Yeast Infection vs. Bacterial Vaginosis: How to Tell the Difference

This is not medical advice and is for informational purposes only. Please seek out your medical provider before engaging in any of these treatments.
Dr. Tamika Cross is a board‑certified OB‑GYN and a paid partner of Vagisil. She was compensated for creating this content. The views expressed are her own medical opinions.

If you’ve ever felt vaginal itching, irritation, or noticed a change in discharge, you’re not alone. Two of the most common causes are yeast infections and bacterial vaginosis (BV). While they can feel similar at first, they’re actually very different conditions that require very different treatments. One of the biggest mistakes women can make is treating the wrong condition at home. Let’s break it down so you know what you’re dealing with and what to do next.
 

What Is a Yeast Infection?

A yeast infection is caused by an overgrowth of a fungus called Candida, which naturally lives in the vagina in small amounts. While a healthy vaginal pH lives around 3.8-4.5, in the event of a yeast infection, the pH is typically within this normal range. The issue at hand is the overgrowth of the fungus, not a pH imbalance.

Common symptoms:

• Thick, white, “cottage cheese-like” discharge
• Intense itching and irritation
• Redness or swelling of the vulva
• Burning with urination or sex

Common triggers:

• Antibiotic use
• High sugar levels (ie. diabetes)
• Excessive intake of beverages containing yeast (ie. wine and beer)
• Hormonal changes (pregnancy, birth control, stress)
• Tight, non-breathable clothing
   

What Is Bacterial Vaginosis (BV)?

BV happens when there’s an imbalance in the vaginal bacteria, specifically, a decrease in “good” bacteria (lactobacilli) and an overgrowth of other bacteria. Again, a healthy vaginal pH lives around 3.8-4.5, in the event of a BV infection, the pH is typically more basic with a pH greater than 4.5. It is important for the vaginal pH to stay more acidic to avoid overgrowth of “bad” bacteria. When the pH is more basic, it produces an environment more conducive to allow this “bad” bacteria to grow.

Common symptoms:

• Thin, gray or white discharge
• Strong fishy odor 
• Mild irritation or none at all
• Burning with urination (sometimes)

Common triggers:

• New or multiple sexual partners
• Unprotected sex (semen raises the pH level)
• Douching
• Anything that causes a change in vaginal pH

Why Knowing the Difference Matters

Treating a yeast infection with BV medication or vice versa won’t fix the problem. In fact, it can prolong your symptoms and disrupt your vaginal health even more. This is especially important because BV can increase your risk of STIs and complications in pregnancy. Also, recurrent yeast infections may signal underlying issues like diabetes or immune changes that require further diagnostic testing from a trusted healthcare provider.

Can You Treat It at Home?

For Yeast Infections:

If you’ve had a yeast infection before and your symptoms feel exactly the same, it’s reasonable to try an over-the-counter treatment that contains an FDA approved antifungal like miconazole or tioconazole such as Vagistat.

For BV:

Although you will find many home remedies online, the recommended treatment for BV is prescription antibiotics (like metronidazole or clindamycin) from a healthcare provider.

When to See a Doctor

Don’t guess. Get checked by a trusted healthcare provider if:

• You’re not sure what it is
• It’s your first time having symptoms
• Symptoms aren’t improving after 2-3 days of treatment
• You have recurrent infections (more than 3–4 per year)
• You have pelvic pain, fever, or abnormal bleeding

Key Takeaways

Not all vaginal irritation is created equal. If you’re experiencing itching and a thick, white discharge, think it is likely yeast. Trying over the counter proven antifungal treatments like Vagistat is a reasonable first option. If you are experiencing a fishy odor with a thin, frothy discharge, think of BV. Since BV needs to be treated with antibiotics, an over the counter antifungal will not be effective at treating this. Please consult with your OBGYN.

Knowing the difference helps you treat it correctly, faster, and protects your long-term vaginal health.

And always remember, your vagina is self-regulating. Skip the douching, be mindful of products you use, and listen to your body when something feels off. If you’re ever unsure, trust your instincts and check in with your OB/GYN. Getting it right the first time saves you time, discomfort, and unnecessary frustration.

Frequently Asked Questions (and answers)

1. Is BV or Yeast infections sexually transmitted?

While neither is directly sexually transmitted, both can trigger changes in your vaginal environment. BV is strongly associated with sexual activity as semen raises your pH, making it easier for BV to develop. Yeast infections are not transmitted sexually either but friction, moisture, and changes to the vaginal environment after sex can trigger symptoms as well.

2. Can my period trigger BV or yeast?

Absolutely. Blood has a higher pH than the vagina which can disrupt your vaginal pH balance temporarily. Hormonal shifts can also make you more susceptible to yeast infections.

3. How do I know my symptoms are not an STI?

This is important as delayed treatment for an STI can have serious complications to your reproductive organs. If you are ever unsure, it is always best to get tested by your doctor. Symptoms of BV can sometimes overlap with common STIs such as trichomoniasis such as abnormal discharge and a higher vaginal pH. If you are ever uncertain, the safest option is to go get tested.