Updated April 6, 2026. Medically reviewed by Jordan Stachel, MS, RDN, CPT. To give you technically accurate, evidence-based information, content published on the Everlywell blog is reviewed by credentialed professionals with expertise in medical and bioscience fields.
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Bacterial vaginosis (BV) and trichomoniasis are both common vaginal infections that can cause similar symptoms, which is why they’re often confused. However, they have different underlying causes and require different treatment approaches. Because these symptoms can be similar, the most effective way to determine the cause is through reliable testing—whether at home or through your healthcare provider.
Trichomoniasis vs. BV: at a Glance
| Category | Trichomoniasis | Bacterial Vaginosis (BV) |
|---|---|---|
| What it is | A sexually transmitted infection (STI) caused by a parasite called Trichomonas vaginalis. | A vaginal infection caused by an overgrowth of bacteria and imbalance in the vaginal microbiome. |
| Who can get it | Both men and women can get trichomoniasis. | Only women or people with a vagina can get BV. |
| Cause | Caused by a parasite. | Caused by an imbalance of naturally occurring bacteria in the vagina. |
| How it spreads | Transmitted through sexual activity; cannot be spread through non-sexual contact like sharing food or drinks. | Not contagious and not transmitted through sexual activity, though sex can increase risk. |
| Risk factors | Unprotected sex and/or sex with an infected partner. | Being pregnant, having unprotected sex, using certain birth control (like an IUD), having multiple sexual partners, and taking certain antibiotics. |
| Symptoms |
|
|
| Symptom overlap |
|
|
| Diagnosis | Diagnosed through a physical exam and/or lab testing of genital discharge samples. | Diagnosed through a pelvic exam and/or lab testing of vaginal discharge. |
| Treatment | Treated with antibiotics and requires treatment to clear; it will not go away on its own. Fully curable with treatment. | Often treated with antibiotics, though some cases may resolve on their own. Medical guidance is recommended. |
| Complications | Untreated trich can increase the risk of developing HIV. | BV is generally not considered an STI but can impact vaginal health if untreated. |
| Prevention | Safe sex practices and STI testing for you and your partners. | Avoid douching, practice safe sex, maintain proper hygiene, avoid spreading bacteria, and wear moisture-wicking underwear. |
| Testing | Testing recommended if symptomatic or at higher risk; may require follow-up testing after treatment. At-home test kits are available. | Testing done via provider or at-home kits using discharge samples or vaginal pH testing. Follow-up care may be needed. |
| Key difference | An STI caused by a parasite and is contagious. | Not an STI; caused by bacterial imbalance and not contagious. |
What Is Trichomoniasis?
Trichomoniasis, or trich, is a sexually transmitted infection (STI) caused by a parasite known as Trichomonas vaginalis. Both men and women can get trichomoniasis, and it can present with or without symptoms.[1] Some signs and symptoms of trichomoniasis include:
- Foul-smelling discharge or changes to the color of discharge
- Redness or burning of genitals
- Pain during sex or while urinating
It is important to know about trich because it is a fairly common STI and is the most common nonviral STI.[1] Trich is transmitted through sexual activity and cannot be spread through non-sexual acts like sharing food or drinks.
If you are experiencing symptoms of trich, it is important to get tested, as untreated trich can lead to other health issues. For example, if left untreated, trich can lead to an increased risk of developing human immunodeficiency virus (HIV).[1]
To diagnose trich, a healthcare provider can complete a physical exam. This may or may not include a pelvic exam for women. A lab test can also be completed, which is when samples are discharged from the genitals and sent to a lab for examination of signs of infection.
Trich is typically treated with antibiotics to kill the parasite that causes the infection.[1] The condition needs to be treated and won’t go away on its own, so it is important to seek care. The good news is that trich is completely curable with treatment. It also can be prevented by having safe sex and by being tested for STIs for both you and any sexual partners you are with.
What Is Bacterial Vaginosis?
Bacterial vaginosis (BV) is a vaginal infection caused by an overgrowth of bacteria.[2] BV can only be contracted by women or people who have a vagina. There are increased risks of getting BV, which include[2]:
- Being pregnant
- Having unprotected sex
- Using certain types of birth control, like an intrauterine device
- Having many sexual partners
- Taking certain antibiotics
It can be helpful to know the symptoms of BV to understand if you should be tested. Some common symptoms of BV include[2]:
- Changes to the color or smell of discharge
- Itching of the vagina
- A burning sensation during urination
The vagina has a lot of natural bacteria always present. BV can be caused by a change to this natural bacterial environment and if the vagina ends up having more bad bacteria than good.[2] BV cannot be spread from person to person and is not spread through sexual activity. For this reason, BV is not considered to be an STI. However, because sex can change the bacterial environment of the vagina, sex is considered to be a risk factor for BV.
A healthcare provider typically diagnoses BV by performing a pelvic exam and/or by taking a sample of vaginal discharge.[2] This sample is then sent for testing to determine if you have BV.
BV is treated using antibiotics. However, there are cases in which BV can go away on its own without the treatment of antibiotics. To be safe, it is always best to consult a qualified healthcare provider if you are having symptoms of BV and are questioning if you need treatment.
To lower the risk of contracting BV, it is advised to avoid douching, make sure that you are not spreading bacteria from the anus to the vagina, have safe sex, test yourself and your sexual partners for STIs, and wear underwear that naturally wicks moisture away.[2]
How Is Trichomoniasis the Same as BV?
Trich and BV have some overlapping similarities. Some of these include[1,2]:
- Women can get both trich and BV
- There is an increased risk of getting trich and BV due to having unprotected sex and/or sex with infected individuals
- Both BV and trich can progress without symptoms. If symptoms do appear, there are some overlapping symptoms for each condition, which include changes to discharge, discomfort of the genitals, burning during urination, and discomfort during sexual activity
- A healthcare provider performs a diagnosis through a physical exam for both trich and BV.
How Is Trichomoniasis Different From BV?
While there are some similarities between trich and BV, there are also some important differences. Some of the differences between trich and BV include[1,2]:
- Trich is considered to be an STI; BV is not considered to be an STI
- Only women can get BV; both men and women can get trich
- A parasite causes trich; a bacteria imbalance causes BV
- Trich is contagious and is transmitted through sexual activity; BV is not contagious and is not transmitted through sexual activity
- Treatment with antibiotics is needed to cure trich; it will not go away on its own. BV may or may not need to be treated with antibiotics; it may go away on its own
How to Know If You Have Trichomoniasis or BV?
The most reliable way to determine whether you have trichomoniasis or BV is through testing by a qualified healthcare provider. They can evaluate your symptoms and test results to accurately distinguish between the two conditions.[3]
While symptoms can overlap, understanding key differences may offer clues. For example, if you have not had sexual activity but are experiencing symptoms like painful urination and changes in discharge, trich is less likely, since it is sexually transmitted. In these cases, BV may be more likely.
Regular screening with a healthcare provider is important for maintaining your sexual health and overall well-being.
Testing for trich is recommended if you have symptoms or are at higher risk. Follow-up testing may also be needed after treatment to confirm the infection has cleared, as some cases require more than one round of antibiotics—especially if partners are untreated or resistance occurs.[4]
At-home test kits are available for trich and can serve as a starting point. Samples are sent to a lab for analysis, and positive results should be followed by additional care.
Similarly, BV can be diagnosed by a healthcare provider or through at-home testing kits, which may involve analyzing discharge samples or measuring vaginal pH.[5] If results suggest BV, follow-up care with a healthcare provider is recommended.
Take Control of Your Sexual Health With Everlywell
Everlywell offers an at-home trich test via a urine sample that screens for the bacteria that causes trich. With an easy-to-use at-home lab test, you will be given everything you need to take this test from the comfort of your own home. From there, if your results are positive, you will be connected with a qualified healthcare provider who can advise you on the next steps. You don’t need to go on this journey alone. Take control of your sexual health today to ensure that you are in tip-top health with Everlywell.
References
- Trichomoniasis. Cleveland Clinic. Last reviewed December 27, 2022. Accessed February 23, 2025. https://my.clevelandclinic.org/health/diseases/4696-trichomoniasis
- Bacterial vaginosis. Cleveland Clinic. Last reviewed February 6, 2023. Accessed February 23, 2025. https://my.clevelandclinic.org/health/diseases/3963-bacterial-vaginosis
- Vaginitis (yeast infection, BV, trich). Indiana University Bloomington: Student Health Center. Accessed February 23, 2025. https://healthcenter.indiana.edu/health-answers/gyn-health/vaginitis.html
- Trichomoniasis test. MedlinePlus. Last updated July 5, 2023. Accessed February 23, 2025. https://medlineplus.gov/lab-tests/trichomoniasis-test/
- Bacterial vaginosis test. MedlinePlus. Last updated May 17, 2023. Accessed February 23, 2025. https://medlineplus.gov/lab-tests/bacterial-vaginosis-test/
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