Bacterial Vaginosis vs. Yeast Infections: Everything You Need To Know

Not only is having itchiness, abnormal discharge, or other vaginal symptoms uncomfortable, it can immediately make you concerned about serious vaginal conditions like sexually transmitted infections (STI). While it’s always a good idea to get tested by a healthcare provider if you notice any unusual vaginal symptoms, the most common types of vaginal infections are urinary tract infections, bacterial vaginosis (BV), and vaginal yeast infections.

According to the Cleveland Clinic, about 1 in 5 women will have a urinary tract infection in their lifetime, while 1 in 3 will get BV. (1,2) Yeast infections are even more common; the Mayo Clinic estimates that 3 in 4 women will experience a yeast infection throughout their lifetime, and many will experience multiple infections. (3)

Yeast infections and BV can display similar symptoms, which can make it hard to identify which infection is plaguing you if you experience unusual vaginal symptoms. BV and yeast infections are just two of many vaginal infections that fall under a range of common vaginal infections known as vaginitis Knowing what symptoms to look for is an important first step in your road to treating the root causes, but understanding what causes these infections is also critical to preventing them for the long term.

At Happy V, we want to normalize the conversation around these common vaginal infections, so you can get the information you need to feel better without embarrassment or judgment. So let’s dive into everything you need to know to tell the difference between bacterial vaginosis and yeast infections (and get the right treatment!).

What is Bacterial Vaginosis?

Did you know around 21.2 million women aged 14 to 49 in the United States alone have bacterial vaginosis, and 84% of these women had an asymptomatic infection according to the Centers for Disease Control and Prevention? That’s right—you could be infected with BV and not even know it!

Bacterial vaginosis is an imbalance in the body’s natural balance of good and bad vaginal bacteria. When the balance of bacteria is disrupted, bad anaerobic bacteria may grow uncontrolled, which may lead to a BV infection. In fact, because BV is caused by this overgrowth of anaerobic bacteria, physicians and researchers often refer to BV as a vaginal microbiome dysbiosis, or an overgrowth of bacteria, rather than an infection or a disease. (4)

BV is most common in women of reproductive age (between ages 16–44) and in pregnant women. If you’re experiencing BV symptoms, you’re not alone—about half of the gynecological problems reported every year are caused by BV.

Read our Ultimate Guide to Bacterial Vaginosis to learn more about the science behind BV, symptoms and treatment options!

How Does Bacterial Vaginosis Occur?

To understand how bacterial vaginosis occurs, we need to get to talk about the most prominent bacteria in the vagina—Lactobacillus. Lactobacillus is a friendly probiotic that naturally occurs in the vagina and helps other beneficial bacteria to grow. Lactobacillus is a type of lactic acid bacteria, which means it:

• Produces lactic acid as a natural defense against bad bacteria
• Helps the vagina maintain an optimal pH between 3.8–4.5
• Displaces pathogens in the epithelium – the nutrient site for these probiotics

So, why is it important to know about Lactobacillus? When Lactobacillus levels are depleted in the vagina, the subsequent increase in vaginal pH creates a less acidic environment that’s perfect for pathogenic bacteria to grow.

Lots of things can impact your body’s Lactobacillus levels and increase your likelihood of developing BV. Having sex with multiple sex partners, especially with other female partners, can increase your risk of harmful bacteria growth. Wearing wet clothes, bathing suits, or panty liners for long periods of time can also increase your risk, as can douching.

As BV progresses, a dense biofilm covers the vaginal walls. (5) This biofilm shelters harmful bacteria, nurturing them and shielding them from antimicrobial agents, antibiotic treatment, and good bacteria that could restore the vagina’s natural bacterial balance.

Common Symptoms of BV

If you are experiencing any of the following symptoms, you might have a bacterial infection from BV:

• Thin gray, white, or green vaginal discharge
• An unusual vaginal odor that’s often described as a strong fish-like odor
• Vaginal itching
• Burning during urination

Treatment for BV

If you think you have BV, it may be a good idea to get a formal diagnosis by a healthcare provider. To diagnose the cause of your symptoms, your healthcare provider may need to perform a pelvic exam or take a sample of your vaginal discharge.

Prescription medications may be used to treat BV. If you’d prefer a more natural option over an antibiotic for BV, a probiotic for vaginal health can help restore your body’s Lactobacillus levels and improve your infection. Taking vitamin C for BV can also help flush out bad bacteria from your system.

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What is a Yeast Infection?

In the U.S., vaginal yeast infections are the second-most common vaginal infection type, with around 1.4 million cases reported every year. (6)

Similar to BV, yeast infections (also known as vaginal candidiasis) are caused by an overgrowth of a bad pathogen. However, in the case of a yeast infection, the bad pathogen is a specific fungus known as Candida Albicans.

Candida is not always harmful—in fact, vaginal yeast is a common microorganism that can also be found in your mouth, intestines, and skin!

How Does a Yeast Infection Occur?

Like BV, certain situations can support the overgrowth of Candida. For example:

• Prescription antibiotic use can harm your body’s stores of Lactobacillus, which can affect your natural vaginal flora balance
• Undiagnosed diabetes or poor blood sugar regulation can increase the amount of sugar in the vagina, which can cause Candida fungus to grow
• A weakened immune system during cold and flu season or after an illness can make you susceptible to a yeast infection.
• Birth control pills can increase your body’s natural estrogen levels, which can cause a yeast infection.

Common Symptoms of Yeast Infections

• Burning, redness, and swelling of the vagina and the vulva
• Pain when urinating
• Pain during sex
• A thick, white vaginal discharge that looks like cottage cheese and does not have a bad odor
• Sores – typically painful and raw
• Bumps – may feel firm and are often less painful.

Treatment For Yeast Infections

The duration of a yeast infection is typically proportional to the severity of the infection. Mild yeast infections may clear up within a couple of days, while moderate to severe infections with uncomfortable symptoms may require medical attention and prescription treatment such as antifungal medications or creams. Some over-the-counter medications and creams can help treat yeast infections, but it’s important to get medical advice before starting any antifungal treatment to ensure your symptoms are due to a yeast infection and not a more serious condition.

What’s the Difference Between a Yeast Infection and BV?

Both of these infections have similar signs and symptoms, making it difficult for women to determine which type of infection they may have. If you’re trying to determine whether your symptoms are due to a yeast infection or BV, examine three characteristics of your vaginal discharge:

• ODOR—Yeast infection discharge is typically unaccompanied by odor, while the discharge produced as a result of BV has a strong and unusual smell.
• TEXTURE—The texture of the discharge from a yeast infection is typically thick and lumpy, like cottage cheese. The discharge produced in BV infection is usually thin and milky.
• COLOR—The color of discharge can help you determine what infection you are experiencing. In the case of a yeast infection, the discharge is normally whitish in color. The color of the discharge in a BV infection will be grayish-white to green.

Normally, BV is recurrent and its symptoms worsen after sex, whereas the symptoms of a yeast infection can be controlled, especially during pregnancy or when you are taking hormonal supplements.

The Importance of Getting Treatment for Vaginal Infections

If BV and yeast infections remain untreated for a long period of time, they might become chronic and recurrent in nature. Not only that, but studies also show that they can lead to other conditions such as pelvic inflammatory disease, different types of vaginal and cervix problems, infertility, preterm birth for pregnant women, and more. If left untreated, BV can also increase the risk of developing an STI.

Can I Have BV and a Yeast Infection at the Same Time?

If you cannot tell the differences between the BV symptoms and yeast infection symptoms listed above, you may be experiencing both infections at once.

Both BV infections and yeast infections are caused by low Lactobacilli levels. In the case of BV, low Lactobacilli allows harmful anaerobic bacteria to grow. In the case of a yeast infection, low Lactobacilli allows Candida fungus to grow. This may lead you to assume that yeast infections and bacterial vaginosis always occur together, but that’s not the case. However, they can occur simultaneously in some people.

How To Prevent Common Vaginal Infections From Occurring

To prevent vaginal infections from happening, you need to adhere to lifestyle practices that maintain your body’s normal stores of Lactobacilli. When your body’s bacterial balance is just right, good bacteria help you stay healthy and halt the production of yeast and anaerobic bacteria.

Here are five tips for keeping a happy V:

• Eat a diet high in probiotic foods to keep your vaginal pH in balance. Healthy probiotic foods include yogurt with live strains, kimchi, tempeh, and more. You can also take a dietary probiotic supplement.
• Reduce your sugar intake. Excess sugar in your diet can create a good environment for yeast to grow.
• Don’t douche. The vagina is capable of cleaning itself. Douching not only washes away the bad bacteria but the good as well.
• Keep your underwear dry. Change clothes after leaving the gym, and bring a change of underwear after exercising or swimming.
• Reduce stress in your life. We’re more prone to infection during high-stress times in our lives, and excess cortisol production weakens the immune system.
• Drink at least 8-10 glasses of water per day to help flush out yeast infections

To Safeguard Your Vaginal Health, Get Support from Happy V

At Happy V, our mission is to empower you with knowledge and evidence-based products to help keep you and your body healthy. Our vaginal probiotics are made with clinically proven strains to balance the vaginal flora and maintain a balanced pH.

For more tips on how to prevent vaginal infections from recurring, check out our article on 10 ways to take care of your vagina.