Bacterial vaginosis or yeast infection?

Bacterial vaginosis (BV) and yeast infections are both common types of vaginal infections.

Although they share some symptoms, BV is caused by bacteria, while yeast infections are caused by fungi. There are over-the-counter (OTC) and prescription treatments for yeast infections, but for BV, you need a prescription.

Read on to learn more about the symptoms, causes, treatment, and tips for preventing BV and yeast infections.


The symptoms of BV and vaginal yeast infections are very similar. This makes it difficult to know what type of infection you are dealing with.

The appearance and smell of leucorrhea help differentiate the two.

Yeast infections usually don’t change the smell of vaginal discharge, while BV usually produces a strong fishy smell.

With a yeast infection, vaginal discharge usually thickens and is whitish with a cheese-like appearance. Bacterial vaginosis discharge is usually thin in texture and grayish-white in color.

Another difference in symptoms is that BV usually doesn’t cause redness or swelling in and around the vagina, whereas a yeast infection does.

Here’s more information about common symptoms of bacterial vaginosis and yeast infections.


  • Thin, off-white vaginal discharge

  • A strong “fishy smell,” usually more pronounced after sex or during menstruation

  • discomfort

  • Stimulate

  • itching and burning sensation

yeast infection

  • Thick, white, and lumpy discharge that may resemble cottage cheese

  • irritation or itching

  • burning sensation during sex or urination

  • redness and swelling around the vagina or vulva


While some symptoms of BV and yeast infections overlap, the causes of each are completely different.


BV is a bacterial infection caused by an imbalance in the microbiota, or vaginal flora, around and within the vagina.

Bacteria and other microbes thrive in their favorite environment. Any change in the environment can cause a bacterium to get out of control, leading to an infection.

BV is usually caused by a change in pH (the acidity of the environment).

When the acidity changes, the number of lactic acid bacteria decreases. This bacteria helps maintain the balance of a healthy vaginal flora, and when the number of lactobacilli declines, other types of bacteria are more likely to grow.

The bacteria that cause most BV infections are Gardnerella vaginalis.

What affects vaginal pH?

Your vaginal pH can be affected by:

  • regular sex
  • new or multiple sexual partners
  • vaginal douching
  • hormonal changes such as hormonal birth control, menstruation, pregnancy and menopause

Causes and Risk Factors of Bacterial Vaginosis

yeast infection

Yeast infections are caused by fungi. Yeast has the potential to overgrow when pH and the environment change.

The type of yeast or fungus that causes a yeast infection is Candida.

risk factors Candida Overgrowth includes:

  • Hormonal changes due to menstruation, pregnancy, or hormonal contraception
  • diabetes and high blood sugar
  • a weakened immune system, such as during cancer treatment or with a disease such as HIV
  • antibiotic

Causes and Risk Factors of Yeast Infections


If you’re not sure which type of infection you have, it’s best to see a healthcare provider. It can be difficult to distinguish the types of vaginal infections, and finding the cause is important for proper treatment.

If this is your first time experiencing a yeast infection, it’s best to see a healthcare provider for an accurate diagnosis.

During your appointment, your healthcare provider may:

  • Collect symptom history
  • Have a pelvic exam
  • Take a sample of vaginal discharge to test for pH and bacterial or yeast overgrowth


Depending on the cause of the infection, different medicines are needed to treat BV and yeast infections. The intensity, type, and duration of treatment will depend on the severity of the infection.

Regardless of the treatment regimen you use, be sure to follow the directions and complete the entire treatment process. If you stop midway through treatment, the infection may not clear up completely.


Bacterial vaginosis can be treated with antibiotics in the form of pills, gels, or creams. This usually requires a trip to a healthcare provider’s office to get an antibiotic prescription.

BV can be treated by:

  • Metronidazole: an oral pill or gel that is inserted into the vagina
  • Clindamycin: a cream or oral pill that is inserted into the vagina with an applicator
  • Tinidazole: an oral pill

Treatment options for bacterial vaginosis

yeast infection

Antifungal medications are used to treat yeast infections. Unlike BV, there are over-the-counter (OTC) and prescription medications available to treat yeast infections. These include:

  • Fluconazole: A prescription oral antifungal drug, usually prescribed as a single dose.
  • Terconazole or Miconazole: Available as creams and suppositories for application to and within the vagina. These can be purchased over the counter or as a prescription.
  • Clotrimazole: belongs to a class of antifungal drugs called imidazoles. It works by stopping the growth of the fungus that causes the infection.
  • Tioconazole: It is inserted into the vagina in the form of creams and suppositories.
  • Butconazole: It is inserted into the vagina in the form of a cream. It is usually used daily at bedtime.

How to Get Rid of a Yeast Infection


Vaginal infections are common, but there are things you can do to reduce your risk of reinfection.

The following tips may help prevent BV and yeast infections:

  • Wear loose-fitting clothing and cotton underwear to reduce moisture
  • Limit time spent in hot baths or hot tubs
  • Avoid rinsing, especially scented products
  • Eat a nutritious diet and probiotic foods
  • Immediately change out of gym clothes that get wet with sweat and swimsuits

VigorTip words

Bacterial vaginosis and yeast infections can be easily confused because their symptoms are similar. But the treatments needed to clear the infection are very different. Yeast infections can be treated with over-the-counter antifungal medications, while BV usually requires a prescription for antibiotics from a healthcare provider.

If you are not sure what caused your infection or if it recurs, talk to your healthcare provider. You may need stronger medicine, or you may be treating the wrong type of infection.

Frequently Asked Questions

  • How do I know if I have a yeast infection or bacterial vaginosis?

    odor. Bacterial vaginosis causes vaginal discharge with a strong fishy smell.

  • Can bacterial vaginosis be as itchy as a yeast infection?

    Sometimes, but not always. Both bacterial vaginosis and yeast infections can cause vaginal itching. Yeast infections are also more likely to cause genital itching. You can also have bacterial vaginosis but not experience itching, irritation, or redness.

  • Can bacterial vaginosis go away on its own?

    Mild bacterial vaginosis may go away on its own within a few days, but antibiotics are needed most of the time. Talk to your gynecologist if you think you may have BV.