Jessica is a medical writer with an unquenched thirst to discover something new. She believes that medical content should be accessible to everyone and strives to write content that every single person can understand. When Jessica isn’t writing, she can usually be found reading a book with a dog cuddled in her lap. Jessica has a Masters of Engineering degree in Biomedical Engineering.
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Amy is a Board Certified Family Health Nurse Practitioner (FNP) with over 15 years of experience working in Hospital Medicine, Urgent Care and Primary Care practices. Amy graduated Thomas Jefferson University with high distinction earning a Bachelor of Science in Nursing in 2008, a Master of Science in Nursing in 2010 and a Post Master's Certificate in Adult Gerontology Acute Care (AGAC) in 2014. She was recognized by the Elite American Nurses Association in 2013 for her dedication, achievements and leadership in the field Nursing. She served as a clinical preceptor for a number of Nurse Practitioner students and enjoys teaching the bright minds of future NPs.
Two different types of vaginal inflammation (or vaginitis), yeast infections and bacterial vaginosis, commonly abbreviated to BV, both have very different symptoms, causes, and methods of treatment, therefore, it is essential to understand which one you are experiencing so you can get the right treatment.
Table of Contents
- Differences Between BV vs Yeast Infection
- What Are the Differences Between Bacterial Vaginosis (BV) and a Yeast Infection?
- Risk Factors
- How Long Do They Last?
- How to Prevent BV or Yeast Infections?
- When to See a Doctor?
- Key Takeaways
Differences Between BV vs Yeast Infection
|Bacterial Vaginosis (BV)
|Main symptoms include:
|Pain, itching, or vaginal burning. Itching around the outside of the vagina. Strong fish-like odor, especially after sex.
|Vaginal itching, irritation, pain, or soreness. Burning during intercourse or urination. Redness and swelling of the vulva.
|Common causes include:
|Douching (washing the inside of the vagina). Not using condoms. Having new or multiple sexual partners.
|Excessive antibiotic use, contributing to an imbalance in the vaginal flora. A weakened immune system. Disruption or changes in hormonal balance.
|The discharge is white and watery, often with a strong fishy smell.
|The discharge is either thick, white, and without odor, usually resembling watery cottage cheese.
|Risk factors include:
|Being sexually active or having concurrent STIs (sexually transmitted infections). Certain sexual practices, such as receiving oral sex or having sex with women. A raised vaginal pH, caused by menstruation, semen in the vagina, or using vaginal washes in the bath.
|Being pregnant. A lower immune system. Using medications like antibiotics, birth control pills, or steroids. Lifestyle factors, such as wearing wet or sweaty underwear or bathing suits.
|Is usually diagnosed by a vaginal exam by a qualified healthcare professional, similar to a regular gynecological checkup.
|Is usually diagnosed by a doctor or nurse by swabbing the vagina for examination.
|BV can only be treated by prescription antibiotics, such as pills or cream.
|Yeast infections in most cases can be treated without medical intervention, by a course of antifungal medication in the form of creams, pills, ointments, or suppositories.
What Are the Differences Between Bacterial Vaginosis (BV) and a Yeast Infection?
BV is a common cause of vaginal discharge, which may display some of the symptoms of an STI, but is not classed as one, however, having BV can increase the risk of getting an STI. BV is the most common vaginal condition in women between 15 and 44, and while the trigger for bacterial vaginosis is not known, symptoms of BV usually appear when there are changes in the vaginal pH that fosters bacterial growth.
A yeast infection is a fungal infection caused by the naturally occurring fungus Candida albicans. Vaginas contain a natural mix of yeast, including bacteria and candida; a yeast infection occurs when there is an imbalance between the two, specifically when there is a larger ratio of candida to bacteria. As the presence of bacteria such as lactobacillus helps the body fight infection, when the body has fewer bacteria and more yeast, this contributes to the yeast infection.
Ultimately, BV is bacterial and a yeast infection is a fungal infection, so you have to deal with them in different ways. While both are common types of vaginitis, they are two very distinct infections.
Common symptoms of BV include:
- Thin, gray, white, or sometimes green vaginal discharge.
- A strong smell of fish from the vagina.
- Vaginal itching and burning, either during urination or not.
It’s also important to note that over half of women do not display any signs or symptoms of BV, which is why it’s important to get it checked out, especially after changing sexual partners.
Yeast infection symptoms include:
- Itching or irritation around the vagina and/or vulva.
- Burning or pain when urinating.
- Discomfort or pain during intercourse.
- Soreness, blisters, redness, or swelling around the vulva and vagina.
- Abnormal vaginal discharge.
It’s important to note that yeast infections can display similar symptoms to other diseases. For example, the symptoms could be a sign of a sexually transmitted disease (STD) such as genital herpes. While in most people, symptoms of a yeast infection can be mild to moderate, there can be the likelihood of a complicated yeast infection. If you have any of the following, these could all be symptoms of a complicated yeast infection:
- Extensive swelling, itching, or redness.
- Are pregnant.
- Have a weakened immune system
- Have uncontrolled diabetes.
- The infection is caused by a less prominent fungus.
Developing BV can arise from a number of different risks. These include:
- Specific sexual practices, for example, oral sex or multiple sexual partners.
- Being sexually active, may or may not increase the risk of developing BV.
- Changing sexual partners regularly. It is also worth noting that women who have sex with women are at a greater risk of developing BV because they share similar vaginal bacterial patterns.
- Circumstances that raise the vaginal pH, such as menstruation, the presence of semen, and using vaginal products such as deodorant, washes, or antiseptics in the bath.
- Smoking increases susceptibility to BV and STIs.
- Ethnicity, as BV is more prevalent in black women than in caucasian women.
Risk factors that contribute to yeast infections do not relate to any underlying health problem, but some of the following are risk factors:
- Hormonal contraceptives, as women who use birth control methods containing estrogen may have a higher risk of yeast infections.
- A weakened immune system, as people who use certain medications like chemotherapy medications or steroids, or are experiencing conditions relating to weakened immune systems like HIV are more commonly associated with yeast infections.
- Uncontrolled diabetes, as women are at higher risk of yeast infections when blood sugar is not well controlled.
- Pregnancy, and while a yeast infection is not always the cause of vaginal discharge, it becomes more prominent during pregnancy.
- Using contraceptive devices such as diaphragms, IUDs (intrauterine devices), and vaginal sponges.
- Using lots of antibiotics, as antibiotics naturally strip the body of these beneficial bacteria that protect the body from infection.
BV is typically diagnosed by a doctor. To diagnose BV, a doctor will conduct some of the following practices:
- Examine the vagina for signs of infection, usually in the form of a pelvic exam. When the doctor examines for signs of infection they will insert two fingers into the vagina while also pressing the abdomen to look at the pelvic organs for any other signs of disease.
- Gain insight into your medical history. Because BV is predominantly transmitted through sex, the doctor will very likely ask about sexually transmitted infections, previous vaginal infections, as well as your sexual history.
- The doctor will also take a sample of your vaginal secretions to check for the overgrowth of bacteria. This may also involve checking the acidity of the vagina. As BV is assumed to be the result of an imbalance of acidity and alkalinity, a pH strip may be used. A pH of 4.5 or over is usually a sign of BV.
Diagnosing a yeast infection may also involve a visit to the doctor, but this is only if the patient has never had a yeast infection before or needs a professional opinion. The process of diagnosing a yeast infection is not always clear cut because while you may exhibit yeast infection symptoms in a mild to moderate manner, there can also be signs of a complicated yeast infection.
This is why, if you have any medical history of a compromised immune system, are pregnant, or have uncontrolled diabetes, your doctor may want to diagnose a yeast infection through some of the following methods:
- Discussing your medical history, for example, if you are pregnant, have had past vaginal infections or sexually transmitted diseases, or if you are experiencing a less common type of fungus.
- They may perform a pelvic exam by placing a speculum into the vagina to examine the cervix and the vaginal area. In addition, they may also send a sample of the vaginal fluid for testing.
If you are experiencing symptoms of complicated yeast infections, it’s important to identify if the fungus is a less common one and can treat the problem better. This is especially true if you are prone to recurrent yeast infections, which is classed as having more than 4 in the space of 12 months. Between 5% and 8% of women are known to have recurring yeast infections.
Treating BV may involve one or a combination of medications. There are a number of antibiotics used to treat BV including metronidazole, which may be taken as a pill or as a topical gel. Clindamycin is another common treatment, which is a medical cream inserted into the vagina. There are also other oral medications such as tinidazole and secnidazole.
Treating yeast infections will depend on the individual infection. Most people experience mild to moderate symptoms of a yeast infection and treatments for these types of infections will either be oral medication such as fluconazole, either taken in one single dose or in a course for between 3 and 7 days which you can get from a drugstore, pharmacy, or supermarket.
Antifungal medications such as terconazole and miconazole are available in a number of forms, such as pills and creams. If symptoms do not disappear or return within two months, this could be a sign of a complicated yeast infection, and a doctor may prescribe a longer dose of antifungal medication for up to 2 weeks or additional doses of an antifungal pill instead of creams or ointments.
How Long Do They Last?
BV is a common condition that can be treated successfully, but approximately 50% to 75% percent of women have no symptoms of BV, and does not cause other immediate health problems. If left untreated, it can increase your risk for:
- Sexually transmitted diseases.
- Infections after a procedure on the female organs, for example, a C-section or abortion.
- Pelvic inflammatory disease, can cause the risk of ectopic pregnancy or infertility.
- Can cause early labor when pregnant.
When treated, the symptoms of BV usually appear within 2 to 3 days. While it can resolve by itself without treatment, it can take longer to clear up and, in some cases, can return.
A mild yeast infection can clear up in as little as a few days and may not require treatment. Moderate or severe infections can take longer to clear, usually between 1 and 2 weeks.
Most infections disappear within a few days of starting treatment, but if a yeast infection is deemed to be a complicated one or you experience a number of yeast infections throughout the course of a year, you may want to speak to a doctor to make sure it isn’t something else.
Symptoms of a yeast infection can recur for a number of weeks but there may be other concerns such as BV, chlamydia, vulvitis, or other STIs.
How to Prevent BV or Yeast Infections?
Ensuring you know how to prevent BV or yeast infections will reduce the risks of developing these conditions. You can reduce the risk of developing BV by:
- Practicing consistent safe sex.
- Have a circumcised partner.
- Take hormone contraception, as a meta-analysis found that progesterone-only contraception and combined hormonal contraception were associated with a reduction in BV.
- Asking partners to be examined for BV.
- Avoiding douching.
- Wash the genital area with mild soap and water.
75% of women will get at least one yeast infection during their lifetime. While it’s not always possible to prevent yeast infections, practicing some of the following can make a big difference:
- Keep your body temperature low around the genitals, as raising the moisture around the vagina increases the possibility of a yeast infection.
- Wear dry clothes, especially if you spend a lot of time swimming or working out to lower the chances of infection.
- Wear breathable underwear or underwear that doesn’t hold onto moisture or heat.
- Changing pads or tampons regularly when on your period.
- Increase the level of good bacteria in your body, for example, by eating yogurts or consuming probiotics.
When to See a Doctor?
If you think you have BV, you should book an appointment with a doctor in some of the following circumstances:
- There is a new vaginal discharge with an odor.
- You’ve tried to treat yeast infections unsuccessfully.
- You’ve had a new sexual partner or multiple partners.
While yeast infections can clear up by themselves, you will need to see a doctor in the following circumstances:
- You develop other symptoms.
- You’ve never had yeast infection symptoms before.
- You’ve attempted to relieve your symptoms without success.
- You don’t know if you’ve got a yeast infection.
How Can DrHouse Help You?
At DrHouse, we understand that dealing with BV or yeast infections can be uncomfortable and embarrassing. Our team of medical professionals are here to provide support and expert advice on the best course of action for treating BV or a yeast infection.
We offer an on-demand telehealth service where you can see an online doctor within minutes and receive a diagnosis, treatment plan, and medication if necessary. Our online doctors are experienced and knowledgeable, so you can rest assured your care is in safe hands.
Which Is Worse, BV or Yeast Infection?
If left untreated, BV can cause a number of risks, such as sexually transmitted diseases, and can increase the risk of complications relating to pregnancy and infertility. Symptoms-wise, BV tends to be uncomfortable instead of painful. A yeast infection will display symptoms such as burning sensations, pain itching, and discomfort, but there are fewer risks of long-term complications.
Can You Test for BV or Yeast Infection at Home?
While it’s recommended to speak to a doctor for BV there are a number of over-the-counter testing kits which work by measuring the pH levels in the vagina. It is also possible to test for yeast infections with a similar type of kit that measures the pH level.
How to Tell the Difference Between Yeast Infection and BV?
The most common difference between a yeast infection and BV is in the discharge. Yeast infections can be mistaken for BV, but the one major difference between the symptoms of a BV and yeast infection is the color. BV discharge color is usually white and watery with a strong fishy smell, and yeast infections have a thick white discharge resembling cottage cheese, but without an odor.
Can a Yeast Infection Cause a Bacterial Infection?
Because a yeast infection is caused by the candida fungus and BV is a bacterial infection, these two are distinct from each other. A yeast infection cannot cause a bacterial infection.
Are BV and Yeast Infections Treated the Same Way?
Treating BV, like any other bacterial infection, involves antibiotics to lower the levels of the bacteria present in the vagina. Yeast infections are fungal infections and are usually treated with antifungal medications.
While both are classed as types of vaginitis, yeast infections, and bacterial vaginosis are both different infections.
Both have distinct symptoms that result in pain or discomfort and can both be treated. At DrHouse, we provide BV and yeast infection treatment online with our online consultation and prescription service. Identifying the symptoms of BV and yeast infections is pivotal so you can get the treatment you need.
Both BV and yeast infections are both treatable conditions, and it is important to get a professional opinion as soon as possible. BV, if left untreated and symptomless, can result in complications, and yeast infections that don’t go away by themselves can develop into complicated yeast infections, but there are treatments for both BV and yeast infections.
- Bacterial Vaginosis – CDC Basic Fact Sheet. Centers for Disease Control and Prevention (CDC). Available from: https://www.cdc.gov/std/bv/stdfact-bacterial-vaginosis.htm#
- Vaginal Candidiasis. Centers for Disease Control and Prevention (CDC). Available from: https://www.cdc.gov/fungal/diseases/candidiasis/genital/index.html
- Bacterial vaginosis. NHS. Available from: https://www.nhs.uk/conditions/bacterial-vaginosis/
- Yeast Infection. John Hopkins Medicine. Available from: https://www.hopkinsmedicine.org/health/conditions-and-diseases/candidiasis-yeast-infection
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- Aida Abd El-Razek & Gamila Ayoub & Fadwa Alhalaiqa & Ibtisam Al-Zaru, 2016. “Efficacy of Sodium Bicarbonate in Early Management and Reduce Vaginal Yeast Infection among Women in Jordan: A Quasi-Experimental Study,” Academic Journal of Life Sciences, Academic Research Publishing Group, vol. 2(5), pages 29-36, 05-2016.
- Zhou, X., Brown, C., Abdo, Z. et al. Differences in the composition of vaginal microbial communities found in healthy Caucasian and black women. ISME J 1, 121–133 (2007). https://doi.org/10.1038/ismej.2007.12
- Jeanne M. Marrazzo, Laura A. Koutsky, David A. Eschenbach, Kathy Agnew, Kathleen Stine, Sharon L. Hillier, Characterization of Vaginal Flora and Bacterial Vaginosis in Women Who Have Sex with Women, The Journal of Infectious Diseases, Volume 185, Issue 9, 1 May 2002, Pages 1307–1313, https://doi.org/10.1086/339884
- Kamlesh Singh, Basavaraj Kallali, Ajay Kumar, Vidhi Thaker. Probiotics: A review. Asian Pacific Journal of Tropical Biomedicine, Volume 1, Issue 2, Supplement, 2011, Pages S287-S290, ISSN 2221-1691. Available from: https://doi.org/10.1016/S2221-1691(11)60174-3.
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Jessica Guht Nov. 27, 2023
Jessica Guht Nov. 27, 2023