Dr. Caitlin Morin discusses and compares BV v. yeast infections. Sbe explains how symptoms and treatment options differ and shares tips for preventing both.
TL;DR: Dr.Caitlin Morin explains the key differences between bacterial vaginosis (BV) and yeast infections, covering symptoms, causes, treatments, and prevention. Learn how to recognize signs, when to seek care, and how to maintain vaginal health. Always consult your provider for an accurate diagnosis and treatment tailored to your needs.
- Vaginal discharge is normal and varies throughout the cycle.
- Yeast infection symptoms: thick, white discharge; itching; redness; burning.
- BV symptoms: thin, gray discharge; strong odor; mild irritation.
- Causes include bacterial or yeast imbalance, antibiotics, blood sugar, and sexual activity.
- Diagnosis: provider uses history, pelvic exam, pH, and swab tests.
- Treatment: yeast infections need antifungals; BV requires antibiotics.
- Pregnancy considerations: infections are more common; treatment differs.
- Boric acid may help in select cases under medical guidance.
- Prevention tips: breathable underwear, avoid douching/irritants, control blood sugar, limit antibiotic use.
- When in doubt, see your provider—accurate diagnosis ensures effective relief.
Ahhh! Summer is here. You’re packing your beach bag, dusting off your favorite sundress, and grabbing a delicious ice cold beverage.
All of a sudden…what’s that itch? What’s that odor? Something is not right “down there!”
Vaginal infections can be both uncomfortable and frustrating. Two common vaginal infections are yeast infections (Candidiasis) and bacterial vaginosis or “BV.”
Do you know the difference between BV vs. a yeast infection? How do you know if you have a yeast infection or BV? Why do we get these vaginal infections? What can we do to treat and prevent them?
In this guide, I’ll be providing the advice I give my patients about how to manage these conditions. With these tips, you’ll be experiencing relief in no time. Let’s dive in!
Is vaginal discharge normal?
Noticing discharge is not a sign for alarm on its own. Everyone has vaginal discharge!
The vagina is a very complex environment of bacteria and other organisms. A healthy vagina is rich in “good” bacteria called lactobacilli. These bacteria work to prevent other organisms from overgrowing. Your vagina produces discharge to keep itself clean and healthy.
What does normal vaginal discharge look like?
Normal vaginal discharge is clear-to-white in color and may have an earthy odor. This discharge may look yellow when it dries on underwear. Around the time of ovulation, there may be a noticeable increase in discharge for a few days. That’s usually about 2 weeks before your period.
What does a yeast infection look like?
Changes in your vaginal discharge may be one of the first signs that you’re dealing with a yeast infection or BV.
Discharge during a yeast infection may be:
- Thick and white, often described as “cottage cheese-like”
- Usually odorless
- May be accompanied by itching, burning, and redness
What does bacterial vaginosis look like?
In comparison, BV discharge may:
- Appear thin and grayish-white
- Have a strong, fishy odor, especially after sex
- Be accompanied by mild itching or irritation (less intense than with a yeast infection)
However, there are many other differences between a yeast infection and BV. You can’t (and shouldn’t!) try to diagnose yourself based on the appearance of your discharge alone. We’ll discuss other symptoms to look for below.
Why do vaginal infections like BV and yeast infections occur?
The organisms that cause yeast and BV live in the vagina. They are usually kept at healthy levels by the “good” bacteria (lactobacilli) that also lives there. The problem occurs when harmful bacteria, yeast, or other organisms grow uncontrolled. This imbalance is what leads to vaginal infections.
What’s the difference between bacterial vaginosis vs. yeast infection?
How do you know if you have BV or a yeast infection? Let’s explore the differences in BV symptoms vs. yeast infection symptoms. Then we’ll take a look at the specific causes of each infection.
Yeast Infection Symptoms vs. BV Symptoms
Symptoms of a yeast infection include:
- Thick discharge
- Vaginal soreness
- Irritation
- Itching
- Redness
- Swelling
- Burning
- Pain
BV symptoms include:
- Increased discharge
- Odor
- Irritation
Does BV itch like a yeast infection?
Yes, both infections can come with itching and irritation.
That’s why it’s challenging to accurately diagnose your condition using a single symptom.
It’s always better to get tested to ensure you receive the correct treatment. The sooner you see your doctor, the sooner you’ll experience relief!
When should I see a doctor for BV or a yeast infection?
It’s important to see your provider if you think you may have either of these vaginal infections. Everyone experiences vaginal infections differently. That means it can be difficult to tell if you have BV or a yeast infection based on your symptoms alone.
Only a physician can to correctly diagnose what type of infection is causing your symptoms. Treatment for each infection differs, and choosing the correct one matters!
Does bacterial vaginosis go away on its own?
In some rare cases, the vaginal environment can work its magic and rebalance itself naturally. This is more common in women who are not sexually active. However, it is never guaranteed that a bacterial infection like BV will go away on its own.
Likewise, over-the-counter yeast infection meds won’t work for BV. If you notice symptoms you think might be a BV infection, the best treatment is a prescription from your healthcare professional. Proper treatment can keep your BV from becoming a recurring problem.
If you experience BV during pregnancy, always see your physician as soon as you notice symptoms. Untreated BV during pregnancy is linked to complications like preterm birth. Also, women with recurrent or persistent symptoms should seek treatment as soon as possible.
Do yeast infections go away on their own?
In women with healthy immune systems, yeast infections can, on rare occasions, resolve on their own. However, we don’t recommend counting on this.
There are plenty of over-the-counter treatments available for home treatment. Prescription treatment is often a single pill! There’s no need to endure discomfort.
How are BVs and yeast infections diagnosed?
It’s normal to feel a little bit nervous before going to see your healthcare provider, especially if you’re worried that something may be wrong. It can help to understand what to expect during an appointment for a BV or yeast infection diagnosis.
You’ll begin by talking to your provider. We will ask you about your medical history and about any symptoms you’ve been experiencing. We might also ask you about recent antibiotic use, diabetes, or pregnancy.
Next, we will probably perform a pelvic exam. During the exam, we visibly examine you for signs of irritation and discharge. During the exam, we also take a swab of your discharge.
Sometimes, we can give you results the same day. Often, a lab culture is required, and you’ll typically have results within 3-5 days.
Causes of a yeast infection
Yeast can cause problems when it evades the vagina’s normal defense mechanisms and begins to overgrow. This overgrowth of yeast is what can cause an inflammatory reaction. It can occur for a variety of reasons, including:
- A weakened microbiome (decreased “good” bacteria)
- High sugar levels in the urine (often the case with women who have untreated, undiagnosed or poorly controlled diabetes)
- Taking medications or having medical conditions that suppress the immune system
- Trauma” to the vulvar/vaginal tissue from scratching, friction or sex
Causes of bacterial vaginosis
Bacterial Vaginosis occurs when there is a reduction in “good” bacteria, which leads to an overgrowth of “harmful” bacteria. BV infections can occur due to the following:
Environmental exposures
Spermicide, antibiotics, vaginal products, douching, and cigarette smoking all decrease the good bacteria. That can increase the likelihood of getting BV.
Menstrual cycles
Our good bacteria often binds to red blood cells. Thus, levels of good bacteria decrease significantly right after a menstrual cycle. Blood and bleeding can also change the pH of the vagina. That provides more nutrients for “harmful” bacteria to grow.
Sexual activity
The semen released by ejaculation can temporarily cause elevations in vaginal pH. Similar to blood, pH changes can help “harmful” bacteria grow.
Additionally, sexual partners can carry different bacteria. That bacteria can be transmitted to the delicate vaginal environment and disrupt its balance. Condoms can protect against BV, especially if BV infections seem to recur after intercourse.
BV is not a sexually transmitted infection itself. However, it can increase the chances of acquiring an STI such as gonorrhea, chlamydia or HIV.
How are yeast infections and BV treated?
As mentioned, yeast infections and BV have very different courses of treatment. Yeast infections are typically treated with antifungal medications, whereas BV is typically treated with antibiotics. Once you have been tested and your provider has diagnosed whether you have a yeast infection or BV, you can begin treatment.
Yeast Infection Treatment
Yeast infections are treated with a class of drugs called “azoles.” Azoles are creams and suppositories that are available over-the-counter. Monistat is one example. Creams and suppositories typically come in one-, three- and seven-day options.
The creams can often be soothing for symptoms. However, if the vulva/vagina is very inflamed, applying any product on the area can cause pain and burning.
A single-dose oral medication called fluconazole (Diflucan) is also available for yeast infection treatment with a prescription. The medication works for 72 hours.
Sometimes a second dose of the medication is recommended after 72 hours if symptoms are still present. Giving a second dose sooner is not necessary. It can take a full week for all of the inflammation and symptoms to subside.
BV Treatment
BV can be treated with antibiotics that work by killing the harmful bacteria. There are a few options for treatment.
An antibiotic pill called metronidazole can be taken twice daily for 7 days. Common side effects include GI upset and nausea. Some patients may experience a serious reaction (vomiting) if this antibiotic is taken with alcohol. It is recommended to avoid alcohol during treatment.
An antibiotic vaginal gel can be applied intravaginally, nightly for 7 days. This medication can produce a clumpy discharge that may be confused with yeast, although the actual risk for yeast is low. Contact your provider and get tested if you think you may have a yeast infection.
Do boric acid suppositories really treat vaginal infections?
In specific situations, boric acid may be an appropriate treatment for either of these vaginal infections.
Boric acid has two uses:
- It can treat specific types of yeast that are known to be resistant to commonly prescribed anti-yeast medications.
- It can treat recurrent bacterial vaginosis suspected to be caused by “biofilm.” Biofilms coat bacteria and make them resistant to antibiotics and regular treatment.
Boric acid can be irritating to the vaginal tissue. Always talk to your healthcare provider before starting boric acid supplements to make sure this is the right treatment for you.
Boric acid can be deadly if ingested, so make sure you store it away from children/pets. You should not have receptive oral sex within 24 hours of using boric acid supplements.
Susceptibility to vaginal infections during pregnancy
During pregnancy, lots of changes occur to the cervix, vagina and vulva–even as early as the first few weeks. Most women will notice they produce more discharge when they are pregnant. This is normal!
Pregnant women are at an increased risk of yeast infections and bacterial vaginosis. This may be due to the higher levels of estrogen and progesterone that your body produces during this time. It may also be caused by the mild immunosuppression that normally occurs with pregnancy.
Topical azoles (creams and suppositories) are the preferred treatment of yeast infections in pregnancy. That’s because there is currently some conflicting data about the safety of oral azoles during pregnancy. It is safe to treat BV with antibiotics during pregnancy.
Make sure to talk to your provider asap if you are pregnant and think you may have a vaginal infection.
How common are yeast infections and BV?
Yeast and BV infections are very common. Approximately 75% of women will have at least one yeast infection in their lifetime. Likewise, 30% of women will experience a BV infection.
This is even more of a reason to seek treatment if you’re uncomfortable! These infections are normal and not shameful!
How to prevent yeast infections and BV
You’re probably wondering, is there anything I can do to avoid getting these infections? There are lots of vaginal products at the grocery store and I’m confused…
The answer is yes! There are little things you can do to maintain a healthy vulvar/vaginal environment. All of these tips can potentially reduce your risk of getting an infection.
1. Avoid trapping moisture and causing friction to the vulva
Ways to do this:
- Avoid tight-fitting clothing
- Wear underwear made of breathable materials (cotton) that fits well (i.e. does not cause chaffing)
- Wear loose-fitting “boxers” or pajamas or no underwear at night
- Change out of wet swimsuits or sweaty workout clothes as soon as possible
- Avoid using only pads and pantyliners when you have your period. These products have a plastic backing and keep warmth and moisture close to the body. Consider trying “period underwear.”
2. Avoid irritants and vaginal “cleaning”
Your vagina does its own self-cleaning. Vaginal cleaning products and douching can disrupt this process. Pass on “feminine hygiene” sprays, wipes, washes, or soaps (e.g. Summer’s Eve, Vagisil, etc). I promise your vagina does not need to smell like a tropical breeze in order to be healthy.
These products contain tons of irritants and have no medical benefits. Even the “sensitive skin” products contain irritants. Use water only or a gentle facial cleanser like Cereve or Cetaphil to clean the vulva (the area outside the vagina). Do not douche.
3. Use a laundry detergent that is in the “free and clear” category
Certain detergents can irritate the vagina. Avoid fabric softeners and dryer sheets – use dryer balls instead.
4. Maintain blood sugar levels
Yeast loves to feast on sugar! If you are diabetic, make sure you are maintaining normal blood sugar levels. If you have recurrent yeast infections, ask your doctor if you should be tested for diabetes.
5. Avoid antibiotics unless necessary
Antibiotics can wipe out your “good” bacteria, allowing other organisms to overgrow and cause infections. That said, if you need antibiotics, you need them. You should never stop your antibiotics prematurely if you think you have a vaginal infection.
Your provider can help you clear an infection quickly and safely
If you think you have a vaginal infection, talk to your provider. Taking medications for an incorrect self-diagnosis can lead to vulvar reactions and inflammatory skin conditions. Both of these things can make symptoms much worse.
It is essential to properly diagnose the right infection. That way, we can properly treat you and help you get back to enjoying the rest of your summer!
To make an appointment with an OB/GYN provider at one of our Richmond, VA, locations, call VPFW at 804-897-2100 or message us to schedule online.
