Is it BV or a UTI? The key differences, and when to see a doctor

When we’re dealing with uncomfortable symptoms like burning, itching, or an urgent need to pee, it can really do a number on our daily lives. 

Bacterial vaginosis (BV) and urinary tract infections (UTIs) are two common issues, but telling them apart isn’t always easy. Symptoms can overlap, and it’s important to get the right diagnosis from a doctor so you can start to feel better.

Here’s what you need to know about the difference between BV and UTIs, and how to figure out which one you might be dealing with, before you make that all-important doctor’s appointment – with expert insight from Samantha M. Pfeifer, M.D.

Let’s get into it.

What causes BV and UTI?

BV happens when the balance of bacteria in your vagina is disrupted. This often leads to an overgrowth of certain bacteria, causing symptoms like unusual discharge and a strong, fishy odor. Things like douching, new sexual partners, or even hormonal changes can trigger BV.

UTIs, on the other hand, are typically caused by bacteria like E. coli entering the urinary tract. While they can occur after sex, they’re not sexually transmitted. Anything from holding your pee too long to dehydration can set the stage for a UTI.

Overlapping symptoms of BV and UTI

Whilst a lot of people may assume one is the other, both conditions have fairly different symptoms, says Dr. Pfeifer.

You might notice:

• Burning sensations: Both conditions can cause discomfort or a burning feeling, but with BV, it’s more about vaginal irritation, while UTIs tend to cause burning during urination.
• Frequent urination: If you’re peeing more than usual, you might think it’s a UTI. However, BV can also irritate the urinary tract, making it feel like you need to go constantly.
• Pain or discomfort: Both conditions can cause discomfort in the pelvic area, but with a UTI, you may also feel pressure in your lower abdomen.

If you are having confusing symptoms down there, medical professionals will typically look at both the urinary and the vaginal areas, says Dr. Pfeifer.

The key differences between BV and UTI symptoms

Certain distinct symptoms can help you figure out whether you’re dealing with BV or a UTI, explains Dr. Pfeifer.

These include:

• Discharge: BV often comes with thin, grayish-white discharge and a foul fishy smell. UTIs don’t usually cause discharge.
• Smell: A strong vaginal odor is a telltale sign of BV, but UTIs rarely have an associated smell unless a secondary infection develops.
• Discomfort location: UTI pain is generally focused around the bladder or urethra and is associated with urinary urgency, while BV discomfort tends to be in the vaginal area.

Can BV feel like a UTI?

Yes, BV can sometimes feel like a UTI. Irritation from BV can spread to the urinary tract, causing burning or frequent urination. 

That’s why it’s so important to get checked out – what feels like a UTI could actually be BV (or vice versa).

Can you have BV and a UTI at the same time?

Unfortunately, yes, says Dr. Pfeifer.

Some studies also tell us that BV can increase your risk of developing a UTI because the imbalance in vaginal bacteria may allow harmful bacteria to travel to the urinary tract. 

If you’re dealing with symptoms of both conditions, it’s a good idea to see your doctor for an accurate diagnosis and the right treatment plan.

It’s important to treat both

“This is so they don’t develop into a more severe infection”, says Dr. Pfeifer. “UTIs, if ignored, can spread to your kidneys and cause a more serious infection known as pyelonephritis.”

Left untreated, BV can lead to pelvic inflammatory disease (PID), and, as Dr. Pfeifer explains, “is associated with adverse outcomes during pregnancy.”

Home remedies vs professional care

You’ve probably heard about home remedies for BV or UTIs, like yogurt, cranberry juice, or aloe vera. While some of these may provide temporary relief, they won’t cure the infection. 

BV and UTIs both require antibiotics, so make an appointment with your doctor to get the right treatment.

That said, we love a checklist – and there are steps you can take to ease discomfort or reduce your risk of future infections.

• For BV: Avoid douching, use unscented soaps, and consider probiotics to support healthy vaginal flora.
• For UTIs: Drink plenty of water, don’t hold your pee, and wipe front to back after using the bathroom.

When to see a doctor

We’ve said it before and we’ll say it again. If you’re unsure whether you’re dealing with BV or a UTI – or if you think you might have both – it’s time to call your doctor. 

As cringe as it can feel, be prepared to describe your symptoms clearly, as this will help guide their diagnosis.

Remember, both conditions are common and easily treated with the right care. While it’s tempting to power through uncomfortable symptoms (we’re guilty of this too) seeking medical help ensures you get the right antibiotics and avoid any complications.

BV vs UTI – the bottom line

While BV and UTIs are different conditions, their symptoms can overlap, making it hard to tell them apart. 

Pay attention to the key differences, like discharge and odor for BV versus pain and frequent urination for UTIs, and don’t hesitate to see your doctor.

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