Bacterial Vaginosis vs Candidiasis: what’s the difference?

What are bacterial vaginosis and candidiasis?

Both situations are quite common in women and look somewhat similar, but as it turns out they are very different, and have very different treatments. So, what are each of them?

Bacterial vaginosis

Bacterial vaginosis – and the name gives it away – is a vaginal inflammation caused by bacteria. It only affects women. Bacterial vaginosis is related to the pH of and to the natural bacteria found in the vagina. On one hand, an imbalance in the pH can cause the proliferation of one or more of the bacteria, and on the other, the lack or excess of a bacteria in the vagina can seriously disrupt the pH.

It is characterised by a thin, foul-smelling discharge, which tends to be the sole symptom. However, sometimes can be accompanied of a sensation of burning in the lower part of the vagina. Bacterial Vaginosis, or BV, is treated with antibiotics that need to be prescribed by a doctor. While it is not sexually transmissible from a woman to a man, BV can be sexually transmitted between two women.

Some risk factors for developing BV are:

  • Having multiple sexual partners;
  • Douching;
  • Using intimate soaps (especially those with perfumes or with a too basic pH);
  • Using scented menstrual products;
  • Using vaginal deodorants;
  • Natural lack of the good bacteria in your vaginal flora.

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Candidiasis, also known as thrush, candida, or yeast infection, is a fungal infection, caused by a fungus. It can develop in the genitals and in the mouth (oral candidiasis), in both men and women, and in more rare cases can also develop in areas like armpits, groins and between the fingers. Candidiasis can be caused by over 20 different types of fungi of the Candida genus, especially Candida albicans. This fungus is naturally found in the gut flora.

Vaginal candidiasis happens when, for some reason, there is an imbalance in the vaginal flora that promotes the proliferation of the fungus. It can be transmitted from person to person, but it is not considered a sexually transmitted infection, since it can be transmitted by kissing (oral candidiasis), breastfeeding, among others.

The common signs of having (vaginal) candidiasis are a thick, lumpy and white discharge that kind of resembles cottage cheese. This discharge does not normally smell bad. Some other symptoms are itchiness, swell, and soreness in the vagina and vulva, and pain or burning during urination. It is treated with anti-fungal medication, which is mainly over-the-counter medication and doesn’t have many side effects.

Some risk factors for developing candidiasis are:

  • Taking antibiotics;
  • Wearing very tight clothes and underwear;
  • Wearing underwear made of synthetic fibres;
  • Using scented menstrual products;
  • Douching;
  • Wearing wet clothes or underwear (swimwear, for example) for too long periods;
  • Using hot tubs, and taking very hot baths.

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Both bacterial vaginosis and candidiasis are treatable rather easily, but if left untreated for a long time can have more serious complications.

How to tell bacterial vaginosis and candidiasis apart?

Although these two are very different, the symptoms can be confusing, and it is usual to mistaken one for the other. What happens normally is that people try to treat BV with Candidiasis medication, which is over the counter medication, and the result is not always the same: sometimes it helps alleviate some symptoms, sometimes it makes some symptoms a bit more intense, sometimes it does absolutely nothing.

So, to avoid making that mistakes, learn how to tell bacterial vaginosis and candidiasis apart by symptoms:

Bacterial Vaginosis  Candidiasis
Discharge is thin, abundant, and runny; Discharge is thick and lumpy (cottage cheese-like);
Discharge is yellow-, grey-, or green-ish; Discharge is white;
Discharge is foul smelling, with a “fishy” smell or at least unpleasant; Discharge is not foul-smelling, usually without any smell at all;
Sensation of burning in the vagina and possibly while urinating; Itchiness, soreness and swell in the genital area, and pain or burning while urinating;
Smelly discharge tends to worsen after sexual intercourse. Sexual intercourse can be painful.


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What should I do if I have bacterial vaginosis or candidiasis?

If you suspect you might have bacterial vaginosis or candidiasis, seek advice from a pharmacist, from your GP, or from your gynaecologist. There are some sexually transmitted diseases than can resemble bacterial vaginosis or candidiasis, so it is important to get the right diagnosis.

To look for BV, your doctor might perform a pelvic exam, collect a sample of your vaginal secretion (and look it up under a microscope), or perform a pH test. If you have bacterial vaginosis, you most likely will be treated with an antibiotic. But attention: it is very common for bacterial vaginosis to recur within 3 to 12 months, even after being successfully treated. Bacterial vaginosis recurrence is not yet very well understood by doctors. If BV symptoms recur after treatment, talk to your doctor about possible treatments.

To look for signs of Candidiasis, your doctor might perform a pelvic exam or test your vaginal secretions. If you do have candidiasis, you will be treated with an anti-fungal medication. Since candidiasis is a fairly common infection, if your doctor can’t see you in person (for example, during these times when people are advised to avoid hospitals) or if you can only talk to a pharmacist, you might be instructed to use an over-the-counter medication (normally a vaginal cream). In case you have candidiasis very frequently, you should talk to your doctor for long-term treatments or treatment options.

Most importantly: take care your vagina!

Meanwhile, avoid risk factors for both bacterial vaginosis and candidiasis – for example, wearing synthetic underwear, especially in very hot days, or wearing synthetic pads or panty-liners. The fungi the cause candidiasis just looove warm and humid environments. Know the 7 rules of vagina-friendly underwear. These same fungi, on the other hand, are not very fond of breathable, natural fabrics, or all-natural organic cotton pads. In regard to bacterial vaginosis: just keep miles away from scented menstrual products, bubble bath bombs, and if you use intimate soap, make sure to choose an appropriate one.

Take care, Of yourself. Of your planet. Of your vagina.


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