How many women have had a yeast infection? How many women thought they had a yeast infection and instead it was bacterial vaginosis (BV)? What’s the difference?

The vagina is its own little ecosystem. It plays host to a number of flora that live in there and has the ability to self-correct if things get off balance. Typically, your pH runs from 3.5 to 4.5, so it’s relatively acidic. Blood (from your period) and semen increase the pH to be around seven. Ovulation also increases your pH to match that of potential incoming sperm (making it a friendly environment instead of killing them off).

When your pH shifts, the healthy lactobacillus bacteria count shifts and can make way for other things to grow up, such as yeast, BV and bacteria. This is when the symptoms begin. You may experience itching, redness, discharge, burning and/or odor. But how do you know what’s what?

First of all, get yourself tested. The itch of yeast and the itch of BV may be the same, yet the treatments are very different.

Bacterial vaginosis always occurs with a higher pH (typically above 5). Very characteristic is the ‘fishy odor’ especially after sex, although it is not always there. The discharge is usually thin and gray, white or yellow.

Yeast can grow up in either a high or low pH. It typically resides in your vagina; however, it’s the job of your healthy bacteria (lactobacillus) to keep it under control. Many women know the symptoms to include itching, burning, redness, white discharge and possibly swelling of the labia.

There are other bacteria that can grow up and cause similar symptoms, such as E.coli and Beta hemolytic strep. The only way to know for sure is to have your health care practitioner collect a swab to look under the microscope and send out for culture.

To help protect yourself, practice good hygiene, take probiotics (the good bacteria such as lactobacillus), especially if you are on antibiotics, eliminate sugar (yeast feed on this), use cotton underwear, be wary of tight thongs and do not use scented soaps, lotions, douches or tampons in and around the vagina.

Don’t forget about fertile mucus! Sounds strange, but I have had women concerned about the amount of discharge they produce every month and treat themselves for yeast. Upon examination, the discharge comes around ovulation and is on the stretchy side.

Of course, there are a number of sexually transmitted diseases that also cause vaginal symptoms. Trichomoniasis (Trich), Chlamydia, Gonorrhea and Syphilis require medical attention and antibiotics. Probiotics and cotton underwear will not make these go away.