeast infections have thick discharge with significant itching and redness [1][2][3]. 
  • Treatments: BV requires antibiotics, whereas yeast infections are treated with antifungal medications [1][3]. 

Diagnosis of vaginal infections 

Proper diagnosis is key for effective treatment, and both conditions need a visit to a doctor. 

  • Bacterial vaginosis: Diagnosis often includes a pelvic exam, testing the pH of vaginal discharge, and examining it under a microscope [2][3]. 
  • Yeast infection: Diagnosis involves a pelvic exam and examining the discharge under a microscope to spot Candida [2][3]. 

Treatments for bacterial vaginosis and yeast infections 

  • Bacterial vaginosis: Treated with antibiotics like metronidazole or clindamycin [1][3]. 
  • Yeast infections: Treated with over-the-counter antifungal medications or prescription oral or topical antifungals [1][3]. 

If you suspect you have either condition, it's best to see a doctor for proper diagnosis and treatment. Trying to self-diagnose can be difficult since the symptoms can overlap. Untreated BV and yeast infections can lead to complications, so it's important to get the right treatment. With proper treatment, symptoms should clear up within a few days. 

Prevention strategies for vaginal infections 

Maintain vaginal hygiene 

  • Avoid douching, which can disrupt the vagina's natural pH and bacterial balance [1][4]. 
  • Wipe from front to back after using the bathroom to prevent spreading bacteria [1]. 
  • Change tampons, pads, and liners frequently during your period [1][4]. 
  • Avoid scented vaginal products like sprays, wipes, and deodorants [1][4]. 

Wear breathable underwear 

  • Choose cotton underwear and loose, breathable fabrics to allow airflow and prevent bacterial overgrowth [4]. 
  • Change out of sweaty workout clothes or wet swimsuits as soon as possible [4]. 

Practice safer sex 

  • Use condoms during sex to prevent the spread of bacteria between partners [2][5]. 
  • Avoid having multiple sex partners, as this increases BV risk [2][5]. 
  • Clean sex toys thoroughly after each use [4]. 

Take probiotics 

  • Probiotics containing Lactobacillus strains may help maintain a healthy vaginal microbiome and prevent BV recurrence [1][3]. 
  • Consult your doctor about taking a probiotic supplement [3]. 

Consider boric acid suppositories 

  • Boric acid capsules inserted into the vagina may help treat recurring BV when used in addition to antibiotics [4]. 
  • Only use boric acid as directed by your doctor, as it can cause irritation if used incorrectly [4]. 

Maintaining a healthy vaginal pH 

Maintaining a healthy vaginal pH balance is crucial for preventing infections like bacterial vaginosis (BV) and yeast infections: 

  • The normal vaginal pH is slightly acidic, around 3.8-4.5. This acidic environment helps keep harmful bacteria and fungi in check [1][2]. 
  • The acidity is maintained by beneficial lactobacilli bacteria that produce lactic acid. This acidic pH creates an inhospitable environment for pathogens like Gardnerella vaginalis (which causes BV) and Candida (which causes yeast infections) [1][3]. 
  • When the vaginal pH becomes less acidic, it allows overgrowth of these harmful bacteria and fungi, leading to infections. Factors like antibiotics, douching, hormonal changes, and semen can disrupt the pH balance [1][2][3]. 
  • Maintaining good vaginal hygiene, avoiding douching, wearing breathable underwear, and using condoms during sex can help preserve the acidic vaginal pH and prevent infections [2][4]. 

Knowing the difference between bacterial vaginosis and yeast infections is important for getting the right treatment. Both conditions are common and treatable, but proper diagnosis and following treatment plans are essential. 

How HealthHero can help 

HealthHero offers comprehensive information and support for vaginal health. Our online prescription service for bacterial vaginosis makes it easy to get the right treatments. Visit our online prescriptions page for bacterial vaginosis to learn more about how we can assist you in keeping your vaginal health in check.