Individuals can experience both bacterial vaginosis (BV) and a yeast infection simultaneously. These are distinct conditions affecting the vaginal environment, but their co-occurrence is recognized by medical professionals. Research indicates that a notable percentage of individuals diagnosed with BV may also have a co-existing yeast infection.
Understanding Each Common Vaginal Infection
Bacterial vaginosis is a common vaginal infection caused by an imbalance in the natural vaginal flora. It occurs when anaerobic bacteria overgrow, outnumbering beneficial Lactobacillus species. While not considered a sexually transmitted infection (STI), BV can be associated with sexual activity and changes in sexual partners.
A yeast infection, or candidiasis, results from an overgrowth of a fungus, typically Candida albicans, which naturally resides in the vagina. This overgrowth disrupts the natural balance of microorganisms. Factors like certain medical conditions, stress, or a weakened immune system can contribute to this imbalance.
Recognizing the Signs
Bacterial vaginosis often presents with a distinct strong, fish-like odor, more noticeable after sexual intercourse. Other common indicators include a thin, off-white, gray, or greenish vaginal discharge. Some individuals may also experience vaginal itching, irritation, or a burning sensation during urination. However, BV is often asymptomatic.
Conversely, a vaginal yeast infection is characterized by intense itching and burning in and around the vagina. Redness and swelling of the vulva and vagina may also occur. A hallmark symptom is a thick, white vaginal discharge resembling cottage cheese, typically with little to no odor. Pain during sexual intercourse or urination can also occur.
Some symptoms, such as itching, burning, and changes in discharge, can be present in both BV and yeast infections, making self-diagnosis challenging. While a fishy odor suggests BV and cottage cheese-like discharge points to a yeast infection, these features are not always definitive. The symptom similarity underscores the need for professional medical evaluation to accurately identify the infection(s) present.
Why Co-occurrence is Possible
The vaginal environment maintains a delicate balance of microorganisms. Any disruption can make it susceptible to infections, creating conditions conducive to both bacterial overgrowth and fungal proliferation. The mechanisms leading to BV and yeast infections can sometimes overlap, predisposing an individual to the other.
A common reason for co-occurrence is the use of antibiotics. Antibiotics prescribed to treat bacterial infections, including BV, can inadvertently eliminate beneficial bacteria in the vagina. This reduction in protective bacteria can then allow Candida yeast, which is naturally present, to overgrow, leading to a yeast infection. This phenomenon is a frequently observed consequence of antibiotic therapy.
Certain risk factors can also increase the likelihood of developing either or both conditions. Practices like vaginal douching can disrupt the natural pH and bacterial balance of the vagina, making it more vulnerable to infections. Hormonal changes, such as those occurring during pregnancy or due to the use of oral contraceptives, can also influence the vaginal environment and contribute to susceptibility. Additionally, a compromised immune system can reduce the body’s ability to keep both bacteria and yeast in check, increasing the risk of overgrowth.
Seeking Diagnosis and Treatment
Overlapping symptoms make self-diagnosis unreliable and can lead to incorrect self-treatment. Attempting to treat one condition when another, or both, are present can result in ineffective relief, prolonged discomfort, or worsen the situation. For example, using over-the-counter yeast infection medication for undiagnosed BV will not resolve the bacterial imbalance.
A healthcare provider will typically diagnose these conditions through a combination of methods. This often involves a discussion of symptoms and medical history, followed by a pelvic exam. A vaginal swab is usually taken to collect a sample of discharge, which can then be examined under a microscope for specific bacterial patterns or the presence of yeast. pH testing of vaginal fluid can also provide clues, as BV is associated with a higher vaginal pH, while yeast infections typically do not alter pH significantly.
Treatment approaches differ for each condition. Bacterial vaginosis is generally treated with prescription antibiotics, which can be administered orally or as a vaginal gel or cream. It is important to complete the full course as prescribed, even if symptoms improve, to ensure the infection is cleared and reduce recurrence risk. For yeast infections, antifungal medications are used, available as over-the-counter or stronger prescription formulations, in oral or topical forms.
If both BV and a yeast infection are present, a healthcare provider will devise a treatment plan addressing both. Often, the bacterial infection is treated first. Regular hygiene practices, such as avoiding harsh soaps and douching and wearing breathable underwear, can help maintain vaginal health and reduce recurrence.