Bacterial Vaginosis Vs. Yeast Infections: Differences and Similarities

While they’re both different types of “vaginitis” (or vaginal inflammation), bacterial vaginosis (BV) and yeast infections have very different causes, symptoms and treatments. While both can be treated without severe long-term effects, it’s important to know which of the two you’re dealing with.

A vagina is full of both “good” and “bad” vaginal flora, or bacteria. Bacterial vaginosis is the result of the bad, or anaerobic bacteria disrupting that balance and becoming overgrown. It could be caused by several types of bacteria, but the typical overgrowth is due to the Gardnerella vaginalis bacteria. With BV, a doctor may find that the pH of the area is higher than 4.5.

The main difference between a BV vs yeast infection is that yeast infections are fungal – typically the result of the Candida fungus in the vagina.

Both of these types of vaginitis are very common, with three out of every four women experiencing a yeast infection in their lifetime. Other types of diseases like trichomoniasis are sometimes confused for a yeast infection or BV, which is why it is not always advised to do self-diagnosis for these symptoms. We recommend a pelvic exam for anyone with an ongoing issue.

Bacterial Vaginosis vs Yeast Infection Symptoms

Both these forms of vaginitis are typically accompanied by vaginal itching, burning sensations and discomfort, with a few key differences in symptoms. There is one typical, major difference between symptoms of a yeast infection vs BV: discharge color. Beyond that, the other key difference is the odor.

Vaginal Bacterial Infection Symptoms

• A fishy odor, which gets stronger during menstruation and after sex
• Burning sensations while urinating
• Discomfort
• Itching
• Thin yellow, white, gray or even greenish discharge

Difference #1: The bacterial vaginosis discharge color can be white, gray, yellow or greenish and is typically thin.

Difference #2: There is not typically redness or inflammation around the vaginal opening or on the vulva, as with a yeast infection.

Difference #3: BV tends to be uncomfortable rather than painful. Pain or burning during sex may be an indication that it’s a yeast infection.

Yeast Infection Symptoms

• Burning sensations while urinating
• Burning sensations during intercourse
• Pain or discomfort
• Itching
• Redness/swelling around the vaginal opening and/or vulva
• Thick, white, clumpy discharge

Difference #1: The typical yeast infection discharge color is white with a thick, clumpy texture like cottage cheese.

Difference #2: There is not typically a specific odor associated with yeast infections.

Causes and Risk Factors

As they’re very different issues, a BV or yeast infection are caused by very different things. But a sudden change in your vaginal flora may be caused by numerous factors, and should not be accompanied by shame. We’ve also covered some ways to prevent these issues from arising in the future.

BV Causes

• Douching or rinsing out your vagina with water or a cleansing agent typically disrupts the normal vaginal environment. It may strip away the good bacteria or introduce new bad bacteria. This is one of the most common causes of bacterial vaginosis.
• Sudden hormonal changes, like pregnancy, menopause and menstruation, may change your vaginal pH and trigger BV.
• Intercourse with a new partner may introduce new bacteria to the area or change your vaginal pH, especially intercourse without a condom.
• Smoking also can be a risk factor of BV.

Yeast Infection Causes

• Taking regular antibiotics may lead to the decrease in the “good” (or lactobacillus) bacteria causing yeast to grow.
• Taking birth control pills that contain estrogen can sometimes lead to yeast infections.
• Major hormonal changes including pregnancy may lead to a yeast infection.
• People with diabetes or high blood sugar are more likely to contract one.
• People with weakened immune systems are more likely to contract one.

Preventative Steps for Both Types of Vaginitis

• Swap tight-fitting clothing like jeans, leggings or underwear for loose, moisture-wicking cotton underwear and loose-fitting clothes.
• Avoid douching or rinsing the vagina.
• Avoid scented feminine hygiene products, like tampons or scented soaps.
• Avoid remaining in wet clothes or bathing suits after swimming.
• Avoid remaining in hot tubs or hot baths for extended periods of time.
• Wipe from front to back after using the restroom.
• Wear condoms during intercourse and properly clean any toys.
• Consider taking probiotics to encourage the “good” bacteria in your vaginal flora.

Treatment

BV is typically treated by antibiotics (like Metronidazole, Clindamycin and Tinidazole).

Yeast infections are typically treated with antifungal medications (like Miconazole, which is an over-the-counter medication, and Fluconazole). Severe yeast infections may require a long course of antifungal meds or special treatments.

If the discomfort and itching persist, it’s important to get a pelvic exam from a gynecologist to rule out a BV or more serious issues. Your gynecologist may test the pH of your vagina or take a sample of secretions to be examined under a microscope in order to make a diagnosis of a BV or yeast infection. Schedule an appointment to speak with a doctor in the future.