Vaginal itching, burning, unusual discharge, and changes in odor are common concerns for many women. Two of the most frequent causes of these symptoms are vaginal yeast infections and bacterial vaginosis (BV).
Although both conditions can cause vaginal discomfort and changes in vaginal discharge, they have different causes and require different treatments. Knowing the differences between a yeast infection and bacterial vaginosis can help you understand your symptoms and recognize when medical evaluation may be necessary.
What Is a Vaginal Yeast Infection?
A vaginal yeast infection, medically known as vulvovaginal candidiasis, occurs when a type of fungus called Candida grows excessively in the vagina.
Candida can normally be present in the vaginal environment without causing problems. When the natural balance of microorganisms changes, the yeast may multiply and cause inflammation and irritation.
Yeast infections are common and are generally treatable with antifungal medication.
What Is Bacterial Vaginosis?
Bacterial vaginosis, commonly called BV, occurs when there is an imbalance in the bacteria normally found in the vagina.
Unlike a yeast infection, BV is not caused by a fungus. It develops when certain types of vaginal bacteria become more abundant than others, changing the normal vaginal environment.
BV is not classified as a sexually transmitted infection, although sexual activity can influence the risk of developing it.
Yeast Infection vs. Bacterial Vaginosis: What Is the Difference?
The symptoms of a yeast infection and BV can sometimes overlap, but there are several important differences.
A yeast infection is more likely to cause intense itching, redness, swelling, irritation, and thick white vaginal discharge. The discharge may have a consistency similar to cottage cheese and typically does not have a strong odor.
Bacterial vaginosis, on the other hand, is more commonly associated with thin vaginal discharge that may appear white, gray, or slightly greenish. A noticeable fish-like vaginal odor is one of the most characteristic symptoms of BV, particularly after sexual intercourse.
It is important to remember that symptoms alone cannot always determine which condition is present. Some women may have mild symptoms or even no symptoms, particularly with BV.
Symptoms of a Yeast Infection
Common symptoms of vaginal candidiasis include:
- Intense vaginal or vulvar itching
- Burning or irritation
- Redness and swelling
- Thick, white vaginal discharge
- Discharge that may resemble cottage cheese
- Pain or discomfort during sexual intercourse
- Burning during urination when urine comes into contact with irritated tissue
A strong vaginal odor is generally not typical of a yeast infection.
Symptoms of Bacterial Vaginosis
Bacterial vaginosis may cause:
- Thin vaginal discharge
- White or gray discharge
- A noticeable fish-like odor
- Odor that may become stronger after sex
- Mild vaginal irritation or itching in some women
Many women with BV do not experience noticeable symptoms, which means the condition can sometimes be present without the woman realizing it.
What Causes Yeast Infections?
Several factors can increase the likelihood of developing a vaginal yeast infection.
These may include:
- Recent antibiotic use
- Pregnancy
- Hormonal changes
- Uncontrolled diabetes
- A weakened immune system
- Certain medications
- Changes in the vaginal environment
Yeast infections are not considered sexually transmitted infections.
What Causes Bacterial Vaginosis?
The exact cause of bacterial vaginosis is not completely understood. It occurs when the normal balance of bacteria in the vagina changes.
Factors that may increase the likelihood of BV include:
- Having a new sexual partner
- Having multiple sexual partners
- Douching
- Changes in the vaginal microbiome
BV can occur in women who are not sexually active, so having BV does not automatically mean that an STI is present.
How Are Yeast Infections and BV Diagnosed?
Because several vaginal conditions can produce similar symptoms, an accurate diagnosis may require a medical evaluation.
A healthcare provider may:
- Ask about your symptoms and medical history
- Perform a pelvic examination
- Examine a sample of vaginal discharge
- Check vaginal pH
- Perform laboratory testing for yeast or bacterial vaginosis
- Test for sexually transmitted infections when appropriate
Proper diagnosis is important because the treatments for yeast infections and BV are different.
How Is a Yeast Infection Treated?
Vaginal yeast infections are treated with antifungal medications.
Depending on the patient’s circumstances, treatment may include vaginal antifungal creams or suppositories, oral antifungal medication, or prescription treatment for recurrent or complicated infections.
Pregnant women should consult their healthcare provider before using medication to treat vaginal symptoms.
How Is Bacterial Vaginosis Treated?
Bacterial vaginosis is generally treated with antibiotics.
Treatment may involve oral or vaginal medication prescribed by a healthcare professional. It is important to follow the prescribed treatment instructions and complete the recommended course.
Antifungal medications used for yeast infections do not treat bacterial vaginosis.
Can You Have a Yeast Infection and BV at the Same Time?
Yes. A woman can have both a yeast infection and bacterial vaginosis at the same time.
If symptoms are unusual, severe, recurrent, or do not improve after treatment, additional testing may be necessary to determine whether there is more than one infection or whether another condition is causing the symptoms.
Can BV or a Yeast Infection Be an STI?
Neither BV nor a vaginal yeast infection is classified as an STI.
However, sexual activity can influence the risk of BV, and some sexually transmitted infections can cause symptoms that resemble a yeast infection or bacterial vaginosis.
If you have a new sexual partner, unusual symptoms, or possible exposure to an STI, your healthcare provider may recommend appropriate testing.
Can Yeast Infections or BV Affect Pregnancy?
Both conditions can occur during pregnancy. However, bacterial vaginosis is particularly important to diagnose and manage because symptomatic BV during pregnancy can be associated with certain pregnancy complications.
Pregnant women experiencing new vaginal discharge, odor, itching, or irritation should speak with their healthcare provider before taking medication.
When Should You See a Doctor?
You should consider scheduling an appointment with a healthcare professional if:
- You are experiencing vaginal symptoms for the first time.
- You are unsure whether you have a yeast infection or BV.
- Symptoms do not improve after treatment.
- Symptoms repeatedly return.
- You experience unusual vaginal bleeding.
- You have pelvic or abdominal pain.
- You develop a fever or feel significantly unwell.
- You may have been exposed to an STI.
- You are pregnant and develop new vaginal symptoms.
Repeatedly treating yourself without confirming the cause can delay the diagnosis of another infection or gynecological condition.
Frequently Asked Questions About Yeast Infections and BV
How can I tell if I have a yeast infection or BV?
A yeast infection is more commonly associated with intense itching, irritation, redness, and thick white discharge. BV is more commonly associated with thin discharge and a fish-like odor. However, symptoms can overlap, so testing may be necessary.
Does BV smell worse than a yeast infection?
BV commonly causes a noticeable fish-like odor, while yeast infections generally do not cause a strong vaginal odor.
Can a yeast infection go away on its own?
Some mild infections may improve, but symptoms can persist or return. If you are unsure about the cause of your symptoms, medical evaluation can help determine the appropriate treatment.
Can bacterial vaginosis go away on its own?
Symptoms can sometimes fluctuate, but persistent or symptomatic BV should be evaluated by a healthcare professional to determine whether treatment is appropriate.
Can I treat BV with yeast infection medicine?
No. Antifungal medications treat yeast infections and do not treat bacterial vaginosis. BV generally requires antibiotic treatment.
Should I see a doctor if vaginal symptoms keep coming back?
Yes. Recurrent symptoms should be evaluated to confirm the diagnosis and determine whether another infection or gynecological condition may be responsible.
Take the Next Step for Your Women’s Health
Yeast infections and bacterial vaginosis are common and treatable conditions, but they have different causes and require different treatments. While itching, discharge, and odor can provide clues, symptoms alone are not always enough to determine the cause.
This article is intended for general educational purposes and should not replace professional medical evaluation, diagnosis, or treatment.
