Yeast infection vs bacterial vaginosis: how do I tell the difference?

Bottom lineYeast infections cause intense itching with thick, white, odorless cottage-cheese discharge and are treated with antifungals, while bacterial vaginosis causes a thin gray discharge with a strong fishy odor (and little itching) and needs prescription antibiotics. The quick tell is yeast itches, BV smells; they can occur together, so when unsure, get tested rather than self-treating with an over-the-counter antifungal.

Yeast infections and bacterial vaginosis (BV) are the two most common vaginal infections, and they're easy to confuse. Telling them apart matters, because the treatments are completely different and using the wrong one delays relief.

The quick tell

• Yeast itches. BV smells.

Yeast infection

• Cause: overgrowth of the fungus Candida
• Discharge: thick, white, cottage-cheese-like
• Smell: usually none
• Main symptom: intense itching, burning, redness, swelling
• Treatment: antifungal (cream, pessary, or tablet), often available over the counter

Bacterial vaginosis (BV)

• Cause: an imbalance where protective lactobacilli drop and other bacteria overgrow
• Discharge: thin, white or gray
• Smell: strong fishy odor, often worse after sex
• Main symptom: the odor; itching is usually mild or absent
• Treatment: prescription antibiotics (metronidazole or clindamycin)

Why it's worth confirming

Over-the-counter antifungals only treat yeast. If you actually have BV and use one, your symptoms won't improve. The two can also occur together, and the symptoms overlap, so when you're unsure, get tested rather than guessing.

When to see a doctor

• You're not sure which one it is
• Symptoms keep coming back
• It's your first ever infection
• You're pregnant, or have pain, fever, or abnormal bleeding

For everyday context and the 2026 update on treating recurrent BV, see our complete vaginal health guide.

Log discharge type and odor in Femora so you and your clinician can see the pattern at a glance.