Bacterial Vaginosis vs. Yeast Infection: Symptoms, Causes, and Treatment Differences

Key Differences at a Glance

Feature	Bacterial Vaginosis (BV)	Yeast Infection (Vulvovaginal Candidiasis)
Cause	Overgrowth of anaerobic bacteria (e.g., Gardnerella vaginalis), disrupting normal lactobacilli dominance	Overgrowth of Candida yeast (usually C. albicans)
Prevalence	Most common vaginal infection in reproductive-age women	Very common; 75% of women experience ≥1 episode
Discharge	Thin, white/gray, homogeneous	Thick, white, clumpy ("cottage cheese")
Odor	Strong, fishy (especially after sex or menses)	Usually none or mild yeasty smell
Itching/Burning	Mild or absent	Moderate to severe vulvar itching, burning, redness
Pain with Sex	Possible	Common
Vaginal Dryness	No	Yes, often
pH	>4.5	Normal (3.8–4.5)
Treatment	Antibiotics: metronidazole (oral/vaginal), clindamycin, secnidazole, tinidazole	Antifungals: fluconazole (oral), topical azoles (clotrimazole, miconazole, terconazole)

Prevention Strategies for Both

• Avoid douching—disrupts natural microbiome.
• Use condoms consistently; semen raises vaginal pH.
• Wear breathable cotton underwear; avoid tight synthetics.
• Wipe front to back.
• Limit unnecessary antibiotics.
• Probiotics (oral or vaginal) with Lactobacillus strains may help maintain healthy flora.
• Manage blood sugar if diabetic.

Important: Self-diagnosis is unreliable. See a clinician for exam, pH testing, microscopy (whiff test, saline/KOH prep), or NAAT to confirm diagnosis and receive appropriate therapy. Recurrent infections warrant evaluation for underlying factors (immune status, diabetes, hormonal changes, partner treatment).