There are two main vaginal infections which can be easily mistaken for each other, BUT have clear differences between them. Thrush and BV (bacterial vaginosis) have many differing symptoms as well as differences in treatment. Let’s take a look…….
If you have never heard of Thrush or Bacterial Vaginosis, you are either extremely lucky or perhaps not yet sexually active (you can still get these infections without sex, but tend to be more common post sex). The first point to mention in both infections is that they are extremely common and absolutely nothing to be embarrassed about!
As much as the vagina is amazing and incredible, it’s also fairly susceptible to some common nasties, BUT it’s important to note that although thrush and bacterial vaginosis are vaginal infections, they are NOT sexually transmitted diseases.
Let’s do a quick overrun on what we’re dealing with here…
Thrush can also be known as a yeast infection, and is caused by the overgrowth of candida. You always have a level of candida in your body and the friendly bacteria usually keep these levels under control, but when the levels get out of control - we get the issue.
So, what are the symptoms of thrush?
Firstly, thrush is a devil and can affect your body in numerous places including your mouth, throat, gut, skin, anus and of course, the vagina, which is what we are talking about right here, right now.
You may notice a change in your vaginal discharge to a thicker, heavier and cottage cheese like consistency and white in colour OR you might have a thin and watery discharge. Some women may not experience a discharge which can make this confusing however thrush is bound to leave you with red inflamed skin, an intense itch, pain during sex, or burning while weeing. It won’t smell fishy, but your natural vagina aroma may smell more obvious/yeasty - as if you are smelling bread. Hard to explain, but if you’ve had thrush before you’ll know what I mean!
What causes thrush?
The vagina is naturally acidic in its environment & has a natural pH environment which when it becomes unbalanced, and changes to be more alkaline, means that yeast can thrive and multiply. It becomes a perfect environment for yeast to grow. Yeast also thrives on sugar (and obviously yeast) so it is said that cutting these foods out of your diet should help - however this is also debated as to whether it makes a difference in Dr. Jen Gunter’s book ‘The Vagina Bible’. But in my personal opinion, especially if you have thrush through the digestive tract I’m sure cutting the foods out that thrush eats, will help.
Thrush can also be caused by (you can upset your vagina’s pH level by) taking antibiotics. It is advisable to try and take probiotics alongside this to help keep the good bacteria levels in check.
Using products down there that you shouldn’t be (fragrances, shower gels, bubble baths)- leave it alone! You will make yourself sore and give yourself infections
Tight clothing - especially non breathable materials, tight pants and lycra type materials
Having diabetes can be a much higher risk cause for getting thrush
Going through chemotherapy or any other invasive medication where your good bacteria will be at risk
During or just before/after your period
And finally, one that caused me to have repeated bouts of thrush…..
THE PILL. (and other hormonal contraception devices) I can safely say since stopping the pill I’ve been so so sooo much better and rarely suffer from thrush!
So we’ve established what thrush is, and we’ve spoken about how you get it - so how can you treat it?
Thrush isn’t life threatening but it’s obviously not pleasant and you can pass it on to your male partner, which if you then heal and he has it, can pass back to you and it’s just a big load of pain and a viscous cycle.
It’s always best to get a swab taken so that you can be 100% sure that it’s thrush as you don’t want to harm yourself further by using treatment when you don’t need it. However saying this, if you’ve had thrush a few times already it does become pretty obvious when it reappears.
You can buy over the counter medication in three different forms being;
An oral pill (there’s only one pill in the packet and this medication is called fluconazole and is an anti-fungal)
Pessaries (again one tablet in the packet) this is a tablet that you insert vaginally. I remember being taken aback by this when i first heard of it but its no different from inserting a tampon, you pop it in the end of an applicator and insert it up there (it’s also much smaller than a tampon). The active ingredient in here is Clotrimazole which again is an anti-fungal agent. Advice for pessaries would be to use them at NIGHT so they don’t fall out and then the next few days wear a liner or pad as the residue will naturally start to come back out in a chalky like substance.
And lastly, good old Canesten thrush cream. Usually this is applied twice morning and night and solely for outside use - no internal use.
If your thrush is more severe, aggressive or continuously coming back, you may be put on a longer course of the above. For me, I had a stage where I was on oral fluconazole for 6 months and had 7 pessaries to use back to back.
The overall thing to remember is it would be very rare for a woman to live her whole life and not experience thrush one time… so please, if you think you’re alone with this, you really really really aren’t. It’s so normal it’s just not spoken about.
Now, we move on to our second vagina friend - the glorious, ocean smelling, Bacterial Vaginosis. The big difference with thrush and bacterial vaginosis, is that thrush is caused by candida (yeast infection) and Bacterial vaginosis
is when BACTERIA called anaerobic bacteria (meaning they don’t need oxygen to survive) are accompanied by an organism called Gardnerella vaginalis. Kinda sounds like Cinderella, but it’s not a princess.
What are the symptoms of BV?
This bacterial infection occurs when there is a disturbance to the ecology of the vagina and can mean you will experience a thin, watery grey, green or even yellow coloured discharge. This discharge doesn’t typically cause vaginal it
ching (a key thrush symptom) or irritation, but it usually really smells of fish. I hate to say it but the typical ‘fishy fanny’ insult is in fact technically true, there’s never smoke without fire...is that the right expression idk..
This is why it’s important to potentially sniff your pants every now and then when you go to the toilet to just check everything’s in line, however if you have BV you will most likely know about it. It’s REALLY important that you get yourself down to a doctor as soon as possible, I know it might be embarrassing to go there for it but if BV does not clear up on it’s own it’s crucial that you get checked. This is because
What happens if BV is left untreated?
If BV is left untreated it has been found to be linked to miscarriages or premature labour. Periods may also be heavier and more painful and in some cases you may even experience breast abscesses. Untreated BV puts you at higher risk of pelvic infections and therefore to avoid any further implications it’s really important to get swabbed, checked and treated.
So what causes BV?
OVER CLEANING!!! STAPPPP! Once you actually end up smelling fishy it’s also important not to hide it for the doctor as this is a key symptom they will be looking out for.
Do NOT vaginal douche. I don’t understand why anyone would do this but it’s probably THE most common cause of bacterial va
ginosis. Douching upsets the natural balance of the vagina & leads to the overgrowth of the anaerobic bacteria.
Bubble baths, oils & detergents are also huge culprits for causing a major disruption to this environment and are not needed. I’m so sorry but lush bath bombs are NOT good for your vaginas. The general rule here is any over washing or trying to disguise natural bodily scents with fragrances leads to PROBLEMS, DON’T DO IT.
If you are a smoker you are also at much higher risk of experiencing BV. I can’t tell you what habits to follow but I think we can all agree that smoking doesn’t really come with any benefits...it can also make your downstairs smell worse in general.
If you use a copper IUD as your method
of contraception. The increased risk is probably because IUDs cause heavier and longer menstrual bleeding, which is known to disturb the vaginal microbiome & therefore doubles your risk
Sexually active women - Semen is alkaline and often women find they notice a fishy smell after having sex. This is because the vagina wants to be slightly acidic, but if it's knocked out of balance by the alkaline semen, and can trigger BV.
So lastly, how do we get rid of BV and treat it?
A course of antibiotics are usually prescribed if BV does not resolve by itself (it will only resolve by itself if you take the right steps like avoiding bubble baths, douching etc)
You can buy over the counter medications
but I can’t personally vouch for whether these are effective or not, however I know that BV pessaries are available, potentially this is something that could help milder cases.
If you’re having sex, using a condom can help massively to stop the sperm from sitting in the vaginal canal (non scented condoms) as well as using a vaginal friendly lubricant (no flavoured chemical lubes).
So there we have it, we know what thrush and bacterial vaginosis are, we know what signs to look out for and we know how to trea
t them!! As always, it is nothing to be embarrassed over, it’s important to talk about so that we can look after our health and we all have the same body parts so there should never be any judgement.
Healthy and happy vaginas - check !