Is Your Irritated Vagina a Yeast Infection or Bacterial Vaginosis? Here’s How to Tell

They’re both a huge drag, but they come with distinct symptoms, risk factors, and solutions.

By Erica SloanMedically reviewed by Sanaz Ghazal, MD

February 27, 2025

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So it feels like your vagina is on fire. Let me first say, I’m so sorry you’re here. You might initially assume you’re dealing with a yeast infection—it’s just the vagina problem with the best PR. And as many as 75% of people with vaginas will get a yeast infection over the course of their lifetime, making it a pretty good guess. But there’s another condition that can chart a similar course and is actually a more common cause of a painful vagina: bacterial vaginosis, or BV. In as many as half of cases of vaginal discomfort diagnosed by docs, BV is the culprit, according to research. And figuring out whether you’re dealing with a yeast infection or bacterial vaginosis is key to getting swift relief from the special hell of a burning, itching crotch.

Both a yeast infection and BV are the result of an overgrowth of certain microbes in your nether regions. But where a yeast infection involves excess of a fungus called Candida (almost always Candida albicans, but sometimes other types like Candida glabrata or Candida tropicalis), bacterial vaginosis occurs with an overload of anaerobic (or non-oxygen-requiring) bacteria, commonly Gardnerella vaginalis. To be clear, every vagina has some amount of yeast and anaerobic bacteria living in there on a good day; you’ll only wind up with a problem when the numbers of either surpass their usual quantity, resulting in an imbalance.

Read on to learn how to tell what’s throwing things off-kilter down there, how to find relief, and why you might be stuck playing this unfortunate guessing game on repeat.

Here’s how yeast infection and bacterial vaginosis symptoms differ.

Both yeast infections and BV can make your nether regions feel supremely uncomfy. But there are some key differences in how they tend to show up, particularly when it comes to vaginal discharge and odor. While yeast brings a thick, white, and clumpy discharge, the BV version is generally thinner and grayer, Carolyn Ross, MD, a board-certified ob-gyn in Burlington, New Jersey, and medical advisor at Winx Health, tells SELF. And with BV, things will probably smell fishy down there, whereas with a yeast infection, there’s typically no real smell, she adds.

Also helpful to note: The symptoms of a yeast infection tend to colonize your whole vulva (meaning, your external labia), causing irritation and itching throughout, whereas bacterial vaginosis is concentrated in the vagina, Dr. Ross says, so any discomfort is mostly therein.

To recap, with a yeast infection, your symptoms will likely include:

Itching, irritation, and pain in your vagina and vulva
Swelling and discoloration of your vulva
Burning in your vagina when you pee or have sex
Cottage-cheese-like discharge with little or no smell

And with bacterial vaginosis, your symptoms will generally include:

Pain or irritation in your vagina
Burning in your vagina when you pee or have sex
Light gray (or off-white or greenish) discharge with a fishy smell, which may be especially noticeable after sex

Keep in mind, too, that these similarly presenting conditions also have some symptom overlap with common STIs, Dr. Ross says, like trichomoniasis, gonorrhea, and chlamydia, so it’s important to see your doctor if you’re not quite sure whether yeast or BV fits the bill (more on this below). Another disconcerting possibility is that you’re rockin’ a case of both yeast and BV at the same time. It’s not common, but it can happen if your vaginal flora (a.k.a. the community of microbes living there) “gets really out of whack,” Kenosha D. Gleaton, MD, a board-certified ob-gyn in Charleston and medical advisor for Everlywell, tells SELF. “And double the trouble just means double the discomfort.”

Relatedly, if you have BV and then take antibiotics to treat it, you might be at higher risk of developing a yeast infection afterward, Dr. Ross says. That’s because the meds might not just kill off the harmful bacteria; they could also knock out some of the good guys that are typically responsible for keeping yeast in check.

Certain factors can make you more prone to yeast, BV, or both.

Adding to the potential yeast-BV confusion is the fact that they share many of the same risk factors. That’s because anything that can mess with the delicate harmony of your vaginal flora—and lower your numbers of “good” bacteria like Lactobacillus—can also open the door for an overgrowth of either “bad” bacteria like Gardnerella (bacterial vaginosis) or Candida (yeast). So you want to avoid any douching or washing inside your vagina (just stick to your vulva), and steer clear of scented soaps, detergents, or menstrual products—since all of the above can throw off that balance. Similarly, taking antibiotics for a sickness or skin infection elsewhere in your body could up your risk of yeast or BV by wiping out some of those good vaginal microbes.

While neither BV nor yeast is sexually transmitted, changes in your sex life—having sex with a new person or switching between multiple partners—may also raise your risk of either, Dr. Ross says. After all, you’re exposing your vagina to a different set of microbes (the ones populating your new partner’s genitals), which could mess with your ecosystem. Similarly, having your period won’t cause either condition, but the hormonal changes and presence of blood down there could switch up your typical vaginal microbiome and make you more susceptible to both. Same goes for having an intrauterine device (IUD); research suggests that copper ones, specifically, might restrict the growth of good bacteria relative to bad guys, predisposing you to BV, while portions of any IUD could also act as spaces for yeast to multiply.

That said, there are also a few unique factors that could up your likelihood of a yeast infection or bacterial vaginosis. On the yeast front, candida “loves warm, moist environments,” Dr. Gleaton says, so wearing tight or damp clothing (like a wet bathing suit or sweaty workout clothes) for a long period of time might leave you abnormally yeasty. These microbes also go ham for sugar, so if you have an elevated blood-sugar level (as with diabetes) or use flavored or warming lubes containing a type of sugar called glycerin, you could be at higher risk. For the same reason, having extra-high estrogen levels—like during pregnancy or while taking estrogen therapy—could set off yeast overgrowth, as estrogen raises the level of glycogen (a stored form of glucose) in your vagina. As for BV-specific risk factors? There’s evidence to suggest smoking could directly reduce your levels of helpful Lactobacillus bacteria, allowing for the BV-causing bugs to overpopulate.

A correct diagnosis is important, because treatment for a yeast infection vs. bacterial vaginosis looks pretty different.

Because yeast infections and BV involve overgrowth of two distinct organisms, curbing that excess requires two different types of medication: an antifungal for yeast and an antibiotic for BV.

In the case of yeast, there are a bunch of popular OTC antifungal creams and suppositories (which dissolve inside your vagina), including miconazole (Monistat) and tioconazole. If you feel confident that you’re dealing with yeast (perhaps you’ve gotten this type of infection before), it’s generally okay to treat your symptoms on your own with one of these solutions over the course of three to seven days. Just note that if you’re still dealing with pain and discharge past that period, it may be a sign that you’ve taken the wrong medication; if, for instance, it’s actually BV and you’re using OTC yeast infection treatments, you won’t get any relief…and you could even make things more uncomfortable down there.

That’s why it’s generally a good idea to give your doctor a call if you’re at all unsure of what’s plaguing you. An ob-gyn can often pinpoint a yeast infection based on symptoms alone, but they can also gently swab your vagina and use a microscope to check your discharge for signs of yeast or bacterial overgrowth. And if they suspect that something else might be in play, they can send that swab out for a culture test too. This typically checks for a bunch of heavy hitters at once, Dr. Ross says, including, yes, BV and yeast, but also trichomoniasis, chlamydia, and gonorrhea. (If you can’t get in to see your doc for whatever reason, there are also at-home culture and vaginal pH tests available that can give you insight into what’s going on and, in some cases, connect you to a telehealth provider to interpret the results and prescribe you meds if needed.)

If a yeast infection is the culprit, your doc can prescribe an antifungal called fluconazole (Diflucan), which is a one-time pill that can knock out candida overgrowth. (Dr. Ross favors it over the OTC creams, given that ingredients in the latter can sometimes trigger allergic reactions.) And as for BV? The only treatments are prescription antibiotics—typically metronidazole (Flagyl). It comes in the form of a pill, which you’d take twice a day for a week, or you can get it as a vaginal gel that you insert every night for five nights, Dr. Ross says. Other common options include clindamycin (Cleocin, Clindesse), which comes as a pill, cream, or suppository, and Tinidazole (Tindamax), which is taken as a pill.

It’s especially important to see a doc if you’re dealing with recurrent infections—whether yeast or BV.

Getting either one of these infections at some point is basically a fact of life for people with a vagina and is generally NBD, given that the above antifungals and antibiotics can usually knock them out. But in some cases, your vagina might struggle to find a happy state of balance post-infection, leading to repeat appearances of BV or yeast—both of which will require a personalized treatment plan created by your doctor to resolve.

Aside from the factors above that could put you at risk for BV or yeast, it’s also possible that the natural composition of your vaginal flora just makes you more susceptible, Dr. Ross says. Or if you’re immunocompromised in any way or on consistent antibiotics for a different condition, your body could have a harder time fighting off either infection. In the case of yeast, you could also be dealing with an atypical fungus like Candida tropicalis or Candida glabrata, which may require a specific type of antifungal. Or for whatever reason, your particular brand of BV or yeast may just need a stronger or longer dose of meds to eradicate.

Unsurprisingly, the treatment for recurrent BV or recurrent yeast tends to involve extending the usual care—that is, doing a lengthier course of antibiotics for BV or antifungals for yeast as determined by your doctor, for up to six months. In certain scenarios, your doc might suggest trying boric acid suppositories, which may help acidify things down there in a way that hinders the growth of either microbe. (But this is generally a last-ditch effort, given boric acid’s efficacy isn’t super well supported.) And they can also help determine whether an underlying condition might be messing with your immune system, hormones, or blood sugar levels in a way that’s opening you up to yeast infections or BV on the reg.

Brushing up on some basic vaginal hygiene could also help mitigate repeat yeast or BV (even if both often happen for reasons beyond our control). As Dr. Ross notes, it can’t hurt to use a sensitive skin-friendly laundry detergent, opt for scent-free soap and menstrual products, wear loose cotton underwear, and make a point to change out of a wet bathing suit or sweaty gym clothes as soon as possible. It might be a little extra maintenance, but it can go a long way toward keeping your vagina cool and calm—so you can be too.