BV vs. UTI: How to Tell the Difference

At a Glance: BV vs. UTI

Many people can tell when something feels off, but distinguishing between bacterial vaginosis (BV) and a urinary tract infection (UTI) isn’t always straightforward. This table outlines key differences and similarities.

Feature	Bacterial Vaginosis (BV)	Urinary Tract Infection (UTI)
Infection of the vagina	Yes	No
Infection of the urethra and bladder	No	Yes
Caused by bacteria normally in the body	Yes	Yes
Can be caused by sexual activity	Yes	Yes
Sexually transmitted	No (except between female-female partners) [1]	No
Treated with antibiotics	Yes	Yes
Can be recurrent	Yes	Yes
Infects men and women	No	Yes
Prevention strategies reduce recurrence	Yes	Yes
Common in pregnancy	Yes	Yes
Common during perimenopause and menopause	Yes	Yes
Can be treated via telehealth	Yes	Yes

Bacteria are a natural and essential part of the human body. You host a complex microbiome—communities of bacteria, fungi, and viruses—that live in areas like your gut, vagina (if applicable), and urinary tract [2].

Both bacterial vaginosis (BV) and urinary tract infections (UTIs) occur when bacteria move into places where they don’t belong or grow out of balance. This disruption can trigger inflammation and lead to noticeable symptoms.

Bacterial Vaginosis (BV)

BV is caused by an overgrowth of certain bacteria in the vagina. It is the most common cause of abnormal vaginal discharge in people of reproductive age [3].

Common symptoms of BV include:

• Increased vaginal discharge (often thin, gray, white, or green)
• A fishy or foul odor, which may be stronger after penile-vaginal sex
• Burning during urination
• Vaginal itching or irritation

Urinary Tract Infection (UTI)

UTIs are most often caused by bacteria—commonly E. coli—that travel from the gut to the urethra and bladder [4].

Common symptoms of a UTI include:

• Pain or burning when urinating
• Frequent urge to urinate
• Pelvic or abdominal pain (more common in women)
• Foul-smelling or cloudy urine
• Pink, red, or cola-colored urine (a sign of blood)
• Fever or nausea (if the infection reaches the kidneys)
• Side or back pain (if the infection spreads)

Why Symptoms Can Be Confusing

Some symptoms overlap between BV and UTIs, such as burning during urination, pelvic discomfort, and noticeable changes in odor. Because of this, it can be difficult to tell them apart on your own.

While neither BV nor UTI is sexually transmitted, people who are sexually active are more likely to have BV or UTIs [3-6]. Because some of the symptoms overlap with those of common STIs, testing for STIs is a necessary part of figuring out what is causing your symptoms and helping you feel better faster [6].

Abnormal vaginal discharge can result from certain sexually transmitted infections (STIs), including chlamydia, gonorrhea, and trichomoniasis [6,7]. Infections cause by trichomonas, the herpes virus, gonorrhea, and chlamydia can also cause pain or burning when peeing.

If you're unsure about your symptoms, it’s a good idea to speak with a healthcare provider. They can help determine the cause and recommend appropriate treatment.

Once you have the right diagnosis, the good news is that antibiotics can easily treat UTIs and BV [2,3]. However, even with prompt treatment, recurrence is common for both conditions. Healthcare providers classify UTIs as recurrent if you have more than two infections in six months or three to four within one year [4]. As many as 4 in 10 women who experience a UTI will have another within six months [8].

Recurrent BV is even more common—about half of all women diagnosed with BV will experience another infection within one year [9]. BV is considered recurrent if you have three or more confirmed symptomatic episodes within a year [10].

Treat BV and UTIs to Prevent Complications

If not properly treated, both BV and UTIs are more likely to recur and can lead to more serious health issues. While BV may sometimes resolve on its own, untreated infections can increase the risk of complications, which is why prompt care is important [1].

Bacterial Vaginosis (BV)

Getting treated for BV may help reduce your risk of certain sexually transmitted infections (STDs) [6]. BV is typically treated with antibiotics taken orally or applied as a vaginal cream [3].

Untreated BV can lead to:

• Pelvic infections
• Complications during pelvic procedures or surgery
• Increased risk of infertility
• Preterm labor during pregnancy [3]

Urinary Tract Infections (UTIs)

UTI symptoms can sometimes come and go, which may make it seem like the infection has resolved. However, healthcare providers recommend completing antibiotic treatment to prevent complications [4].

Untreated UTIs can lead to:

• Kidney infection (pyelonephritis)
• Preterm labor or low birthweight in pregnancy
• Narrowing of the urethra (in men)
• Sepsis (a potentially life-threatening infection) [4]

If you’re experiencing symptoms of BV or a UTI, it’s important to seek evaluation and treatment. Be sure to take all prescribed medications—even if symptoms improve—to reduce the risk of recurrence.