• Yeast Infection
• Infections
• Bacterial Vaginosis (BV)

BV vs. Yeast Infection: How Do I Tell the Difference?

Medically reviewed and edited by Dr. Banita Sehgal

According to the Centers for Disease Control and Prevention (CDC), bacterial vaginosis (BV) is the most common type of vaginitis that affects an estimated 21.2 million women, while around 1.4 million patients visit a health care provider for vaginal candidiasis (vaginal yeast infections) in the U.S. each year.

While some women who have a yeast infection or BV may be asymptomatic, certain individuals may experience itching, pain, discomfort, and in severe cases, even fever.

Preexisting health conditions, such as diabetes, may increase the risk of developing a yeast infection and BV, but there are steps you can take to decrease your chances of infection.

In this article, we’ll cover yeast infections and BV, their symptoms, causes, and preventative measures that reduce the risk of recurrence.

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What is Bacterial Vaginosis (BV)?

Bacterial vaginosis is inflammation of the vagina caused by an imbalance of vaginal bacteria (disruption of your vaginal pH.)

Over 80% of women with BV have no symptoms, and it most commonly affects women between the ages of 15 and 44. All women can get BV, but those of reproductive age are most susceptible.

What is a Yeast Infection?

Also called candidiasis or vaginal candidiasis, a yeast infection is a type of vaginitis caused by an overgrowth of Candida fungus.

Candida naturally exists in the vagina along with vaginal flora, but an imbalanced microbiome can cause a yeast infection. When Lactobacillus (the good bacteria) can no longer keep the candida fungus under control, a yeast infection occurs.

Anyone can get a yeast infection, but certain factors increase the likelihood of developing the condition. Around 20% of women who have a yeast infection will not exhibit any symptoms.

Because the symptoms of vaginal infections such as BV and yeast infections often overlap, it can be difficult to tell them apart. A visit to the doctor will help you determine which condition you have, but there are some clear distinctions between the two.

Here are some of the symptoms to watch for:

Not BV or a Yeast Infection: What Else Could it Be?

BV and yeast infections are not the only conditions that can cause inflammation of the vagina. In some cases, vaginitis may be caused by the following:

• Gonorrhea

• Herpes

• Chlamydia

• Mycoplasma genitalium (MG), which is a type of bacteria that can cause a sexually transmitted infection

• Campylobacter infection

• Parasites

• Poor hygiene

To rule these out, visit a doctor for an accurate diagnosis.

BV vs. Yeast Infections: What are the Causes?

A bacterial imbalance is the underlying cause of both BV and yeast infections, but there are risk factors that respectively threaten the balance of your vagina’s microbiome. These risk factors are listed below:

Bacterial Vaginosis (BV)

• Unprotected sex

• Multiple sexual partners

• Penile-vaginal sex with someone new

• Hormonal fluctuations caused by menopause, pregnancy, menstruation, or other factors

• Douches or excessive cleansing

• Feminine products, such as scented soaps or vaginal deodorants, that cause irritation

Yeast Infection (Candidiasis)

• Pregnancy

• Antibiotics

• Diabetes

• Menopause

• Hormonal changes caused by stress

• Estrogen therapy

• Scented feminine products

• Non-breathable underwear

• Restrictive clothing

How Do I Treat BV or Yeast Infections?

The course of treatment for BV and yeast infections will depend on the severity of your condition.

Over-the-counter treatments are typically used for a yeast infection, with prescription medications and creams reserved for BV.

How do I treat BV?

If you suspect you have BV based on the symptoms we’ve covered, be sure to schedule a doctor’s appointment to get treatment as soon as possible. Your doctor will confirm a diagnosis and prescribe the right treatment to help you get better.

Common treatment options for BV include:

• Antibiotics, such as metronidazole, secnidazole, and tinidazole

• Suppository creams, such as clindamycin

• Gels, such as metronidazole

Daily probiotic supplements and probiotic-rich foods, such as yogurt, may help decrease the recurrence of BV. However, there is not enough clinical data to support the use of probiotics in combating BV.

What Can I Expect When I Visit the Doctor?

When you’re experiencing vaginitis, a trip to the doctor may seem daunting. However, a doctor’s diagnosis will help you get the proper treatment for BV.

When you visit the doctor for BV treatment, they may:

• Ask questions about your symptoms and medical history

• Perform a pelvic exam

• Take a vaginal discharge sample for analysis

• Request a urine sample

It's possible to self-diagnose a yeast infection and bacterial vaginosis, but OTC medication is only available for yeast infection treatment. If you suspect you have a yeast infection or BV, you can also head over to LifeMD.com to speak to a board-certified doctor from your smartphone, computer, or tablet. A doctor may be able to provide a diagnosis and write you a prescription.

How Do I Treat a Yeast Infection?

For mild cases, you can get over-the-counter treatment, but prescription medication is available for more severe cases.

You can treat yeast infections with the following:

• Antifungal medication, such as miconazole and terconazole. These are typically available as creams, ointments, suppositories, or tablets.

• Oral medication, such as fluconazole.

Be sure to consult your doctor if the above treatments don’t work. There are also vaginal health tests you can purchase to ensure you’re treating the right condition.

If you are experiencing severe symptoms, you may require long-course vaginal therapy, multidose antifungal medication, or boric acid suppositories.

Home remedies may offer some relief, but over-the-counter and prescription medications provide fast, effective treatment if you have a yeast infection.

What Happens If I Don’t Get Treatment?

Sometimes a vaginal yeast infection and BV can clear on their own; however, if symptoms persist or worsen, you should get over-the-counter treatment or seek medical attention promptly for a yeast infection.

Yeast Infections: An untreated yeast infection may cause severe itchiness, pain, and inflammation that could leave the vagina with raw, cracked patches.

Bacterial Vaginosis: If you have BV, getting treatment as soon as possible will help you avoid certain complications that could:

• Increase your risk of contracting sexually transmitted infections (STIs)

• Increase your risk of developing infections that may cause infertility

• Result in premature delivery and a baby with a low birth weight

How Can I Prevent Yeast Infections and BV?

Both are treatable conditions, but there are also certain steps you can take to reduce your chances of developing them.

Here are some ways to reduce your chances of getting BV and yeast infections:

• Choose breathable underwear made of fabrics such as cotton

• Change your underwear regularly

• Steer clear of douching

• Avoid scented soaps and intimate products

• Have protected sex

• Only use clean sex toys

• Have fewer sexual partners

• Take showers instead of baths (or avoid really hot baths)

• Avoid hot tubs

• Wipe the vagina from front to back

• Pat dry genitals instead of wiping, as wiping may cause irritation

• Avoid tight clothing

• Limit sugar

• Eat a balanced diet that includes fermented foods (which naturally contain probiotics)

• Take probiotic supplements

BV, Yeast Infections, and Sex: What Should I Know?

While yeast infections and BV aren’t sexually transmitted diseases, engaging in sexual activity can increase your risk of developing these conditions.

Sex is not a direct cause of BV or yeast infections, but anything that disrupts the vaginal pH can trigger vaginitis.

Below are some useful tips:

• Always use protection when engaging in sexual activities, which includes the use of a dental dam during oral sex.

• Clean sex toys between uses.

• Avoid having sex if you have BV or a yeast infection.

• Wait for at least a week after you complete your treatment before you have sex.

There is also some evidence to suggest that uncircumcised male partners increase your risk of developing BV, so always use protection.

Do I Need to See a Doctor?

It is possible to self-diagnose a yeast infection and bacterial vaginosis, but OTC medication is only available for yeast infection treatment. If you suspect you have a yeast infection or BV, you can make a telehealth appointment here, and speak to a board-certified doctor from the comfort of your home. Your doctor may also be able to write you a lab order to rule out any STDs.

BV and Yeast Infections: Where Can I Learn More?

Bacterial vaginosis or yeast infections can cause uncomfortable vaginal discharge and other symptoms that can make one self-conscious, but there’s no reason why they should affect your quality of life. These conditions are common and quite treatable.

If you’re experiencing some of the symptoms covered in this article, or if you have any concerns about vaginal or sexual health, you can speak to a U.S. based, board-certified doctor from the comfort of your home. Head over ot LifeMD to make your first appointment.

Dr. Banita Sehgal

Dr. Sehgal received her medical degree from Western University in Los Angeles and trained as Chief Resident at White Memorial Medical Center, also in Los Angeles. She’s been practicing medicine for 20+ years and has a specific interest in women’s health.

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