Yeast Infection or BV? Getting the Right Treatment

Yeast infections and bacterial vaginosis (BV) are the two most common causes of vaginal itching, discharge and odor, and they need different treatment. A yeast infection usually means itching and thick, white discharge without much smell. BV more often brings thin gray or white discharge with a fishy odor. Over-the-counter yeast treatment won't clear BV, so if you're not sure which one you have, a quick exam or swab test gets you the right treatment the first time.

Yeast infection vs. BV: how to tell them apart

Yeast infection is an overgrowth of a fungus (usually Candida) that normally lives in the vagina in small amounts. Typical signs:

• Itching and irritation, often intense, inside and around the vagina
• Thick, white discharge, sometimes described as looking like cottage cheese, with little or no odor
• Redness, swelling, and burning when urine touches irritated skin

Bacterial vaginosis happens when the usual balance of vaginal bacteria shifts. It isn't a yeast problem and isn't caused by poor hygiene. Typical signs:

• Thin, gray or white discharge
• A fishy odor, often stronger after sex or during a period
• Less itching than a yeast infection, and sometimes no symptoms at all

The overlap is real. Some people have both at once, and trichomoniasis, a common sexually transmitted infection, can cause discharge, odor and itching that look like either one. That's why a clinician may suggest STI testing when symptoms overlap.

When is over-the-counter yeast infection treatment OK?

Over-the-counter antifungal creams and suppositories work well for a typical yeast infection. They're a reasonable choice if a clinician has diagnosed a yeast infection before, this feels exactly the same, and you're not pregnant. Follow the package directions and finish the full course.

It's worth being seen instead if:

• This is your first time with these symptoms, or they feel different from before
• There's a fishy odor or gray discharge, which points more toward BV
• You've finished an over-the-counter treatment and still have symptoms
• Infections keep coming back, several times a year
• You're pregnant, or have diabetes or a weakened immune system
• You have a new sexual partner, or any chance of an STI
• You have pelvic pain, fever, sores or blisters

Using yeast treatment for something that isn't yeast delays the right treatment, and BV that's left untreated can raise the risk of other infections.

Call 911 or go to the ER if… you have severe pelvic or lower belly pain with fever; heavy vaginal bleeding, such as soaking a pad an hour; you're pregnant and have pain, bleeding or leaking fluid; or you feel faint, dizzy or very unwell along with pelvic pain.

What happens at a visit?

For a yeast infection or BV, a clinician asks about your symptoms, timing, sexual history and anything you've already tried. In the clinic they may do an exam and in-clinic testing of a swab sample to identify the cause. Once it's clear, they can discuss treatment: antifungal medicine for yeast, or antibiotics for BV, by mouth or as a vaginal gel or cream. If symptoms overlap with an STI, they may recommend testing at the same visit.

Typical cases can often be handled by a telehealth video visit, available daily from 8 AM to 11 PM. If the provider thinks you need an exam or a test, they'll tell you, and you can come into a clinic.

Can I prevent them?

Not always, but a few habits help. Skip douching and scented washes, sprays or wipes; they disturb the vagina's natural balance and are linked to BV. Change out of wet swimsuits and sweaty workout clothes soon. Breathable cotton underwear helps some people. Yeast infections are more common after a course of antibiotics, during pregnancy, and when blood sugar is high, so mention those if you're getting them often.

What does it cost?

A telehealth visit is $75 self-pay. Self-pay in-clinic visits are $175 for a standard visit, $250 with one moderate service, and $330 for a procedure or two moderate services; the tier depends on the care you actually receive. If you're using insurance: we contract with all major commercial and government plans, including Colorado Medicaid and Medicare. We can't guarantee a particular commercial plan has us in network, and if you turn out to be out of network or your benefits are denied, we bill you at the self-pay rates. See our cost and insurance page for details.

Where to find us

Four clinics across metro Denver, all ages welcome, se habla español:

• Hampden (Southeast Denver): 8 AM–11 PM daily
• Littleton: 8 AM–11 PM daily
• Thornton: 8 AM–11 PM daily
• Highlands: Mon–Fri 5–11 PM, Sat–Sun 8 AM–11 PM

Walk in, or book online.