Is it bacterial vaginosis or is it thrush? A quick guide to vaginal infections
Have you ever been going about your day and sensed that something doesn’t feel quite right? You may have noticed that your vaginal discharge has an unusual colour and smell or that you have an uncontrollable urge to itch your vulva. It could be because of bacterial vaginosis (BV) or thrush. But how can you tell the difference?
Our vagina is a unique and extraordinary part of our bodies. It’s a powerhouse where an ecosystem of bacteria, yeast and many other microorganisms live together in harmony… well, most of the time! And keeping them in balance plays an important role in our overall intimate health.
Usually, this balance is kept without us having to intervene. Friendly vaginal bacteria called lactobacilli produce lactic acid which makes our vaginal pH unhospitable for the bad kind of bacteria to grow, protecting us from nasty infections. However, the levels of good bacteria can sometimes drop, allowing the harmful ones to grow out of control. This puts us at a greater risk of having conditions such as bacterial vaginosis (also known as BV) and thrush.
Alarming as they may sound, they’re both common and treatable conditions – so try not to panic! By knowing the key differences between them, you can work out what’s going on and seek the proper treatment to restore your vaginal balance (and stop that annoying itch!).
Let’s talk about bacterial vaginosis (BV)
BV is an infection in the vagina that occurs due to the overgrowth of bad bacteria. It’s one of the most common vaginal infections out there. In fact, 1 in 3 of us will get it at some point in our lives.  Anyone with a vagina is at risk of getting BV, but you’re more likely to experience it between the ages of 15 and 44. 
Generally, BV is a mild problem that goes away on its own. And although the condition is not usually serious, there are times when it might need some extra push-through treatment.
Changes in our body can leave us feeling anxious, especially when it comes to our V-Zones (that’s everything to do with your vagina, vulva, and the V-shaped front of your body that you can see). Just remember that when these things happen, it’s ok to ask for help – there’s nothing shameful about your body! With support from healthcare professionals and your loved ones, you can get rid of these conditions in no time.
What are the signs and symptoms of BV?
In most cases, women+ with BV show no symptoms at all. Even if you have it, you may not notice it straight away. However, the first clue you might find is a change in your vaginal discharge. If it’s watery, white, or grey in colour with a strong and unusual smell that could be described as ‘fishy’, there’s a high chance that it can be bacterial vaginosis. Usually, this condition doesn’t cause itching or soreness, so if that’s the case, it’s a good idea to get checked by a doctor so they can look in the possible causes and treatment.
What are the causes of bacterial vaginosis?
As we know, our vagina hosts a lot of good, friendly bacteria. However, when the conditions are just right, bad bacteria can overgrow and create an imbalance in your vagina that causes infections such as bacterial vaginosis. So, what triggers these bad bacteria to grow out of control?
Having unprotected sex
While BV doesn’t spread from person to person, unprotected sex can increase risk of infection. In some instances, when semen is involved during sex, it can affect the natural pH of the vagina due to its alkaline nature. However, even if semen is not involved, it’s always a good idea to stay protected and have safe sex.
The good news is you can use barrier protection such as condoms or dental dams to keep yourself and your partners safe, not only from bacterial vaginosis but also from sexually transmitted infections (STIs).
“Cleaning” your vagina
While washing your vulva (the external bits of your V-Zone) on a daily basis is a good idea, cleaning the vagina (the internal part) never is, as that may unsettle your vaginal pH. This can cause the opposite of your desired effect and produce smelly bacteria that lead to vaginal infections such as bacterial vaginosis.
Remember that vaginas are not meant to smell like roses or potpourri, each has its own natural scent and that’s completely normal. Not only that, but they are naturally amazing at keeping themselves healthy. So, the best thing you can do is let your vagina look after itself. You can still help it, though, by wearing clean underwear made of breathable materials like cotton and avoiding using scented products like deodorants and perfumes around your intimate area.
Not changing your period products regularly
Keeping track of when you last changed your towel or tampon may be tricky and bothersome but it’s worth it. Menstrual blood has a slightly alkaline pH and not changing period products enough can create the perfect environment for bad bacteria to grow.
To avoid unsettling your vaginal pH, change your period products roughly every 4 hours. Running on a busy schedule? You could try setting a reminder on your phone to prompt you to change your pad or tampon frequently.
Treatment: How to get rid of BV?
If you think you may have bacterial vaginosis, try not to worry. Although it can be a nuisance, it’s pretty easy to resolve. The most common treatment is antibiotics prescribed by a doctor – you can take them orally as tablets or get a gel or cream to apply directly inside your vagina.
Although it can be awkward to open up about intimate issues, speaking to your doctor is always a good idea, as they will be able to reassure you and recommend the best treatment.
Can you get treatment for BV during pregnancy?
Yes, of course! If you notice a change in your vaginal discharge during pregnancy that you suspect could be BV, reach out to your doctor or midwife, as it can be easily and safely treated at any stage. Everything will be back to normal in no time so that you can focus more on your baby and less on some pesky bacterial vaginosis.
Can you still have sex if you are having treatment for bacterial vaginosis?
You can have sex if you’re under BV treatment as long as you and your partners feel comfortable doing so. However, be mindful that some vaginal gels/creams used to treat bacterial vaginosis can weaken latex condoms, therefore, they might not protect you effectively against unwanted pregnancy or STIs while on treatment.
What about getting treatment for BV while on your period?
No worries, you can use your medicine as prescribed even if you’re on your period. If you’re unsure about managing your symptoms while on your period, it’s always a good idea to speak to a medical professional for advice.
How to treat recurring BV?
Although it can be frustrating, it’s quite common for BV to come back. In fact, around half of people will experience it again within one year of treatment,  while some might get it back in as little as three months. 
If your bacterial vaginosis does return, personalized treatment will be needed, so don’t hesitate to reach out to your doctor for help.
Feeling too self-conscious or worried when this happens is absolutely normal – opening up to your loved ones, friends, or family may help get those feelings off your chest. And who knows? You might find out many women+ in your life have been through the same experience and can support you through it.
Red, sore, and itchy vulva – could it be thrush?
Got an itching, burning sensation in your vulva, and all you can think about is how desperately you want to scratch it? Have an unusual, creamy discharge from your vagina? The problem could be thrush. And you’re not the only one. It’s estimated that around 75% of women will experience it in their lifetime,  that’s 3 out of every 4 of us! 
Thrush is a common yeast infection caused by the overgrowth of fungus (known as fungus candida) and your vagina and/or vulva are prime places for yeast to grow as it thrives in warm, damp spots. Although it might irritate us and even affect our self-confidence, the good news is thrush is usually harmless. It’s a mild condition, and in most cases, the right treatment clears it up quickly so that your V-Zone can be back to its usual self and you can live your life fearlessly.
So, what signs and symptoms of thrush should you look out for?
The first thing you may notice with thrush is unusual vaginal discharge that is thick and creamy like cottage cheese, but unlike the kind you get with BV, it usually doesn’t smell. While generally harmless, thrush can make you feel really uneasy or cause an itch that feels impossible to scratch. But don’t fret! It can be easily treated with over-the-counter anti-fungal medications. Before you rush to the pharmacy, though, consider contacting your doctor to confirm if the culprit really is thrush.
What causes thrush?
Basically, we all have yeast in our vaginas (that doesn’t cause us trouble most of the time) and it’s the job of the good bacteria in our body to keep it from growing too fast. But sometimes, when the conditions are just right, this yeast can grow uncontrollably out of balance, leading to an infection. So, what can trigger this?
Taking too many antibiotics
Remember how we mentioned taking antibiotics to help treat BV? Well, it turns out that you can have too much of a good thing! Going overboard with them is one of the most common causes of thrush. While it’s the job of antibiotics to kill bacteria in the vagina, they don’t necessarily know the difference between all the bad and the good bacteria (even the ones that help keep yeast under control).
Changes in hormone levels
As hormonal imbalances are linked to yeast infections, if you’re pregnant, on hormone replacement therapy, taking birth control pills , or even at specific times during your menstrual cycle, there’s a higher chance that you can get thrush.
Treatments: How to get rid of thrush?
If it turns out you do have thrush after all, your doctor will prescribe antifungal medicines to help get rid of the issue. Thankfully, it will usually clear up within 7 to 14 days of beginning the treatment. 
These kinds of medicine come in many forms such as tablets, cream, or pessaries (tablets you insert in the vagina). If you’re applying a pessary for the first time, it can be quite a daunting experience. For reassurance, think of it like applying a tampon (if you’ve used one before — it might even come with an applicator that is very similar to a tampon’s!). Just remember to relax and take deep breaths while inserting it. But don’t worry if that doesn’t feel right for you, as there are other treatment options available... just reach out to your doctor.
Can you get treatment for thrush during pregnancy?
It’s normal for thrush to come and go throughout your pregnancy due to hormonal fluctuations, especially during the final stages of pregnancy. Good news is, though, that you can get treatment regardless. If you believe that you may have thrush, it’s a good idea to consult your doctor as soon as possible so that they can recommend medication (and get you relief from that itchy situation!).
Can you still have sex if you are having treatment for thrush? Is it contagious?
If you or your partners may have thrush, it's best to avoid having sex until the course of treatment is completed and the infection has cleared up. This is because it is contagious and either of you could risk passing it to the others during sex.
Although taking a sexual pause might not be fun, neither is an itchy vulva, is it?
Having problems with recurring thrush?
Although thrush is usually easily treatable, it can be a stubborn problem that returns again and again. In some cases, the infection can become resistant to standard drugs after multiple episodes, leaving you with fewer treatment options.
If you’ve been struggling with recurring thrush, it’s best to see a medical professional, who will be able to find a different treatment or refer you to a specialist. Although it can be somewhat awkward to talk about intimate topics with them, getting help is worth it. You and your vagina deserve to feel better – scratch that – deserve to feel fantastic again!
If you’d like to learn more about how to care for your V-Zone, why not find out about personal hygiene during your period or how you can include intimate care in your daily routine?
The medical information in this article is provided as an information resource only and is not to be used or relied on for any diagnostic or treatment purposes. Please consult your doctor for guidance about a specific medical condition.