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Yeast infection vs BV: what's the difference?
Yeast infection vs BV: compare the discharge, smell and itching, learn how each is diagnosed and treated, and when to see a doctor.
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In short
Yeast infection vs BV: what's the difference?
A yeast infection usually causes strong itching and thick, white discharge like cottage cheese with little smell. Bacterial vaginosis (BV) usually causes thin gray or white discharge with a fishy smell, often stronger after sex, and little itching. Yeast is a fungus and BV is a bacterial imbalance, so they need different treatment. Only a doctor's swab test can tell them apart for sure.
Written by the Gyne team · Medical review: pending
Key takeaways
- Itching and cottage cheese discharge point to a yeast infection.
- A fishy smell with thin gray or white discharge points to BV.
- Up to half of people with BV have no symptoms at all.
- Yeast infection medicine doesn't treat BV, which usually needs antibiotics from a doctor.
- See a doctor the first time you have symptoms, because some STIs look similar.
How can you tell a yeast infection from BV?
The two can feel alike, but a few clues usually differ. Here is how they often compare:
- Discharge: thick, white and lumpy with yeast. Thin, watery, gray or milky white with BV.
- Smell: little or none with yeast. A strong fishy smell with BV, often worse after sex.
- Itching: often intense with yeast. Mild or none with BV.
- Redness and swelling: common around the vulva with yeast. Less common with BV.
- Pain when you pee or during sex: possible with both.
What are the symptoms of a yeast infection?
A vaginal yeast infection, also called thrush, is an overgrowth of a fungus called Candida that normally lives in small amounts in the vagina. Three out of four women get one at some point.
The most common sign is strong itching in and around the vagina. You may also have burning, redness, swelling and soreness, pain when you pee or during sex, and thick white discharge that doesn't smell bad.
What are the symptoms of bacterial vaginosis?
BV happens when the usual balance of bacteria in the vagina changes and less helpful bacteria take over. It's the most common vaginal condition in women aged 15 to 44.
The main sign is thin gray or white discharge with a fishy smell, often stronger after sex. Some people have burning when they pee or mild irritation, and many have no symptoms.
What causes yeast infections and BV?
Both happen when the vagina's natural balance is upset. They share some triggers, but not all.
- Yeast: recent antibiotics, pregnancy, diabetes that isn't well controlled, higher-estrogen birth control and a weakened immune system.
- BV: a new sex partner or more than one partner, douching, not using condoms, pregnancy and having an IUD.
- Both: douching, scented washes and vaginal sprays.
Is BV or a yeast infection a sexually transmitted infection?
Neither is classed as a sexually transmitted infection (STI). You can get either one without ever having sex.
But sex can trigger both, and BV is more common in people who are sexually active. If your partner has a vagina, they may need to be checked for BV too.
Trichomoniasis, a common STI, can also cause itching and unusual discharge, often frothy and yellow-green. It's easy to mistake for yeast or BV, which is another reason to get tested.
How are yeast infections and BV diagnosed?
A doctor or nurse may look at your vagina and take a small sample of discharge with a cotton swab. The sample is checked under a microscope, with a quick test in the office or in a lab.
Try to book your visit for a day you don't have your period, and don't douche or use sprays beforehand, because they can hide the signs.
How are they treated?
Yeast infections are treated with antifungal medicine, as a cream, a vaginal tablet or a pill by mouth. Some are sold over the counter. If a doctor has diagnosed a yeast infection before and the symptoms feel the same, ask a pharmacist whether one is right for you.
BV is treated with antibiotics prescribed by a doctor, as tablets or a vaginal gel or cream. Yeast medicine won't clear BV, and using the wrong one can delay the right treatment.
When to see a doctor
- It's the first time you've had these symptoms.
- You're pregnant or breastfeeding and have unusual discharge, itching or a fishy smell.
- Your symptoms don't clear up after treatment, or they come back more than 4 times in a year.
- Your discharge is green, yellow or frothy, or you have sores or blisters.
- You have pain low in your belly, bleeding between periods or after sex.
- You have a fever of 100.4°F (38°C) or higher with pelvic pain.
- You think you may have been exposed to an STI.
How Gyne helps
Gyne keeps your cycle history on a ring and calendar, and when the same symptoms keep coming back before your period, it shows you the pattern. That record can help you describe what's happening when you talk to your doctor.
PeriodsThis guide is general information, not medical advice. Only a doctor can diagnose a condition.