Sometimes, vaginal infections can be so mild, you may not realize you have one. Other times, there is burning, itching and discharge! Still, when you’re experiencing a vaginal issue, it’s not always easy to figure out what type of infection you have. Don’t feel discouraged if you’re confused! Here, we discuss the differences between a yeast infection, aerobic vaginitis and bacterial vaginosis (BV), and the best methods of treatment so you can stay informed and take charge of your well-being.
The Infections
Yeast Infection
Yeast is an incredibly common vaginal infection caused by the overgrowth of yeast, or candida bacteria, in the vaginal microbiome. In fact, it’s so common, almost every woman will have a yeast infection in their lifetime. Yeast, or candida, can be present in some women without symptoms, but disease, or infection occurs when overgrowth leads to inflammation.Yeast infections can be caused by anything that might allow this overgrowth, such as changes in your vaginal flora, caused by certain medications like antibiotics or steroids, sex, hormonal birth control and even pregnancy.
Symptoms of a yeast infection include:
- Thick, white cottage cheese-like discharge
- No smell
- Burning, redness, swelling of the vagina or vulva
- Pain while urinating
- Pain during sex
- Soreness
Aerobic Vaginitis
Aerobic vaginitis is now recognized as a condition distinct from bacterial vaginosis. While they can cause similar symptoms, aerobic vaginitis is less common than bacterial vaginosis and is caused by completely different bacteria. The state of aerobic vaginitis is caused by an overgrowth of this bacteria in the vaginal microbiome which can be due to shifts in the vaginal microbiome like sex, a change in birth control method, your period, stress and smoking. It also might exist in conjunction with sexually transmitted diseases.
These conditions may share some symptoms, but they are caused by different organisms and involve different types of inflammation, which is why accurate testing matters.
Symptoms of aerobic vaginitis:
- Redness or swelling at the vaginal opening
- Sticky, yellow, or green pus-like discharge
- Unpleasant or rotten smell
- Pain during sex
- In severe cases, bleeding and ulcerations
Bacterial Vaginosis
Bacterial vaginosis is a common condition caused by a disruption of the normal vaginal bacterial balance; insufficient ‘good’ bacteria (Lactobacillus species) and excess ‘bad’ bacteria (including but not limited to Gardnerella vaginalis, Prevotella bivia or Atopobium vaginae.) Conditions that can put you at a higher risk for BV include anything that might change this balance; new or multiple sex partners, douching, pregnancy, or using an IUD.
All these conditions share symptoms, which is why testing is often needed. However, they do differ in the types of organisms involved and whether inflammation is present.
Symptoms of bacterial vaginosis:
- White, milky, or gray watery discharge
- Fish-like odor, especially after sex
- Burning during urination
- Itching on the outside of the vagina
- Vaginal irritation
- Some women have no symptoms
When to Call the Doctor
Did you know a lot of women often misdiagnose the type of vaginal infection they have? With so many overlapping symptoms between infections, it shouldn’t be a surprise. MyPathAdvantage provides detailed information about your vaginal health to help guide next steps. The results should be reviewed with your healthcare provider, who can interpret them in the context of your symptoms, your medical history and recommend appropriate treatment.
If your symptoms persist, worsen, or recur, follow up with your doctor for further evaluation. You can bring your MyPathAdvantage results to your appointment to support the discussion and treatment plan.
Common Treatments
Bacterial Vaginosis: Prescription medications such as metronidazole and clindamycinare the top drugs used to treat BV. Untreated BV can affect fertility, so it’s important to consult with your doctor if your BV doesn’t go away or recurs frequently.
Yeast Infection: You can treat yeast infections with an over the counter antifungal cream, ointment or suppository if you’ve had an infection before, and recognize its symptoms. If treatment is unsuccessful, you may need a different medication or a different infection could be the culprit. Likewise, if yeast infections recur (defined as more than 3 infections a year) see your doctor for help.
Aerobic Vaginitis: Mild cases of AV may be treated with antibiotics like clindamycin or augmentin. However, some forms are treated with corticosteroids, to decrease the inflammation, and other forms are treated with estrogen preparations, to cause maturation of the vaginal lining (which is more protective.). Untreated AV can put you at risk for complications such as pelvic inflammatory disease, STIs, infertility, miscarriage, and UTIs so be sure to talk with your healthcare provider about your treatment options.
Treatment for all these vaginal infections are fairly simple, but if left untreated can lead to complications with fertility, UTIs, and pelvic inflammatory disease. Be sure to get it checked out by a doctor and rechecked after treatment to be sure it’s been fully treated.
Sources:
Cleveland Clinic. “Bacterial Vaginosis: What Is It, Symptoms, Causes & Treatment.” Cleveland Clinic, 6 Feb. 2023, my.clevelandclinic.org/health/diseases/3963-bacterial-vaginosis.
Donders, Gilbert G.G., et al. “Aerobic Vaginitis: No Longer a Stranger.” Research in Microbiology, vol. 168, no. 9-10, Nov. 2017, pp. 845–858, https://doi.org/10.1016/j.resmic.2017.04.004.
Mayo Clinic . “Yeast Infection (Vaginal) – Symptoms and Causes.” Mayo Clinic, 11 Jan. 2023, www.mayoclinic.org/diseases-conditions/yeast-infection/symptoms-causes/syc-20378999.
