BV vs. Yeast Infections: How to Tell The Difference
If you have vaginal itching, burning, or unusual discharge, you may have searched online for answers. But you may have come away confused. Some sources might say you have bacterial vaginosis (BV). Others may say you have vulvovaginal candidiasis (a yeast infection). Many people have trouble telling these common conditions apart because they can cause overlapping symptoms.
Your healthcare provider can diagnose these conditions. They may use a vaginal swab to perform a test. When they have a result, they’ll explain how they typically treat your condition. Knowing a few key differences between BV and yeast can help you know what to ask and decide what to do next.
What causes bacterial vaginosis and yeast infections?
BV and yeast infections both occur when something disrupts the normal, healthy balance of the vaginal environment. Healthy bacteria and yeast naturally live in the vagina. They usually stay in balance and help maintain a healthy vaginal environment.
When this balance gets thrown off, though, it’s easier for BV or a yeast infection to take hold. This further unsettles the vaginal microbiome.
BV: Some risk factors include:
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A new partner, multiple sexual partners, or unprotected sex. (Because it can temporarily change vaginal pH. BV is not considered a sexually transmitted infection.)
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Douching or using intravaginal hygiene products (such scented soaps or other scented intimate hygiene products)
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Antibiotic use
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Some intrauterine devices (IUDs)
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Smoking
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Stress
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Low estrogen levels (from being postmenopausal or postpartum, using certain oral contraceptives, etc)
Yeast infections: Some risk factors include:
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Sexual intercourse. (Because this can temporarily change vaginal pH. A yeast infection is not a sexually transmitted infection.)
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Antibiotic use
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Estrogen use
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Immunosuppressant use (which causes a weakened immune system)
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Uncontrolled diabetes
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Pregnancy
BV and yeast infections can both develop when something disrupts your vaginal balance. However, each condition has a different cause.
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BV develops when healthy Lactobacillus bacteria decrease. This change lets harmful anaerobic bacteria overgrow.
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Yeast infections develop when Candida albicans and related fungi outnumber the good bacteria.
What is the difference between BV and a yeast infection?
|
Bacterial Vaginosis (BV) |
Vulvovaginal candidiasis (Yeast Infection) |
|
|
Vaginal discharge color |
Grayish-white discharge |
White discharge |
|
Vaginal discharge texture |
Thin, consistent texture |
Thick or clumpy. Often called a “cottage cheese-like” texture |
|
Odor |
An unpleasant or “fishy” odor |
Usually no odor |
|
pH level |
Vaginal pH levels above 4.5 |
Normal vaginal pH levels of 4.0 |
|
Discomfort/irritation |
Often none; you might feel irritation near your vaginal opening, or a burning sensation when you pee. |
Redness and swelling, itching, and burning |
|
Who is at risk? |
At NeuEve, many of our customers with BV are women over 50.* Black and Latina women may experience increased risk. |
Women of reproductive age might face the highest risk.** Hormone therapy may increase your yeast infection risk after menopause. |
|
Timing |
Things like douching and sexual activity may trigger it. You may notice your symptoms more after sex or during the first few days of your period. |
Many factors, including antibiotic use, can trigger it. Wearing damp clothing for long periods may also contribute. You may notice your symptoms most just before your period (though this can also happen with other conditions such as cytolytic vaginosis) |
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Typical treatment |
Treatment with antibiotics such as clindamycin and metronidazole. (Taken orally or vaginally.) |
Treatment with antifungal medications such as miconazole and clotrimazole. (Applied inside or around the vagina, or taken orally.) |
*Most studies show higher rates of BV in women of reproductive age. There is less research on BV in women over 50, so we need more data to better understand BV in this group.
**Exact risk factors for yeast infections are still unclear. Many people self-diagnose their infections. Because many cases go unreported, researchers have limited data.
Other conditions, including a serious one called pelvic inflammatory disease, can also cause abnormal discharge. For example, green or yellow discharge may mean a different infection.
If your symptoms don't fit BV or a yeast infection, try our Symptom Checker Quiz. It can help you prepare to talk with your healthcare provider.
Our Symptom Checker Quiz can also help you discover which NeuEve products may help you the most. We have products and kits that can help you manage the symptoms of BV and yeast infections. We also help women who discover they have other, less common conditions, such as aerobic vaginitis or cytolytic vaginitis.
Why does BV usually cause noticeable odor while yeast infections often do not?
The bacteria that cause BV produce compounds that create the common fishy smell. In contrast, yeast infections typically do not produce these odor-causing compounds.
Can menopause increase the risk of BV and yeast infections?
The menopause transition can increase your risk of BV, but it usually does not increase your risk of yeast infections.
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BV: During the menopause transition, estrogen levels drop. This reduces the number of healthy Lactobacillus bacteria and raises vaginal pH. These changes make it easier for BV bacteria to grow.
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Yeast infections: Yeast tends to grow when vaginal pH is low. Since vaginal pH usually rises after menopause, yeast infections are less common. Lower estrogen also makes vaginal tissue thinner and drier. Because yeast grows best in warm, moist environments, these changes may make fungal infections in the vagina less common after menopause.
Can BV and yeast infections happen at the same time?
Yes, BV and yeast infections can happen at the same time. In some cases, antibiotics used to treat BV can even lead to a yeast infection.
If you think you have both infections, tell your healthcare provider. Some women and their providers find it helps to combine a yeast-fighting medication such as fluconazole with the antibiotics that treat BV.
At NeuEve, we’ve pioneered an alternative approach to managing these tricky combinations of conditions. Let’s discuss some natural options that can help.
What natural, non-pharmaceutical approaches may help support vaginal balance?
NeuEve offers natural, non-pharmaceutical ways to maintain vaginal balance. After treatment, you can take steps to support healthy vaginal flora.
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Concern |
NeuEve support |
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Bacterial Vaginosis (BV) |
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Vulvovaginal candidiasis (Yeast Infection) |
Support for BV and yeast infections
It can be difficult to tell the difference between BV and a yeast infection. To get an accurate diagnosis and treatment, start by talking to your healthcare provider, if you have one. We understand that not everyone has a provider they trust, though.
NeuEve also offers health coaching to help you understand your symptoms and support your vaginal health. While coaching is not the same as medical care, it can help you get started on a path to recovery. If you’re interested, check out NeuEve Medical Coaching.
Sources
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Van Gerwen OT, Smith SE, Muzny CA. Bacterial Vaginosis in Postmenopausal Women. Curr Infect Dis Rep. 2023;25(1):7-15. doi:10.1007/s11908-022-00794-1
Jeanmonod R, Chippa V, Jeanmonod D. Vaginal Candidiasis. In: StatPearls. Treasure Island (FL): StatPearls Publishing; February 3, 2024.
Lin YP, Chen WC, Cheng CM, Shen CJ. Vaginal pH Value for Clinical Diagnosis and Treatment of Common Vaginitis. Diagnostics (Basel). 2021;11(11):1996. Published 2021 Oct 27. doi:10.3390/diagnostics11111996
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Hildebrand JP, Carlson K, Kansagor AT. Vaginitis. In: StatPearls. Treasure Island (FL): StatPearls Publishing; January 19, 2025.
Vaginal Candidiasis (Yeast Infection). J Midwifery Womens Health. 2021;66(6):825-826. doi:10.1111/jmwh.13326
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Rautemaa-Richardson R, Sobel JD, Stone N, et al. State-of-the-Art Review: Managing Vulvovaginal Candidiasis. Clin Infect Dis. 2026;82(3):371-382. doi:10.1093/cid/ciaf673
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Kim JM, Park YJ. Probiotics in the Prevention and Treatment of Postmenopausal Vaginal Infections: Review Article. J Menopausal Med. 2017;23(3):139-145. doi:10.6118/jmm.2017.23.3.139
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