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Difference between bacterial vaginosis and a yeast infection

Bacterial vaginosis and vaginal thrush are the two most common vaginal complaints. For many years thrush had been better understood and more readily treated than bacterial vaginosis, which led to a common misconception that any unusual discharge, itching and pain in the intimate area is caused by Candida.

Today, it is known that bacterial vaginosis is just as common as thrush, it appears in about 1/3 of women, and it is treated in a completely different way from vaginal yeast. In order to apply an adequate treatment, a woman must first know which of these two common complaints she is dealing with.

BV versus Yeast: head-to-head


Different symptoms

Both bacterial vaginosis (BV) and a yeast infection are characterised by an abnormal discharge, but the appearance of the discharge is rather different. While BV generally causes a thin, watery, white or grey discharge with a specific fishy odor, thrush is better known for a thick white discharge similar to cottage cheese, with a weak yeasty smell.

Women who have thrush mostly suffer from very intensive itching and irritation, and less often pain during intercourse or urinating. The skin of the vulva is pink or red, sometimes with white marks that can’t be removed. While irritation and pain commonly appear in bacterial vaginosis too, itching is seen less often. The pH of the vaginal environment is also different in bacterial vaginosis and yeast infection. While the normal pH of the vagina is acidic, in BV it becomes more alkaline, while thrush doesn’t have an effect on the acidity of the vaginal environment. This difference is the basis for the most common over-the-counter tests for vaginal infection.


Neither of these two complaints are considered an infection as such, but rather an imbalance of the bacterial flora. However, the differences between bacterial vaginosis and a yeast infection are not always obvious, and sometimes can even be confused with symptoms of other, more serious, problems, so it is always a good idea to talk to your doctor or gynaecologist.

“Both bacterial vaginosis (BV) and a yeast infection are characterised by an abnormal discharge, but the appearance of the discharge is rather different”

Different treatments

Bacterial vaginosis can be treated with antibiotics, such as metronidazole, or with natural products and prebiotics which would restore the balance of the vaginal flora. Bacterial vaginosis treated with antibiotics has much more impact on the beneficial vaginal microflora as it also affects the good bacteria (lactobacilli), and antibiotics can also have annoying side effects. As a result, there is a high recurrence rate when BV is treated with antibiotics.

Natural products are more directed to restoring the good vaginal flora instead of disrupting it further by killing off both pathogenic (harmful) bacteria, and the good bacteria. Similarly, candida can be treated with antimycotics, or by a product which restores the balance and stimulating the beneficial lactobacilli flora in the vagina. In case you choose to use an over-the-counter self-treatment product, it is advisable to visit your doctor when the symptoms persist.