Both bacterial vaginosis and thrush are very common conditions associated with women, but they’re often misunderstood and misdiagnosed. One condition can often be confused for the other but they’re treated in different ways and it’s important to know whether you have BV or thrush so you get the right treatment.

We’re here to clear these infections up, both literally and in terms of what they are and how they differ. We give you the symptoms to look out for and what to do if you have either infection. 

BV vs Thrush 

It’s easy to mistake one condition for the other as the symptoms can often be the same, in some cases there may not be any symptoms present at all. Knowing the differences between them and the symptoms to look out for will help you to spot the signs early on and get treatment before complications occur. 

So, is it thrush or is it bacterial vaginosis? 

What is bacterial vaginosis? 

Bacterial vaginosis is the most common vaginal infection that usually affects women of reproductive age who are sexually active. This infection is caused by a pH imbalance in bacteria in the vagina, and when there are more bad bacteria than good, this can cause an infection. 

A BV infection can go undiagnosed as symptoms don’t always show, but when they do you may get an unusual vaginal discharge that is thin in consistency and grey, yellow or green in colour, it may also have a strong ‘fishy’ odour particularly after sex or during menstruation. You may also experience a feeling of itching or burning around the vagina or when you pee. 

There are a number of triggers for BV and some do’s and don’ts when it comes to preventing the infection. The vagina naturally has bacteria and there are many reasons why there may be an imbalance, this can often be due to hormones during the menopause or pregnancy, but it can also be triggered by having sex particularly having sex with a new partner, some hormonal contraceptives, and excessive cleaning or ‘douching’ of the vagina. 

Yes, being too clean can cause BV. This doesn’t mean you should stop cleaning but excessive cleaning with strong perfumed products is unnecessary and can actually upset the natural bacteria in the vagina. Mild soap and water work just fine and are gentle on this intimate area. 

Here’s how to prevent a bout of BV:

What is thrush? 

Thrush is a very common vaginal yeast infection, however, this infection can occur in other areas of the body such as the mouth. A thrush infection occurs when there is an imbalance of the fungus that lives naturally in the vagina, this is known as Candida. When the Candida albicans fungus overgrows this can lead to infection. 

The symptoms of vaginal thrush slightly differ from bacterial vaginosis. Just as with BV you’ll likely get an unusual discharge with thrush, unusual discharge is often associated with thrush as this is the more well known vaginal infection, but more often than not it’s actually bacterial vaginosis.

With thrush, the discharge will be thicker and white resembling a cottage cheese consistency, but it is usually odourless compared to the strong odour of BV. There may also be itching and soreness around the entrance of the vagina, pain during sex, and in severe cases, red, cracked or damaged skin around the vagina. 

Women in their twenties and thirties are more prone to getting vaginal thrush, and it can often be triggered when there are changes to hormones or the condition of the vagina such as during pregnancy, or if you’ve had a course of antibiotics, or if you have vaginal dryness and have sex when you’re not fully aroused. Having sex when you’re not fully relaxed and the vagina is dry can trigger thrush. 

Thrush in men 

Unlike BV, thrush can affect the opposite sex. Thrush in men is not as common as thrush in women but it can happen. In men, it affects the head of the penis causing irritation, burning, itching, redness, discharge (which may have an odour), and there may be difficulty pulling back the foreskin. It’s possible that your partner can pass thrush to you through sex, so if you’re being treated for thrush you should avoid sex until the infection has completely cleared. 

Does this mean that BV and thrush are STIs? 

Not necessarily, although both infections can be triggered by sex and can be passed through sex (with BV this would be woman to woman or woman to man with thrush and vice versa), neither is considered to be a sexually transmitted infection. Having these infections, however, does put you at an increased risk of contracting an STI as the acidity of the vagina is reduced meaning there is less protection from infections. 

How are thrush and bacterial vaginosis infection treated? 

If you suspect you have either of these infections you should first get a proper diagnosis before you get treatment, as BV treatment is different from thrush treatment.

As thrush is a fungal infection it must be treated with antifungal medicines that come in the form of oral capsules, and pessaries and creams that are applied inside the vagina. If you’ve had thrush before and you know the symptoms you may only need to visit your local pharmacy for some over the counter medicines or simply order online from a doctor service such as Doctor 4 U, many patients find this is more convenient and more discreet if they’re too embarrassed to speak to a pharmacist or doctor face to face.

However, if it’s the first time you’ve had thrush you will need to see your doctor face to face for a diagnosis before you can get treatment. Some of the main medicines used to treat thrush are known as Diflucan, Fluconazole, and Gyno Daktarin.  

 

 

BV treatment, on the other hand, involves antibiotics. As well as practicing good hygiene, you may also need to treat the bacterial infection with antibiotic gels, creams, or tablets. This will help to restore the acidity in the vagina and balance out the bacteria. Metronidazole is a common antibiotic treatment for BV which can usually clear up the infection in 7 days. Again, you should first get a diagnosis of BV before treating it, you can do this at your GP surgery or nearest sexual health clinic. 

Recurrent BV and thrush 

Annoyingly, BV and thrush infections can make a return even after treatment. If you’re having frequent bouts of either infection you may need to have some tests to make sure there’s nothing else going on that may be causing this, and your doctor may prescribe a longer course of treatment to keep these infections at bay so you can feel more like yourself again without the annoying itch!