Itching, Burning, Discharge! When you have something unpleasant going on down below, it may take a minute—or even a doctor’s appointment—to figure out what kind of infection it is. That’s because some vaginal infections can have similar symptoms. How to differentiate a yeast infection from bacterial vaginosis from aerobic vaginitis? Here, we break down what you need to know to tell these three common vaginal infections apart.
The Three Infections
Bacterial Vaginosis
Bacterial vaginosis (BV) is a common vaginal infection caused by changes in the amount of good bacteria in the vagina. Normally, good bacteria like lactobacilli flourish in the vagina. But when the vaginal microbiome has more harmful bacteria that overrun the good bacteria, BV can develop. Conditions that put you at risk include new or multiple sex partners, douching, pregnancy, or using an IUD. To confirm BV, your healthcare provider will take a sample of vaginal secretions to test for harmful bacteria.
Yeast Infection
Yeast infections are so common that most women have had at least one in their life. An overgrowth of the fungus Candida causes them. Your vaginal microbiome typically contains small amounts of yeast, but an infection develops when too much yeast is present. Women of all ages and races get yeast infections. However, some things put you at increased risk including, pregnancy, uncontrolled diabetes, hormonal birth control, douching, taking antibiotics or steroids, and having a weakened immune system. Many women who have had a previous yeast infection can usually diagnose it themselves, but your doctor can test for yeast by examining a swabbed sample.
Aerobic Vaginitis
Aerobic vaginitis is a vaginal infection characterized by abnormal microflora that contains aerobic bacteria. This type of infection typically makes the vagina red and inflamed and may cause ulcerations. It is less prevalent than BV and may exist in conjunction with other sexually transmitted diseases. Shifts in the vaginal microbiome can also be responsible for AV. Conditions that put you at greater risk include sex, hormonal birth control, your period, stress, and smoking. Your provider can diagnose AV by taking a secretion sample and looking at it under the microscope.
The Symptoms of Each Infection
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
Yeast Infection
- Thick, white cottage cheese-like discharge
- No smell
- Burning, redness, and swelling of the vagina and vulva
- Pain while urinating
- Pain during sex
- Soreness
Aerobic Vaginosis
- Sticky, yellow, or green pus-like discharge
- Unpleasant or rotten smell
- Redness or swelling at the vaginal opening
- Pain during sex
- In severe cases, bleeding and ulcerations
Treatment
Bacterial Vaginosis: Prescription medications such as metronidazole, clindamycin, and tinidazole are 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, a different infection could be the culprit. Likewise, if yeast infections recur, see your doctor for help.
Aerobic Vaginitis: Mild cases of AV are treated with antibiotics like clindamycin. 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, andUTIs so be sure to talk with your healthcare provider about your treatment options.
