Bacterial Vaginosis (BV) vs UTI: Symptoms, Causes, Treatment & More!

Some infections in the body can appear similar to others, making it difficult to distinguish between them. One example of this is bacterial vaginosis and urinary tract infections, which affect two areas of the body close to each other.

Despite their proximity, there are some crucial differences between these two infections. To help with these distinctions, we have compiled a guide comparing bacterial vaginosis vs. UTI so that you can see the difference between these two infections step-by-step.

Table of Contents

What Is a UTI?

A urinary tract infection (UTI) is a bacterial, viral, or fungal infection of the urinary tract, which consists of the urethra, ureters, bladder, and kidneys. While there are many variations in UTIs, they are most often due to a bacterial infection of the bladder.

What Is Bacterial Vaginosis (BV)?

Bacterial vaginosis (BV) results when there is an overgrowth of the bacteria naturally found in the vagina. Good bacteria play an essential role in the vagina and keep it safe from infection. However, if anything changes the chemistry of the vaginal pH level, there can be an increase in bacteria growth.

The most common bacteria in the vagina, and the most common cause of BV, is Gardnerella vaginalis, also known as G. vaginalis.

What Is the Difference Between BV and UTI?

While bacteria cause both BV and UTIs, there are some key differences between these two infections, including what part of the body they affect, their symptoms, and what treatment entails.

Symptoms

The symptoms most commonly associated with a UTI include:

  • burning sensation or pain when urinating
  • frequently needing to urinate
  • urgently needing to urinate
  • feeling as though you cannot completely empty your bladder
  • foul-smelling urine
  • cloudy or bloody urine

In comparison, many people with BV may not have any symptoms. If they do have symptoms, they often come and go or are so mild that someone may not even notice them. For example, there may be a slight burning or itching when peeing, but most people do not experience any discomfort or irritation.

Diagnosing

UTIs can be diagnosed through a urine sample. The urine is examined under a microscope, and the laboratory technicians look for bacteria or white blood cells, which indicate an infection.

A healthcare provider may also use a urine culture to detect and identify the bacteria in the urine, which can aid in finding the proper antibiotic.

However, many UTIs can be diagnosed solely based on symptoms.

As for BV, a diagnosis often begins with a pelvic exam where a doctor visually checks the vagina for signs of infection.

They may also take a sample of vaginal secretions to check for bacterial overgrowth. They check this by placing the vaginal secretions under a microscope where they can look for “clue cells,” which are vaginal cells covered in bacteria.

A doctor can also check for BV by checking the acidity of the vagina. This is done by placing a pH strip in the vagina, with a pH of 4.5 or higher signifying BV.

Discharge

The primary symptom of BV is lots of thin vaginal discharge with a very strong fishy smell that is more noticeable after vaginal sex. The discharge can be dull gray, white, foamy, or greenish.

In comparison, UTIs do not cause vaginal discharge.

However, some clear or white discharge with a mild odor is a normal fluid produced by the vagina, so discharge in general is not always a sign of infection. 

Additionally, other vaginal infections, such as yeast infection, can cause discharge, so general discharge is not always a sign of BV. This is why it is important to consider the color, consistency, and odor of the discharge,  

Causes

Both BV and UTIs are caused by bacteria, with the bacteria most often causing BV G. Vaginalis, and E. coli the bacteria that most often cause UTIs. However, there are certain actions that can increase the risk of these bacteria becoming present and causing an infection.

Changing pH Levels

BV can be caused by anything that affects vaginal pH levels, such as douching or using vaginal deodorants. This is because when vaginal pH changes, the balance between good and bad bacteria shifts, allowing the bad bacteria to overrun the good bacteria.

Sexual Activity

Sexual intercourse is a risk factor for both UTIs and BV. With UTIs, sex increases the risk of introducing bacteria from the anus to the urethra. With BV, the genital chemistry of a partner can change the balance within the vagina, resulting in bacterial overgrowth.  

The birth control method used can also increase the risk of a UTI, with spermicide and diaphragms connected to an increased presence of UTIs.

Additionally, a risk factor for BV is having multiple sexual partners. Scientists are not entirely sure why this increases the risk for BV, but BV more often occurs in women with multiple sex partners or a new sex partner. Women who have sex with women are also more likely to develop BV.

Not using a barrier method (i.e., a condom) also increases the risk of bacteria from a partner infecting the vagina.

Catheter Use

A catheter is a tube that drains urine from the bladder, and its use has been shown to increase UTI risk.

Treatment

Both UTIs and BV are treated with antibiotics. However, UTIs are only prescribed as oral antibiotics (or intravenous in the case of a kidney infection), whereas BV antibiotics may be oral or a gel/cream applied to the vagina.

The most common antibiotics for UTIs are nitrofurantoin, trimethoprim/sulfamethoxazole, and Fosfomycin. The most common antibiotics for BV are clindamycin and metronidazole.

For both infections, it is crucial to complete the entire course of antibiotics to prevent a recurrent infection. This is important even if symptoms have gone away, as bacteria may still be present.

Complications

If a UTI is left untreated, it can develop into a kidney infection, which is a much more severe infection. Since the kidneys directly interact with the blood, the bacteria can spread from the kidneys to the bloodstream, resulting in widespread bodily infection, a condition known as sepsis.

It is not typical for BV to cause complications. However, one complication that can occur in pregnant women is preterm birth.

BV also makes women more susceptible to sexually transmitted infections, such as herpes, HIV, gonorrhea, or chlamydia. In some cases, BV can cause pelvic inflammatory disease (PID), which infects the fallopian tubes and uterus and can increase the risk of infertility.

Can BV Feel Like a UTI?

In some cases, those with BV may experience a burning sensation when urinating, which is a symptom shared with UTIs.

If the other symptoms are not present, this may cause someone to think they have a UTI when, in reality, they have BV.

Can You Have Bacterial Vaginosis (BV) and a UTI at the Same Time?

Since BV and UTIs impact different parts of the body, it is possible for some very unlucky women to have both at the same time.

Additionally, because the microbiomes of the vagina and urinary tract are interconnected due to the proximity of the urethra to the vagina, it is possible that persistent bacterial vaginosis can cause recurrent UTIs. Part of this is because the bacteria most often responsible for BV, G. Vaginalis, can reactivate the gene expression of E. coli, which is the bacteria that most often causes UTIs.

A study on 174 women with complaints of vaginal discharge found that 58 of these women had BV and UTI. Additionally, the study found that women with BV are 13.75 times more likely to have a UTI than women without BV.

How to Prevent BV and UTIs?

There are many actions someone can take if they suffer from recurrent BV, UTIs, or both. For BV, prevention focuses on maintaining a good pH in the vagina, whereas UTI prevention focuses on good urinary health and hygiene.

Avoid Douching

When it comes to preventing BV, the key is avoiding anything that can alter vaginal pH levels. These pH levels are crucial for maintaining a healthy balance of good bacteria. One of the biggest things that alters vaginal pH is douching, so it is never recommended to complete this.

Additionally, douching does not help to clear up an infection if it is already present. And for those with a UTI, douching may actually send the infection further into the urinary tract.

Promote Good Urinary Flow

As for UTIs, prevention lies around the urinary system. One of the most significant prevention methods is ensuring you drink enough water and urinate whenever needed. This helps to flush out the urinary tract regularly and prevents bacteria from having excessive time to grow and reproduce.

Try Probiotics

The bacterial composition of the vagina is crucial for preventing both BV and UTIs, since the bacteria in the vagina help to fight E. coli that finds its way there. The best way to promote good bacterial balance is by taking probiotics, which encourage the growth of “good” bacteria.

Foods high in probiotics include:

  • yogurt
  • kefir
  • sauerkraut
  • kimchi
  • tempeh
  • kombucha
  • miso
  • pickles

Probiotics can also be taken as a supplement.

Practice Good Hygiene

When it comes to preventing UTIs, wiping from front to back after a bowel movement is key. Additionally, women should urinate after having sex to remove any bacteria that may have made their way into the urinary tract.

Avoid Harsh Soaps

Using harsh soaps or other chemicals near the vagina can impact its pH levels, which can then kill off the good bacteria keeping everything healthy. Instead, opt for a mild, fragrance-free cleanser and warm water, and cleanse only the outside of the vagina.

When to See a Doctor?

Since untreated BV increases the risk of STIs, and untreated UTIs can develop into kidney infections or sepsis, it is always recommended to visit a doctor if you suspect you have either of these conditions.

Because of the potential complications that can occur in pregnant women with BV or UTI, it is crucial for these women to see a doctor if any unusual symptoms are observed.

Additionally, you will want to see a doctor whenever there is a change in your vaginal discharge, especially if it is associated with an odor or fever.

If you were prescribed an antibiotic for BV or UTI and still have symptoms after finishing it, be sure to visit your doctor again. Symptoms that persist after taking an antibiotic may be a sign of antibiotic resistance, which requires a different type of antibiotic to clear the infection.

Get Help From an Online Doctor!

For those looking for a convenient way to discuss your symptoms and receive an antibiotic prescription, online doctors are key. With DrHouse, you can meet with an online doctor in just 15 minutes, no matter where you are. While an online doctor cannot perform diagnostic tests for UTIs or BV, they can listen to your symptoms, which in many cases may be all they need to make a diagnosis and prescribe antibiotics.

Key Takeaways

BV and UTIs are two types of infections that may be mixed up due to the proximity in the areas they affect. However, a UTI infects the urinary tract, whereas BV infects the vagina. This causes different symptoms, although some people with BV may experience burning when urinating, which can be mistaken for a UTI.

Because the vagina and urethra are so close, some cases of BV may cause recurrent UTIs. It’s also possible to have both infections at the same time.

Treatment for both BV and UTIs consists of antibiotics, although the antibiotics used for each infection differ. Additionally, prevention of these infections centers on the system where they originate. For example, preventing UTIs focuses on good urinary health, while BV prevention revolves around maintaining proper vaginal pH.

For those unsure if they have BV or a UTI, an online doctor can provide a diagnosis based on your symptoms and prescribe the corresponding antibiotic to help you feel better.

References

DrHouse articles are written by MDs, NPs, nutritionists and other healthcare professionals. The contents of the DrHouse site are for informational purposes only and are not a substitute for professional medical advice, diagnosis, or treatment. If you are experiencing high fever (>103F/39.4C), shortness of breath, difficulty breathing, chest pain, heart palpitations, abnormal bruising, abnormal bleeding, extreme fatigue, dizziness, new weakness or paralysis, difficulty with speech, confusion, extreme pain in any body part, or inability to remain hydrated or keep down fluids or feel you may have any other life-threatening condition, please go to the emergency department or call 911 immediately.

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