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Bacterial Vaginosis vs. Yeast Infection: Which Is It?

by | Feb 28, 2024 | Blog, Sexual Health

a woman curios about identifying a condition - Bacterial Vaginosis or Yeast Infection

Key Takeaways


  • Differentiating Symptoms: BV has a fishy odor and thin discharge; Yeast Infections cause intense itching and thick discharge.
  • Causes: BV is linked to bacterial imbalance, while Yeast Infections stem from Candida overgrowth.
  • Risk Factors: Sexual activity and douching raise BV risks; antibiotics and hormonal changes increase Yeast Infection risks.
  • Prevention Tips: Good hygiene, breathable clothing, and dietary adjustments can prevent both conditions.
  • Seek Professional Help: Self-misdiagnosis can lead to ineffective treatment; hence, consulting a healthcare provider for an accurate diagnosis and appropriate treatment is crucial.

Bacterial Vaginosis (BV) and Yeast Infections are two of the most common vaginal infections affecting women. BV, caused by an imbalance of bacteria in the vagina, and Yeast Infections, typically caused by an overgrowth of yeast, present distinct symptoms and require different treatment approaches.

Understanding Bacterial Vaginosis (BV) and Yeast Infection

Bacterial Vaginosis (BV), also known medically as Gardnerella vaginitis, is characterized by an imbalance of vaginal flora, leading to excessive growth of certain bacteria species such as Gardnerella vaginalis.[1] Yeast Infection, scientifically referred to as vulvovaginal candidiasis, is primarily caused by an overgrowth of Candida species, particularly Candida albicans.


General Prevalence

Both BV and Yeast Infection are among the most frequent types of vaginal infections worldwide. Approximately one out of three women experience BV at least once in their lifetime, while up to 75% of females may encounter a Yeast Infection at some point.[2],[3]


Common Symptoms Comparison


Symptoms Bacterial Vaginosis (BV)  Vaginal Yeast Infection
Discharge Color and Texture Thin, grayish-white discharge Thick, white, cottage cheese-like discharge
Odor Fishy or unpleasant odor, especially after intercourse Typically odorless, distinguishing it from BV
Vaginal Itching Itching around the vaginal area and labia Intense itching, often accompanied by redness and swelling
Pain During Urination Discomfort or burning during urination Discomfort or burning sensation during urination
Pain During Intercourse No or mild discomfort Pain or soreness during sexual activity
Overall Vaginal Discomfort No or mild discomfort, may vary throughout the menstrual cycle General discomfort, redness, and swelling


Unique Symptoms Comparison

Unique Symptoms for Self-Identification Bacterial Vaginosis (BV) Vaginal Yeast Infection
Distinctive Odor Fishy or unpleasant smell, especially after intercourse Typically odorless, distinguishing it from BV
Discharge Characteristics Thin and watery discharge Thick, white, cottage cheese-like discharge
Post-Sexual Activity Exacerbation Symptoms may become more pronounced after sexual intercourse Discomfort during and after sexual activity
Absence of Significant Itching May not always cause significant itching Intense itching, often accompanied by redness and swelling
Fluctuating Symptoms Symptoms may vary in intensity throughout the menstrual cycle Symptoms may vary, but intense itching is a consistent feature
Pain During Intercourse No or mild discomfort during sexual activity Pain or soreness during sexual activity
Specific Redness and Swelling Generally absent Localized redness and swelling around the vaginal area


Causes and Risk Factors for Bacterial Vaginosis (BV) and Yeast Infection

Bacterial Vaginosis (BV)

Causes: Bacterial Vaginosis primarily results from an imbalance in the vaginal flora. The vagina naturally hosts a combination of bacteria, with beneficial bacteria like Lactobacillus helping to maintain a healthy environment.[4] BV occurs when harmful bacteria, notably Gardnerella vaginalis, outnumber the beneficial ones, disrupting the delicate balance.

Risk Factors

  1. Sexual Activity: BV is linked to sexual activity, but it’s not strictly considered a sexually transmitted infection (STI). Multiple or new sexual partners may increase the risk.
  2. Douching: Vaginal douching can disrupt the natural balance of bacteria, increasing susceptibility to BV.
  3. Smoking: Cigarette smoking has been associated with an elevated risk of BV.
  4. Intrauterine Device (IUD): Women using IUDs for contraception may have a slightly higher risk of BV.
  5. Vaginal pH: An alkaline vaginal pH can contribute to BV. Factors such as menstruation and the use of certain hygiene products may influence pH levels.


Yeast Infection

Yeast Infections, or candidiasis, are caused by the overgrowth of the fungus Candida, most commonly Candida albicans. Candida naturally resides in the vagina, but factors leading to its overgrowth can cause an infection. Imbalances in the immune system, hormonal changes, or the use of certain medications can contribute.[5]

Risk Factors:

  1. Antibiotic Use: Antibiotics can disrupt the balance of bacteria in the vagina, potentially leading to yeast overgrowth.
  2. Weakened Immune System: Conditions such as HIV, diabetes, or other immune-suppressing illnesses can increase susceptibility.
  3. Pregnancy: Hormonal changes during pregnancy may elevate the risk of yeast infections.
  4. Uncontrolled Diabetes: Poorly controlled diabetes can create an environment conducive to yeast overgrowth.
  5. Oral Contraceptives: Hormonal birth control methods, particularly high-dose estrogen pills, may influence susceptibility.
  6. Corticosteroid Use: Prolonged use of corticosteroids can increase the risk of yeast infections.
  7. Diet and Lifestyle: A diet high in sugar, poor hygiene practices, and wearing tight, non-breathable clothing can contribute.


Lifestyle, Hygiene, and Health Conditions

  • Hygiene Practices: Overzealous hygiene, including excessive douching or the use of scented feminine products, can disrupt the natural balance in the vagina for both conditions.
  • Sexual Practices: Practicing safe sex and maintaining good sexual hygiene can reduce the risk of both BV and yeast infections.
  • Overall Health: General health, including a balanced diet and regular exercise, can play a role in maintaining a healthy immune system and preventing infections.
  • Clothing Choices: Wearing breathable, cotton underwear and avoiding tight-fitting pants can create a less favorable environment for the development of both BV and yeast infections.


Diagnosis and Testing for Bacterial Vaginosis (BV) and Yeast Infection

Diagnosis Overview

Bacterial Vaginosis (BV)

Yeast Infection

Clinical Evaluation:

Discussion of symptoms, medical history, and relevant factors

Thorough discussion of symptoms and medical history

Physical Examination:

Pelvic examination to observe discharge, odor, and inflammation

Pelvic exam to identify signs such as redness, swelling, and discharge

Vaginal pH Testing / Microscopic Examination:

Testing vaginal pH; BV associated with elevated pH

Microscopic examination of vaginal sample for yeast confirmation


Importance of professional diagnosis to avoid self-misdiagnosis and incorrect treatment

Professional diagnosis is crucial for accurate identification of whether symptoms stem from Bacterial Vaginosis (BV) or Yeast Infection, given their shared common symptoms. Seeking healthcare guidance prevents self-misdiagnosis, as over-the-counter treatments may not be universally effective for various vaginal symptoms, thereby avoiding potential delays in appropriate care. Importantly, professional diagnosis ensures the prescription of the right medications, preventing the exacerbation of symptoms or the development of drug-resistant strains.

Beyond immediate relief, it enables healthcare providers to delve into potential underlying causes or contributing factors, facilitating comprehensive and effective management. Additionally, regular check-ups and professional diagnosis contribute to overall reproductive health, addressing not only the immediate concern but also broader health implications related to the reproductive system.


  • Antiviral Treatments: Acyclovir, valacyclovir, or famciclovir are prescribed to reduce the severity and duration of Cold Sores by suppressing the herpes simplex virus (HSV).[11]
  • Topical Antiviral Creams: Penciclovir or docosanol in topical creams alleviate symptoms and expedite the healing process.
  • Pain Relievers: Ibuprofen or acetaminophen help alleviate discomfort associated with Cold Sores.
  • Cold Compresses: Application of cold compresses reduces inflammation and provides pain relief.
  • Avoiding Triggers: Stress management, illness prevention, and minimizing sunlight exposure are crucial for preventing Cold Sore outbreaks.


Treatment Options for Bacterial Vaginosis (BV) and Yeast Infection

Prescription Medications

BV: Metronidazole (oral or topical gel) and Clindamycin (topical cream) are commonly prescribed for treating BV.[6]
Yeast Infection: Fluconazole (single oral dose) and Nystatin (cream or suppository) are widely utilized for managing Yeast Infections.[7]


Over-the-Counter Options

BV: There are no approved over-the-counter medications specifically designed for BV; however, some products claim to help restore vaginal pH balance, such as boric acid capsules or balancing supplements. Consult your healthcare provider before trying any nonprescription remedy.
Yeast Infection: Monistat® 7 (terconazole) and Femstat® 3 (butoconazole nitrate) are available over-the-counter antifungal creams and suppositories.[8]



It is vital to consult a healthcare provider prior to initiating any form of self-treatment, as misdiagnosis or incorrect treatment choices can lead to persistent or recurring infections. Additionally, pregnant women should always consult their obstetrician before starting any treatment regimen.

Preventive Measures for Bacterial Vaginosis (BV) and Yeast Infection

Bacterial Vaginosis (BV) and yeast infections are common vaginal issues that many women experience. While these conditions are usually not serious, they can cause discomfort and disrupt daily life. Fortunately, there are various preventive measures, focusing on hygiene, dietary considerations, and lifestyle adjustments, to reduce the risk of both BV and yeast infections.[9]

  1. Maintain Proper Hygiene:
    • Gentle Cleansing: Use mild, fragrance-free soap to clean the external genital area. Avoid harsh soaps, douches, and scented feminine hygiene products, as they can disrupt the natural balance of the vaginal flora.
    • Front to Back Wiping: Always wipe from front to back after using the toilet to prevent the spread of bacteria from the anal region to the vagina.
  2. Wear Breathable Fabrics:
    • Cotton Underwear: Choose breathable, cotton underwear to allow air circulation and reduce moisture, creating an environment less conducive to the growth of harmful bacteria and yeast.
    • Loose-Fitting Clothing: Opt for loose-fitting pants and skirts to minimize friction and maintain a dry and comfortable environment.
  3. Dietary Considerations:
    • Balanced Diet: Maintain a well-balanced diet rich in fruits, vegetables, whole grains, and lean proteins. A healthy diet helps support overall immune function and may contribute to a balanced vaginal environment.
    • Limit Sugar Intake: Excessive sugar consumption can contribute to yeast overgrowth. Limiting the intake of sugary foods and beverages may help prevent yeast infections.
  4. Probiotics for Vaginal Health:
    • Probiotic-rich Foods: Incorporate probiotic-rich foods such as yogurt with live cultures, kefir, sauerkraut, and kimchi into your diet. Probiotics promote the growth of beneficial bacteria that help maintain the natural balance of the vaginal flora.
    • Probiotic Supplements: Consider taking oral probiotic supplements, especially those containing Lactobacillus strains, known for their positive impact on vaginal health.
  5. Practice Safe Sex:
    • Barrier Protection: Use condoms consistently and correctly to reduce the risk of sexually transmitted infections (STIs) that can contribute to the development of BV.
    • Monogamous Relationships: Limiting sexual partners and being in a mutually monogamous relationship can also reduce the risk of STIs.
  6. Regular Health Check-ups:
    • Routine Gynecological Exams: Schedule regular gynecological check-ups to monitor and maintain vaginal health. Discuss any concerns or symptoms with your healthcare provider promptly.
  7. Stay Hydrated:
    • Adequate Water Intake: Stay well-hydrated as it supports overall health, including the health of the mucous membranes in the vaginal area.
  8. Avoid Unnecessary Antibiotic Use:
    • Proper Antibiotic Use: Use antibiotics only when prescribed by a healthcare professional, and complete the prescribed course. Unnecessary or improper use of antibiotics can disrupt the balance of bacteria in the body.


FAQ: About Bacterial Vaginosis and Yeast Infection

Q: Is Bacterial Vaginosis (BV) a sexually transmitted infection?
A: BV is not considered a sexually transmitted infection, but sexual activity can increase the risk of developing BV.


Q: Can BV lead to complications if left untreated?
A: Untreated BV can potentially lead to complications such as pelvic inflammatory disease (PID), preterm labor, and an increased risk of acquiring sexually transmitted infections.


Q: Can Yeast Infection be caused by antibiotics?
A: Yes, the use of antibiotics can disrupt the natural balance of vaginal flora, leading to an overgrowth of yeast and potentially causing a Yeast Infection.


Q: Are there dietary considerations that can help prevent Yeast Infections?
A: Limiting sugar intake in the diet is recommended, as high sugar levels can contribute to yeast overgrowth and increase the risk of developing Yeast Infections.


Q: Can Yeast Infections recur frequently?
A: Yeast Infections can recur in some individuals, especially those with weakened immune systems or certain health conditions. Seeking medical advice for recurrent infections is crucial for proper management.


Q: Do probiotics play a role in preventing Yeast Infections?
A: Probiotics containing Lactobacillus strains can help maintain a healthy balance of vaginal flora, potentially reducing the risk of Yeast Infections. Incorporating probiotic-rich foods or supplements may support vaginal health.


Q: How often should I see a healthcare provider for gynecological check-ups?
A: It is recommended to have a gynecological check-up at least once a year, or more frequently if experiencing symptoms or at higher risk for infections.

  1. Catlin BW. Gardnerella vaginalis: characteristics, clinical considerations, and controversies. Clinical Microbiology Reviews. 1992;5(3):213-237. doi:
  2. Wilson J. Managing recurrent bacterial vaginosis. Sexually Transmitted Infections. 2004;80(1):8-11. doi:
  3. Oriel JD, Partridge BM, Denny MJ, Coleman JC. Genital Yeast Infections. The BMJ. 1972;4(5843):761-764. doi:
  4. Borges S, Silva J, Teixeira P. The role of lactobacilli and probiotics in maintaining vaginal health. Archives of Gynecology and Obstetrics. 2013;289(3):479-489. doi:
  5. Calderone RA, Fonzi WA. Virulence factors of Candida albicans. Trends in Microbiology. 2001;9(7):327-335. doi:
  6. Schmitt. Bacterial vaginosis: treatment with clindamycin cream versus oral metronidazole. Obstetrics and gynecology. 2023;79(6). Accessed February 24, 2024.
  7. Priscila H, Clivati M, Farias C, Estivalet I, Edilaine M. Efficacy of Fluconazole and Nystatin in the Treatment of Vaginal Candida Species. Acta dermato-venereologica. 2012;92(1):78-82. doi:
  8. Culbertson C. MONISTAT: A new fungicide for treatment of vulvovaginal candidiasis. American Journal of Obstetrics and Gynecology. 1974;120(7):973-976. doi:
  9. Gaziano R, Sabbatini S, Roselletti E, Perito S, Monari C. Saccharomyces cerevisiae-Based Probiotics as Novel Antimicrobial Agents to Prevent and Treat Vaginal Infections. Frontiers in Microbiology. 2020;11. doi:


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