Do I have BV or a UTI?

If you have a vagina, you might be familiar (and frustrated) with the many infections that seem to appear out of nowhere. Conditions like bacterial vaginosis (BV) and urinary tract infections (UTIs) are extremely common, but what are the differences? While these infections share many characteristics, it’s important to accurately diagnose which one you are experiencing in order to get proper treatment. To learn more about these infections and how to diagnose them, continue reading our guide below.

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If you think you have BV, a UTI, or a combination of the two, Hey Jane’s expert clinical team can guide you through treatment from the comfort and convenience of your phone. To see if you’re eligible for care with Hey Jane, you can fill out this quick online form.

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What is bacterial vaginosis (BV)?

Bacterial vaginosis is the most commonly diagnosed vaginal infection among people with vaginas between the ages of 15 and 44. This infection occurs due to an overgrowth in bacteria that already lives in the vagina. 

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Typically, Lactobacilli bacteria—the most common bacteria in the vagina—help to maintain a healthy balance by keeping other bacterial levels in check. When this balance is disrupted, bacteria such as Gardnerella vaginalis, a BV bacteria, can multiply. Most people who have BV will never experience any symptoms, but for those who do, BV can cause discomfort and stress. The body can usually keep this bacteria in check and get back on track, but sometimes treatment is needed to help get the restore balance

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When the vagina is off balance, it may lead to BV symptoms like:

• Unusual vaginal discharge that appears thin and grayish-white
• A fishy odor (especially that gets worse after sex)
• Discomfort or irritation
• Irritation around the outside the lips or labia of the vagina (especially when peeing)

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Possible risk factors for BV may include the following:

• Douching
• Cigarette smoking
• Unprotected sexual intercourse with a semen-producing partner
• Unprotected sex with same-sex partners*
• Personal care products like scented soaps, bubble baths, and vaginal deodorants
• Increased blood in the vagina (e.g. with your period, after an abortion)
• Diet low in fresh fruits and vegetables*

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*These risk factors are still being studied and may or may not increase your chances of BV

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What is a UTI?

A urinary tract infection (UTI) occurs when bacteria enters your body through the urethra (the hole you pee from) and can spread to become a bladder infection. This infection may affect various parts of the urinary tract, including the bladder, urethra, or kidneys. 

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People with vaginas have a higher risk of getting a UTI than people with penises because their urethras are closer to their buttocks—the main source of UTI-causing bacteria. 

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Like BV, a UTI doesn’t always cause symptoms. But when they do, symptoms can be intense and include:

• Frequent and urgent need to pee
• Pain or burning sensation during urination
• Cloudy or bloody urine
• Discomfort in the lower stomach
• Low back pain, fevers, chills, or feeling under the weather

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What are the differences between BV and UTIs?

Below are the main differences between these infections to be aware of.

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Causes of BV vs. UTIs

An overgrowth in bacteria that already lives in the vagina can lead to BV, while UTIs develop when foreign bacteria (or bacteria that belongs in your butt) gets into your urinary tract. For BV, certain body care products, hygiene habits, and even sex can also disrupt your body’s natural balance of bacteria and create an environment perfect for the infection to thrive.

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Symptoms of BV vs. UTIs

BV symptoms mainly involve vaginal discharge and odor, and UTI symptoms may cause urinary discomfort and changes in urine characteristics (i.e., color, smell, frequency, pain).

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Possible complications of BV vs. UTIs

Untreated UTIs may lead to more serious complications, such as recurring infections or kidney problems. BV typically does not cause severe health problems. Still, in some cases, if it is left untreated, it may increase your risk of a sexually transmitted disease (STD) or pelvic inflammatory disease (PID).

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Both of these infections, while very different, can also increase the risk of early labor in pregnant people. If you think you have either BV or a UTI, it’s important to seek care as soon as you can to avoid these risks—and start feeling relief!

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Can you have BV and UTI at the same time?

Yes, it’s possible to have both BV and a UTI. In fact, one study revealed that people with vaginas who experience BV may have a higher risk of developing a UTI. 

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Can a bacterial infection turn into a UTI?

A bacterial infection can increase your risk of developing a UTI and other infections like HIV, but one doesn’t directly turn into the other. BV and UTIs are caused by different bacteria—BV by an imbalance of vaginal bacteria, and UTIs typically by E. coli left on your skin after using the bathroom. However, BV can disrupt the normal vaginal flora, making the urinary tract more susceptible to infection. Understanding how and why someone might get BV and seeking treatment for BV can help reduce the risk of developing a UTI.

BV vs. UTI treatment

BV has several treatment options that typically require a prescription. A health care provider like Hey Jane can prescribe antibiotics for bacterial vaginosis, such as metronidazole (Metrogel) or clindamycin, in pill or topical gel form. These medications are available as a gel or cream that you’ll insert into your vagina for symptom relief. 

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If you’re uncomfortable with topical medication, your health care provider may offer an antibiotic pill you can swallow. There’s also secnidazole (Solosec), a single-dose treatment of granules (small particles) that you can mix into yogurt. 

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UTI also involves antibiotics to treat symptoms, but the medication varies depending on the severity of the infection, if you have been on antibiotics recently, and if you have a urine culture. Urine culture and sensitivity tests will tell you exactly which antibiotic will work best for the specific bacteria causing your UTI. This is important for many reasons, but most importantly because your UTI bacteria may be resistant to some antibiotics that won’t be able to treat the infection.

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Simple UTIs may be treated with the following medications:

• Trimethoprim and sulfamethoxazole (Bactrim and Bactrim DS)
• Fosfomycin (Monurol)
• Nitrofurantoin (Macrodantin, Macrobid, and Furadantin)
• Cephalexin
• Ceftriaxone

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You can also pick up pyridium (brand name Azo) at most drug stores to help decrease bladder spasms and make you feel better. Note that this over-the-counter medicine will make your pee and tears bright orange temporarily.

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Your health care provider may prescribe fluoroquinolones if you have a severe UTI or a kidney infection. These antibiotics include levofloxacin (Levaquin) and ciprofloxacin (Ciproxin, Ciloxan, and Cetraxal).

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If you know you have BV or a UTI, you can skip the doctor’s office wait and get care from Hey Jane’s telehealth clinic from the convenience of your phone. You can consult with a licensed clinician via text, chat, phone, or video call and pick up your prescription at your local pharmacy. Click here to get started.

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How to treat BV or UTI symptoms at home

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Antibiotics are recommended as the first-line of treatment for BV and UTIs, but there are a few ways to help manage your symptoms at home while you wait for your treatment to kick in. For BV, you can pick up boric acid suppositories from your local drug store to help balance the pH balance of your vagina. Habits like avoiding soaps and fragrances around the vagina, wearing breathable cotton underwear, and not douching can help support a healthy vagina as the balance of bacteria is restored. Your vagina is a self-cleaning oven, and trying to clean it (the way we clean the outside of our body) actually disrupts the natural balance of healthy bacteria.

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UTIs can spread to your kidneys if left untreated, so it’s key to get prescription treatment as soon as possible if you suspect you have an infection. While you wait for treatment to kick in, drinking plenty of water, urinating frequently, and taking over-the-counter pain medications (e.g., pyridium/Azo, ibuprofen and Tylenol) can help reduce any discomfort you may be feeling.

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If you’re looking for effective prescription treatment for your BV or UTI and don’t have time for an in-person doctor’s appointment, you can fill out Hey Jane’s online intake form 24/7. Consult with a provider in 1 business day via text, phone, or video call while you go about your day. If eligible for treatment, we’ll send the prescription to your pharmacy of choice for fast, easy pick up. Ready to get started? See if you’re eligible. 

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How much do BV or UTI treatments cost?

The cost of treatments for these infections may vary depending on your health care provider, insurance coverage, and the specific antibiotics prescribed. At Hey Jane, consultations for BV and UTI treatments are usually similar in cost to a co-pay at a doctor’s office. You can also use insurance to bring your cost as low as $0, or use FSA/HSA funds. 

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Treatment is prescribed to your local pharmacy of choice, where you can use your insurance to also pay for the cost of medication at the pharmacy. If you need financial assistance, we can help you find coupons on GoodRx to reduce your out of pocket costs. Take a look at our list to see if your insurance plan covers our telehealth services so you can start treatment ASAP.

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How to prevent BV or a UTI

Researchers are still trying to understand how BV spreads and the best ways to prevent it, but there are a few things you can do to lower your chances of getting this infection.

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Here are some tips for preventing or reducing the risk of BV:

• Avoid soaps and fragrances when cleaning around your vulva (only use warm water to clean it)
• Wear cotton or cotton-lined underwear to keep your vagina cool
• Don’t douche
• Use condoms when sexually active with new partners or when using lube
• Stay hydrated
• Maintain a diet high in fresh fruits and vegetables

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There’s still a lot to learn about UTI prevention. But what we do know is that there are lifestyle changes you can adopt to prevent or reduce UTIs.

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To prevent or lower your risk of UTIs:

• Pee after penetrative sex
• Stay hydrated
• Always wipe from the front to the back after using the bathroom
• Opt for showers instead of baths when possible
• Don’t douche, apply vaginal sprays, or use powders in the genital area
• Go to the bathroom when you feel you need to 

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It can be hard to prioritize these habits, and not every job gives you time to pee (shout out to nurses, teachers, delivery drivers, and many many more working hard with full bladders). But staying hydrated and peeing regularly helps keep the urinary tract system in tip top shape and flushes it out to prevent UTIs.