Vaginal itching, discharge, and discomfort are very common reasons women visit a gynaecologist in India. Most of the time, the culprit is either a yeast infection (vulvovaginal candidiasis) or bacterial vaginosis (BV)—two different conditions that feel similar but need completely different treatments. Taking the wrong over‑the‑counter medicine can actually make symptoms worse or keep the problem recurring.​

Understanding the differences in discharge, odour, associated symptoms, and triggers helps women know when to suspect yeast vs BV and why a proper medical diagnosis matters.

What Is a Yeast Infection?

A vaginal yeast infection happens when Candida, a fungus that normally lives in small amounts in the vagina, overgrows and irritates the tissues.​

Typical features:

  • Thick, white, curd‑like (“cottage cheese”) discharge.
  • Intense itching, burning, redness, and swelling of the vulva.
  • Burning during urination or sex due to irritated skin.​

Yeast infections are not sexually transmitted infections in the traditional sense; they are often linked to antibiotics, tight clothing, high sugar levels, hormonal changes, or moisture.

 

What Is Bacterial Vaginosis (BV)?

BV happens when the balance of vaginal bacteria is disturbed and “good” lactobacilli decrease, allowing overgrowth of other bacteria.​

Key features:

  • Thin, gray, white, or sometimes yellow/greenish discharge that can be more noticeable after sex.​
  • A strong fishy odour, often worse after intercourse or during periods.​
  • Mild itching or burning; many women have no symptoms at all.

BV is not classified as a classic STI, but sexual activity, new partners, or multiple partners increase risk because they alter the vaginal environment.​

 

Symptom Comparison: Yeast vs BV

Although both cause “vaginitis” (vaginal inflammation), their signature signs differ.

Discharge

  • BV: Usually thin, watery, gray or white, sometimes yellowish/greenish; tends to coat the vaginal walls and may be more evident after sex.​
  • Yeast: Typically thick, white, clumpy discharge, often described as looking like cottage cheese; usually with very little odour.​

Odour

  • BV: Distinctive “fishy” smell, which may intensify after intercourse or during menses.​
  • Yeast: Usually no strong odour; if present, it is not typically fishy.​

Itching, Redness, and Pain

  • BV: Itching may be mild or absent; vulval redness is often minimal.​
  • Yeast: Intense itching, redness, swelling, soreness of the vulva are very common, with burning on urination or sex.​

pH (for clinicians)

  • BV: Vaginal pH usually >4.5.
  • Yeast: Vaginal pH usually normal (≤4.5).​

 

Common Triggers and Risk Factors

Yeast Infection Triggers

  • Recent antibiotic use, which kills protective bacteria and allows Candida to overgrow.​
  • High blood sugar in diabetes or frequent sugary foods.
  • Tight, synthetic underwear, damp clothing, and excessive heat and humidity.
  • Hormonal factors: pregnancy, oral contraceptives, high‑oestrogen states.

BV Risk Factors

  • New sexual partner or multiple partners, lack of condom use.​
  • Vaginal douching or use of harsh washes that disrupt natural flora.
  • Smoking, and sometimes intrauterine devices (IUDs) in some studies.

Both conditions are more likely when the natural vaginal balance is disturbed, but the organisms and treatments differ, so accurate diagnosis is important.

 

Why Self‑Diagnosis Can Be Tricky

Many women assume that any itching equals a yeast infection and buy antifungal creams without testing. However, symptom overlap means this can easily go wrong:​

  • BV and yeast can both cause discharge and some itching.
  • Up to half of BV cases can be asymptomatic, discovered only on testing.​
  • Mixed infections (BV + yeast) also occur, especially in high‑risk or recurrent cases.

Repeated wrong treatment may worsen irritation, alter pH further, and allow resistant organisms to thrive. Persistent or recurrent symptoms always deserve professional evaluation.

 

How Doctors Differentiate Yeast Infection and BV

In clinic, your provider may:​

  • Take a detailed history – onset, type of discharge, odour, triggers, hygiene practices, sexual history, recent antibiotics.
  • Perform a pelvic examination – assess colour, consistency, and smell of discharge; inspect vulval skin for redness, cracks, or sores.
  • Check vaginal pH – elevated in BV, usually normal in yeast infection.
  • Examine a sample under the microscope – clue cells and lack of lactobacilli in BV, budding yeast and pseudohyphae in candidiasis.
  • Use swabs, culture, or molecular tests in recurrent or unclear cases.

Accurate diagnosis guides the right treatment and helps break the cycle of recurrence.

 

Treatment Differences: Why It Matters

Because causes differ, treatments do too.

Treating Yeast Infections

  • Antifungal medications – topical azole creams, pessaries, or oral tablets, usually for a few days.​
  • For recurrent infections, longer courses or maintenance regimens may be needed.

Supportive steps:

  • Keep vulval area dry; avoid perfumed products and tight clothing.
  • Manage blood sugar if diabetic.

Treating Bacterial Vaginosis

  • Antibiotics (oral or vaginal), usually metronidazole or clindamycin in various regimens.​
  • Some women experience recurrences; extended or intermittent regimens may be advised.

Supportive steps:

  • Avoid douching and harsh cleansers; use mild, unscented products externally only.
  • Discuss condom use and sexual practices that might repeatedly disturb flora.

Using antifungals for BV will not fix the problem, and using BV antibiotics for yeast will not relieve the itch—hence the need to tell them apart.

 

When to See a Doctor

Seek medical care if:​

  • It is your first episode of unusual discharge or itching.
  • You have fever, pelvic pain, or bleeding, which could indicate more serious infection.
  • Symptoms keep coming back despite over‑the‑counter treatments.
  • You are pregnant, diabetic, or immunocompromised.
  • There is strong odour, greenish discharge, or pain in the lower abdomen.

In India’s climate and close‑living conditions, recurrent vaginitis is common; long‑term relief requires a mix of correct diagnosis, tailored treatment, and lifestyle changes.

FAQs

1) Can I have both a yeast infection and bacterial vaginosis at the same time?
Yes. Mixed infections can occur, especially in women with frequent antibiotic use, uncontrolled diabetes, or repeated douching. In such cases, symptoms may be confusing—for example, thick discharge plus odour—and simple home treatment often fails. A clinician can confirm the combination with microscopy or lab tests and prescribe a plan that covers both organisms appropriately.​

2) Will BV or yeast infection affect my fertility or pregnancy?
Untreated BV has been associated with an increased risk of pregnancy complications, preterm birth, and post‑surgical infections after gynaecological procedures. Yeast infections mainly cause discomfort and are not typically linked to infertility but can be troublesome in pregnancy. Pregnant women should always consult their doctor rather than self‑medicate; safe, targeted treatments are available.​

3) How can I reduce the chances of getting these infections again and again?
Helpful habits include: avoiding vaginal douching and scented washes; choosing breathable cotton underwear; changing out of wet clothes quickly; managing blood sugar if diabetic; and using condoms where appropriate. If infections recur often, your doctor may check for underlying factors (e.g., uncontrolled diabetes or hormonal influences) and consider longer‑term regimens or probiotic‑supportive strategies to restore healthy vaginal flora.​