December 21, 2023
Yeast and bacterial vaginosis (aka BV) are two of the most common and normal vaginal infections that happen to vaginas everywhere! People who are prone to these infections can likely tell you the signs, symptoms, and treatment better than most medical providers, but these infections can still stump patients and providers alike. In this article we will talk about their unique and shared symptoms, how to tell the difference, and how to treat them so you can start feeling better.
Bacterial vaginosis is the most common vaginal infection and is caused by an overgrowth of some normally-occurring bacteria that live in the vagina. This can happen from having too much of some bacteria, or not enough of others.
Sometimes, this happens when the pH (level of acidity or basicity) of the vagina is off. Vaginas are happiest when their pH is more acidic and between 3.8 and 5. Anything that is more basic that goes in the vagina can throw it off, creating amore likely environment to develop BV. Blood, semen, and soap are some major culprits that can offset this balance, which is why some people report getting BV after their periods, after using a new soap product, or having a new sexual partner.
Many people who have BV don’t experience symptoms at all, and occasionally, the vagina will reset the balance on its own and self correct. Other times, it can cause bothersome symptoms. The main symptoms people describe when they are experiencing BV is a thin, white or gray discharge that can also have a fishy odor to it. Because there is additional discharge, it can also cause irritation. You don’t have to wait to see a doctor in-person—get treatment from the comfort and convenience of your phone with the support of Hey Jane’s compassionate, licensed providers.
A yeast infection is an overgrowth of a fungus that can be found in the vagina called Candida (and no, it’s a different type of yeast than the one you bake bread with!). Similar to BV, this overgrowth is caused by an imbalance of healthy bacteria in the vagina. It’s also why many patients report yeast infections after taking antibiotics, as they can kill both good and bad bacteria. Some medical conditions make people more prone to yeast infections including diabetes and HIV.
A yeast infection has classic symptoms of thick, “cottage cheese” like discharge that is usually accompanied by itching and irritation (including discomfort during sex).
Yeast infections are incredibly common, and can sometimes be treated with over-the-counter anti-fungal treatments in the forms of a vaginal cream or suppositories, which are small cone or egg-shaped medications that are inserted directly into the vagina. You can also get fast, effective relief with prescription anti-fungal treatments through providers like Hey Jane that don’t require an in-person appointment and can be picked up from your local pharmacy asap.
There are some main differences between BV and yeast, both in what causes each and in how they feel.
BV typically presents with thin discharge that is white or gray in color and can be accompanied by a fishy odor. While having additional discharge can cause irritation, BV is not typically itchy.
A yeast infection, on the other hand, usually results in thick, white, and clumpy discharge—often described as “cottage cheese-like” and can be very itchy.
Yes, you can have both a yeast infection and BV at the same time! While each infection prefers a different PH environment (Yeast favors more acidic and BV favors more basic) they both can exist together! If you’re experiencing symptoms that resemble both a yeast infection and BV, you may have a co-infection which can be treated with prescription medications.
The treatments for yeast and BV are different, however, they each have a number of options to choose from to meet your budget, schedule, and preferences.
Yeast infections can be treatment with antifungal topical creams like Monistat, an over-the-counter treatment sold at most pharmacies, and butoconazole (Gynazole) which is a prescription-strength cream you can get from providers like Hey Jane if you want to save time and skip the in-person visit. You can also get a prescription for fluconazole (Diflucan), an oral antifungal tablet that can help treat a yeast infection.
BV has more treatment options, but they all require a prescription. There are topical treatments like metronidazole gel (Metrogel) and clindamycin creams. Lastly, there are antibiotic pills including metronidazole, clindamycin, and tinidazole that are commonly prescribed to treat BV. Secnidazole (Solosec) is another option, which is a one time oral dose of granules that gets mixed into yogurt.
Some people prefer topical treatments to oral pills because they like the idea that the medicine is going exactly where it needs to go, and nowhere else, with less side effects. Others prefer treatment in pill form because they are less messy. The decision is up to you, and together with your provider you can pick the best option for your body and preferences.
Telehealth care with Hey Jane is a safe and convenient way to consult with a licensed provider with expertise in sexual and reproductive health from the comfort and convenience of your phone. Skip the urgent care waiting room, or the long wait for an in-person appointment, and relieve your symptoms ASAP.
We offer care for people who are at least 18 years old, are located in an eligible state (residency not required), and meet certain medical criteria. To find out if you’re eligible, fill out our secure, online form here.
If you’re eligible, our clinical care team will guide you through the process to receive the same FDA-approved medications available in-clinic to treat your infection. We know how uncomfortable and frustrating symptoms like itching and vaginal odor can be, and we work quickly to review your intake form, discuss any questions or concerns you may have, and prescribe treatment to your local pharmacy for pick-up.
Treatment costs will vary depending on your provider, payment method, and treatment. At Hey Jane, our affordable consultations are on par with in-clinic co-pays and can be as low as $0 with insurance. Prescriptions are sent to your local pharmacy of choice where you can pay with insurance, your FSA/HSA, cash, or credit as normal.
We also offer 1 month of ongoing support from our clinical care team via Spruce (our secure messaging app) and helpful resources to help support you during and after treatment.
Want to see if you’re eligible? Get started.
The best way to prevent a yeast infection is to wear breathable underwear, change out of wet clothes and swimsuits as soon as possible, and refrain from douching or using scented vaginal products. If you get yeast infections multiple times a year, your provider may order additional testing to rule out any underlying medical conditions.
The main culprits for BV are blood (like menstruation or during/after an abortion), semen, and soap. All have very basic pH which vaginas don’t like, so they can set you up for BV anytime they are in the vagina. To maintain a healthy vaginal pH, use condoms if you have a semen-producing partner and refrain from using scented soaps or scented products in the vagina to help prevent BV.
Yes! Most yeast infections can be effectively treated with over-the-counter treatments—but not all. Some types of yeast require a prescription oral medication.
Yes! Some people find that boric acid can help prevent BV, and some studies suggest that taking it for long enough can treat it. While it is not FDA-approved for this, it is relatively safe to try and might even help.
Kind of? People do not typically get yeast infections from having sex directly, but elements of sex like having something inside your vagina, using lube, or semen can impact the pH of your vagina and result in a yeast infection.
If you and your partner both have vaginas, some studies suggest that you can give BV to each other—but it does not mean that your partner is cheating as BV has a number of causes. If your partner is semen-producing, having semen in the vagina may disrupt the natural pH of your vagina and cause BV—but it does not mean your partner is cheating.
Absolutely not! Keep in mind, however, that there are entire industries making millions of dollars off of the idea that your vagina is dirty or unhygienic and needs “detoxed” “cleansed” or purified. Selling products to people to encourage them to cleanse or scent their vaginas can actually cause BV. Having BV is very common and very normal, and you have lots of options to treat and prevent it!