BV vs. Yeast Infection: Symptoms & Treatments (2026 Guide)

Bacterial vaginosis (BV) and vaginal yeast infections share similar symptoms, but these are different types of infection and require differing treatments. Both infections are common. The global prevalence rate for BV is as high as 29%, while studies show more than half of women experience at least one vaginal yeast infection during their lifetime. 

In this guide, we’ll discuss key differences between BV and vaginal yeast infections, including underlying causes, symptoms, and treatment methods so you know which to talk to your healthcare provider about. Vaginal infection symptoms can present very similarly to each other but are all treated differently, so it is important to be tested so you receive the appropriate treatment. 

Bacterial Vaginosis (BV) vs. Yeast Infection 

Medication used to treat BV will not be effective against a vaginal yeast infection, and vice versa. Taking the incorrect medications can even worsen symptoms and make your infection more resistant to treatment. Understanding what distinguishes these conditions from one other is crucial to alleviating symptoms and stopping the infection before it leads to serious complications. 

What Is Bacterial Vaginosis?

Bacterial vaginosis (BV) is a vaginal infection that occurs when the vaginal microbiome becomes imbalanced, due to the overgrowth of anaerobic bacteria or other factors that can change the pH of the vagina. There are many theories as to what causes BV, and while the exact cause is still unknown, it is heavily linked to sexual activity. Having unprotected sex with new or multiple partners, having sex with female partners, or anything that disrupts the vaginal flora can increase the risk of contracting BV. 

But BV is not isolated to only sexual activity. Other things that can disrupt the vaginal microbiome and lead to BV include exposure to harsh cleansers or soaps, or regular or recent douching, as these can disrupt the bacterial balance of the vagina and lead to an overgrowth of the bacteria that causes BV.

If you suspect you have BV, it is important to get evaluated and tested by a medical provider. This usually involves getting a pelvic exam and a vaginal swab to test for infection. Because treatment involves antibiotics, it is important to confirm with testing to prevent unnecessary antibiotic use. The treatment of BV can also sometimes lead to yeast infections. 

Because BV alters the levels of good bacteria in the vagina, it decreases its defense system against other infections. If left untreated, BV can increase the risk of contracting HIV and other sexually transmitted infections (STIs), pelvic inflammatory disease, and also lead to adverse effects during pregnancy such as preterm labor. If you receive treatment for BV, it is very important that you complete the medication entirely and abstain from any sexual contact until the treatment is completed to avoid these complications.

Bacterial Vaginosis Treatments

The treatment of BV involves using prescription-strength antibiotics to kill the overgrowth of bad bacteria and restore the bacteria balance in the vagina. There are multiple forms of treatment for BV, involving either oral antibiotic pills, or topical treatments involving vaginal gel or cream suppositories, which are inserts that deliver the medication directly into the vagina. 

Common medications prescribed for BV include metronidazole pills, metronidazole vaginal gel, clindamycin vaginal cream and tinidazole tablets. These treatments are all just as effective and just depend on patient preference, cost, tolerability, and pregnancy status. 

For example, oral antibiotics may be preferred for patients that do not feel comfortable self-administering a vaginal suppository, but may cause stomach upset and can interact with alcohol. Others may prefer the vaginal form because it is administered for a shorter duration and does not typically cause stomach upset. 

It is important to talk to your provider to determine the best treatment for you based on your preference and tolerance.

What Is a Vaginal Yeast Infection?

Vaginal yeast infection, or vulvovaginal candidiasis, occurs when the amount of candida fungus in the vagina increases to excessive levels. Candida fungus is part of the body’s microbiome and is naturally found in the vagina, as well as the mouth, digestive tract, and skin. Normal amounts of candida fungus do not normally cause an infection. 

Yeast infections can occur for different reasons but typically occur whenever there is a change in the body’s natural environment. Some people who take antibiotics to treat bacterial infections may develop a secondary infection because antibiotics work by killing both bad and good bacteria in the body. When the healthy bacteria gets killed, this can change the vaginal pH and chemical balance and lead to overgrowth of candida, leading to a yeast infection. 

Other potential risk factors for yeast infections include obesity, weakened immune system, pregnancy, uncontrolled diabetes, and certain medications, such as birth control pills or immunosuppressant drugs. If you believe you have a yeast infection, your healthcare provider may perform a pelvic exam to confirm the diagnosis. 

Yeast Infection Treatments

Because a yeast infection is caused by a fungus, it is treated with anti-fungal medication. Antibiotics will not treat yeast infections, and may make yeast infections worse. Treatment typically involves antifungal cream, suppositories, or oral tablets. These are available over the counter for mild infections as well as in prescription-strength formulations for moderate to severe infections. 

Common medication options for yeast infections include fluconazole pills, clotrimazole creams, or terconazole vaginal suppositories, but your provider will determine the best treatment course based on your symptoms and medical history. 

BV vs. Yeast Infection Symptoms Side By Side

The symptoms for BV and vaginal yeast infection are similar but not identical. Paying close attention to the discharge texture and color, odor, level of irritation, and other symptoms can help you and your doctor pinpoint what type of infection you have. 

Vaginal Discharge

Vaginal discharge is a catchall term for any secretion from the vagina. It is important to recognize what normal vaginal discharge and abnormal vaginal discharge look like. Vaginal discharge is a normal bodily secretion and helps to lubricate and protect the vaginal environment from infection. It is normal for women of child-bearing age to experience vaginal discharge, and the amount and consistency varies depending on age and hormone levels during menstrual cycles. 

Normal vaginal discharge is typically odorless, ranges from being translucent to slightly white, and may increase or become thicker before ovulation, and is not accompanied by any pain, itching, discomfort, or odor. 

Variations in vaginal discharge can be normal, especially during sexual arousal, menstruation, or pregnancy, but certain changes in the amount, texture, color, and odor of the secretions can sometimes indicate an infection or another medical condition. For example:

• BV can lead to thin, white or gray watery vaginal discharge with a fishy odor.
• Vaginal yeast infections can lead to discharge that ranges from slightly white to thick, white, and chunky secretions that resemble cottage cheese.

It is advised to avoid douches, hygiene sprays or fragrances, and tampons if you experience irregular vaginal discharge. People with BV are also cautioned to avoid using soap in the pubic area when bathing, and to only rinse with warm water instead, as this can avoid disrupting the vaginal environment.

Odor

Odor can be another telltale sign as to whether your condition is BV or a vaginal yeast infection. Like discharge, some mild vaginal odor is normal. However, BV can lead to vaginal discharge that carries a strong, unpleasant fishy smell. This comes from bacterial overgrowth causing proteins to break down into smelly chemicals. Yeast infections, in contrast, do not normally produce a strong odor. Some people with yeast infections report a mild, bread-like smell, but many do not notice any odor whatsoever. 

Itching and Irritation

BV and vaginal yeast infections are both associated with vaginal inflammation, which causes an unpleasant itchiness and irritated feeling in and around the vagina. Inflammation from BV occurs because bacterial overgrowth alters the vagina’s pH and chemical balance, irritating the vulva in the process. With yeast infections, the itching and inflammation is a response from the overgrowth of yeast, which sometimes can lead to a burning pain from the intense itching. Yeast infections typically cause much more itching than BV.  Redness and swelling of the vulva may also accompany the itching if you have a yeast infection.

A mild burning sensation during urination is sometimes common with both conditions, usually as a result from external vaginal irritation. However, experiencing a burning or painful sensation during sex is usually more characteristic of vaginal yeast infection, not BV. 

What Causes BV vs. Yeast Infections?

Both conditions are a result of the alternation of the vaginal flora and microbiome, but each are caused by different organisms. At the foundational level, overgrowth of anaerobic bacteria can lead to BV and an overgrowth of candida fungus can lead to a vaginal yeast infection. However, a person may contract either condition under different circumstances. These include the following: 

• Hygiene products
• Sexual activity
• Antibiotics
• Hormonal changes

With the right treatment and lifestyle changes, BV and vaginal yeast infections are both treatable and preventable. Pinpointing the infection’s underlying cause through diagnostic testing can help identify the best medication and lifestyle changes for treatment. 

Hygiene Products

Using a douche is not recommended for people who want to avoid BV or a yeast infection. While douching can make you feel cleaner, this process removes healthy bacteria that protect against vaginal infections. Sprays, fragrances, and scented soaps can also lead to BV or a yeast infection by upsetting the vagina’s chemical balance and killing off good bacteria.

Sexual Activity

BV is not considered a sexually transmitted infection because it is not caused by a single transmissional pathogen, rather it is a natural bacterial imbalance that occurs in the vagina through certain conditions. However, unprotected sexual activity can increase the risk of acquiring BV.

Likewise, the candida fungus that causes yeast infections can be transmitted through oral, genital, or anal contact to a partner of any sex, although it is less common. If you are having any vaginal symptoms, it is important to abstain from sex and get evaluated right away.

Antibiotics

Antibiotics are used as first-line treatment for most BV cases, but taking antibiotics can also cause a yeast infection after treating BV. Less commonly, BV may also be caused by antibiotic use for another condition. This happens because some antibiotic medications, including broad-spectrum antibiotics, kill good and bad bacteria in the vagina. If there aren’t enough good bacteria to maintain a balanced pH, bacterial overgrowth and imbalance can occur.

Similarly, some antibiotics kill the bacteria that keep candida fungus overgrowth at bay, so taking these medications can also lead to or worsen a yeast infection. This is why it is important to always get testing to confirm your diagnosis and avoid unnecessary antibiotic treatment. If you are susceptible to yeast infections from antibiotic use, let your healthcare provider know.

Hormonal Changes

Estrogen plays a major role in promoting the growth of lactobacillus, a good bacteria that helps maintain vaginal health, ph, and keep out harmful bacterial and fungal growth. Hormone levels change throughout a woman’s life, and these fluctuations can sometimes increase risks of vaginal infections.

A decrease in estrogen levels, which occurs during menopause, can lead to vaginal dryness, irritation, and depletion of lactobacillus, which has been linked to yeast and BV infections. Women undergoing hormone replacement therapy may also be more susceptible to certain infections. 

Can You Have BV and a Yeast Infection At the Same Time?

It is possible to have BV and a yeast infection at the same time. This is known as co-infection. Studies have shown a high incidence rate of vulvovaginal yeast infection in women who also have BV — as many as one-third of women with BV simultaneously experience yeast infection symptoms. 

The same underlying cause, such as using a douche or taking antibiotics, may lead to both conditions. However, it’s still important to note that BV and a yeast infection are two different types of infection and require two different treatments. Your doctor can recommend a comprehensive treatment plan with a course of antibacterial and antifungal medications that won’t interact too strongly with each other or any other drugs you currently take. 

…What If It’s Neither?

BV and vaginal yeast infection are both fairly common, but these are not the only conditions that lead to irregular discharge, texture, odor, pain during urination, and other vaginal symptoms. Other possibilities can include:

• Sexually-transmitted infection (STI): STIs, such as trichomoniasis cause similar vaginal irritation and irregular, foul-smelling discharge. Other STIs, like chlamydia and gonorrhea, are characterized by inflammation, abnormal discharge, and burning during urination. Additionally, the irritation and itching associated with the initial onset of genital herpes are similar to — and commonly mistaken for — the symptoms of a yeast infection. Because these infections can have similar symptoms and are all caused by different types of pathogens, they all require different types of treatment.
• Skin condition: An allergic reaction to certain scented soaps, laundry detergents, and sanitary products can lead to contact dermatitis, a skin condition that produces irritation of the vulva. Eczema and psoriasis can also produce intense redness, swelling, and irritation around the genitals. 
• Hormonal or bacterial imbalance: As we discussed above, fluctuating estrogen levels can affect the chemical makeup of the vagina, leading to irritation and pain during sex. This is especially common during menopause. Cytolytic vaginosis (CV) is another possible cause for these symptoms. This condition occurs when too much good bacteria is present in the vagina, producing a thick, white discharge similar to the secretions during a yeast infection.
• Urinary tract infection (UTI): The inflammation, irritation, and burning symptoms of a UTI can sometimes be similar to the initial symptoms of BV and yeast infection. Because the opening to the vaginal canal is right next to the opening of the urethra/bladder, vaginal infections can sometimes present with symptoms that mimic a UTI. UTI symptoms however, typically have more urinary symptoms such as urinary frequency, urgency, pain with urination, and changes to the appearance of the urine. Treating a UTI requires different types of antibiotics that target bacteria in the bladder, and will not treat vaginal infections. This is why it is important to see a provider and get tested for your symptoms to rule out a UTI versus a vaginal infection to receive proper treatment and avoid complications from unnecessary antibiotic use. 
• Pelvic inflammatory disease (PID): PID is a serious infection of the reproductive organs that can cause irregular vaginal discharge, pelvic pain, bleeding, and pain during sex, among other symptoms. PID is often attributed to untreated gonorrhea, chlamydia, or STIs, but sometimes, untreated BV may be the underlying cause. It is important to get regularly tested for STIs, even if you don’t experience symptoms, and to see your provider for evaluation if you experience any vaginal or abdominal symptoms.

If you experience severe or non-improving symptoms, or your prescribed treatment for BV or vaginal yeast infection is not working, talk to your doctor about a reassessment and additional testing. 

Getting the Right Treatment

BV and vaginal yeast infection require completely different treatments, so identifying the type of infection you have is crucial for alleviating initial symptoms and reducing the risk of long-term complications. BV is a bacterial disease that requires antibiotics, while vaginal yeast infection is a fungal-borne condition that requires antifungal medication.

Digital pharmacy platforms can make getting treatment more convenient with home shipping options. TelyRx is fully licensed and offers FDA-approved medications online for patients with an  existing prescription as well as patients without one. Patients without a prescription can request a prescription through TelyRx, where an independent provider licensed in your state will review the request for safety. If approved, we fill the prescription order through one of our two U.S.-based licensed pharmacies and ship it to your door, allowing you to skip the waiting room and pharmacy lines entirely.

However, not all digital pharmacy platforms are created equal. Take caution when vetting online pharmacies, as some platforms are not legitimate. Look for certification, customer reviews, and a U.S. address. For example, TelyRx is LegitScript-certified, has positive reviews on TrustPilot, and is based out of Clearwater, Florida with shipping services to 48 states and all U.S. territories.

Your Next Steps

If you suspect you have BV or a vaginal yeast infection, keep in mind that proper treatment is critical to recovery. Whether you receive your treatment through your doctor, a traditional pharmacy, or a digital pharmacy platform like TelyRx, it is recommended to follow your prescription’s guidelines for dosage, medication timing, and drug interactions.

Do not abruptly quit your treatment even if your symptoms clear up ahead of schedule. Completing the entire treatment course helps ensure the bacterial or fungal overgrowth is eliminated.