From the Research
No, bacterial vaginosis (BV) and candidiasis (candida) are not the same condition. BV is caused by an overgrowth of certain bacteria in the vagina, particularly Gardnerella vaginalis, while candidiasis is a fungal infection caused by Candida species, most commonly Candida albicans 1. These conditions have different symptoms and treatments. BV typically presents with a thin, grayish-white discharge with a fishy odor, especially after sex, while candidiasis usually causes thick, white, cottage cheese-like discharge with itching and irritation.
Key Differences
- BV is a bacterial infection, while candidiasis is a fungal infection
- Different symptoms: BV has a fishy odor, while candidiasis has a thick, white discharge with itching and irritation
- Different treatments: BV is treated with antibiotics like metronidazole or clindamycin, while candidiasis is treated with antifungal medications like fluconazole or topical azoles
Diagnostic Approaches
- BV is diagnosed using the Amsel criteria, including a milky discharge, pH greater than 4.5, positive whiff test, and clue cells in a wet-mount preparation 2
- Candidiasis is diagnosed using a combination of clinical signs and symptoms with potassium hydroxide microscopy; DNA probe testing is also available 1
Treatment Options
- BV: metronidazole (500mg orally twice daily for 7 days or 0.75% gel intravaginally once daily for 5 days) or clindamycin (300mg orally twice daily for 7 days or 2% cream intravaginally at bedtime for 7 days) 1
- Candidiasis: fluconazole (150mg oral single dose) or topical azoles such as clotrimazole or miconazole (vaginal applications for 1-7 days depending on formulation) 3 The most recent and highest quality study 4 highlights the importance of understanding the microbial composition of the vagina in BV patients, which can inform treatment decisions and improve outcomes. However, this study does not change the fundamental difference between BV and candidiasis. In summary, BV and candidiasis are distinct conditions that require different diagnostic approaches and treatments.