Women's health · Education
BV vs yeast infection: how to tell which one you have
BV and yeast infections cause overlapping symptoms but need different treatments. Here's a clear breakdown of how they differ and when to see a clinician.
By Sophia Nairima, FNP-BC, PMHNP-C · Reviewed May 2026
Quick answer
BV (bacterial vaginosis) and yeast infections are two of the most common vaginal infections. They share some symptoms but have distinct patterns. A clinician evaluation helps confirm which one is present before treatment.
Side-by-side comparison
Bacterial vaginosis (BV):
- Thin, gray/white/off-white discharge
- Strong fishy odor (often worse after sex)
- Mild itching or irritation (less common)
- Burning with urination (sometimes)
- Not a sexually transmitted infection, but sex can affect bacteria balance
Yeast infection (vaginal candidiasis):
- Thick, white, cottage-cheese-like discharge
- No strong odor
- Significant itching and irritation
- Redness and swelling
- Burning, especially with urination or intimacy
What causes each
BV happens when the normal vaginal bacteria get out of balance. Triggers include new sexual partners, douching, antibiotics, and hormonal changes.
Yeast infections happen when Candida fungi overgrow. Triggers include antibiotics, hormonal changes, pregnancy, diabetes, and immunosuppression.
Diagnosis
A clinician can often make a clinical diagnosis based on symptoms, especially for typical presentations. Sometimes a swab or pH test is needed. At Seavaint Health, many California patients can be evaluated by telehealth, though some may need in-person care or testing if symptoms are unclear or recurrent.
Treatment
Treatments differ:
- BV is typically treated with prescription antibiotics (oral or vaginal).
- Yeast infections are typically treated with antifungal medication, available over the counter for mild cases or by prescription.
Using the wrong treatment won't help and can prolong symptoms. That's why getting evaluated matters before treating.
What if it keeps coming back?
Recurrent BV or yeast infections (more than 3-4 episodes per year) deserve closer evaluation. Possible underlying causes include hormonal factors, diabetes, irritants, or other conditions. In-person care or specialist referral may be appropriate.
When to seek urgent or in-person care
Some symptoms suggest something more than BV or yeast and need prompt evaluation:
- Severe pelvic or abdominal pain
- Fever
- Pregnancy-related concerns
- Heavy bleeding
- Sores or lesions
- Symptoms after possible STI exposure
FAQs
Can I treat BV with over-the-counter medication?
No. BV requires prescription antibiotic treatment. OTC yeast infection treatments won't help with BV.
Can I have both at the same time?
Yes. It happens. A clinician can identify and treat both if needed.
Is BV an STI?
No. BV is not classified as a sexually transmitted infection, but sexual activity can affect vaginal bacteria balance.
Can yeast infections go away on their own?
Mild cases sometimes resolve, but treatment is usually faster and more reliable.
Can I get treatment online in California?
Often yes. See our BV treatment page or yeast infection treatment page.
Authored and reviewed by Sophia Nairima, FNP-BC, PMHNP-C. Last reviewed May 2026. This article is educational and not a substitute for individual medical advice. For care, book a visit in the patient portal.