Let’s talk about BV versus thrush. BV is otherwise known as Bacterial Vaginosis. The thrush I am speaking about is vaginal thrush. We will discuss the similarities and the differences.


Perhaps you’ve experienced a vaginal infection. It can be so confusing to know exactly what is going on downstairs. There can often be an overlap in symptoms when it comes to infections of the vagina. So, it can be difficult to distinguish exactly what infection you have. If misdiagnosed, you can experience a lot of discomfort & feeling at the end of your tether with it all.


Two of the most common vaginal infections that you will come across are thrush / yeast infection and bacterial vaginosis.


Hello, I am so thrilled to be here.

For those of you that don’t know me, my name is Michelle Cooke, Period & Hormone Naturopath, Natural Fertility Educator & Naturopathic Emotional Release Practitioner. I help women struggling with their menstrual cycles, have easy, pain-free periods, balanced hormones & emotional wellbeing. I’m the Founder and Director of Reproductive Wellness, a clinic located in Melbourne. I see patients online and face-to-face.


What is BV (Bacterial Vaginosis)?


Otherwise known as BV (Bacterial vaginosis), is a condition where you have vaginal dysbiosis (imbalance of the microorganisms that live in the vagina -bacteria, fungi etc.). There is an overgrowth of various types of anaerobic bacteria including Gardnerella vaginalis, Prevotella species, Mobiluncus species, A. vaginae and other types of BV- associated bacteria.


Normally, we have a healthy concentration of Lactobacillus species living in the vagina.


Symptoms of BV (you may have some, all or none of these)


  • Painful burning or stinging when you do a wee

  • Itchy vagina & vulva (external part of the vagina)

  • Sore vagina & vulva

  • A foul smelling vaginal odour (can be fishy)

  • Abnormal Vaginal discharge (thin, colour may be grey, white or green)

  • Pain or discomfort during & after sex


Symptoms seem to be worse after having sex.

Some women may be asymptomatic and not have any symptoms when they have BV.


What contributes or causes BV?


  • Eating too much sugar & sugary foods: Consistently high blood sugar levels > insulin resistance. Bad bacteria feed off sugar and take over the good bacteria both in the gut & in the vagina. Also, it dampens your immune system making you more vulnerable to infections.


  • Low oestrogen: when you have low oestrogen > less glycogen > fewer lactobacilli bacteria to maintain a healthy vaginal pH which would normally keep the bad bacteria in the vagina under control. The lactobacilli species of bacteria are responsible for producing lactic acid & hydrogen peroxide which maintain the vaginal pH of less than 4.5 (this keeps it acidic, which is healthy)

Times when oestrogen may be low:


  • Hormone fluctuations throughout the menstrual cycle

  • Perimenopause (journey towards menopause)

  • Menopause

  • Oral contraceptives

  • Pregnancy

  • Postpartum



  • Poor gut health & gut bacteria overgrowth:

Poor gut health & gut dysbiosis (imbalance of good and bad bacteria have been shown to contribute to the status of the vaginal microbiome (balance of bacteria in the vagina). There is a specific family of bacteria in the gut called the Estrobolome that manage oestrogen levels. if the Estrobolome is out of balance oestrogen will be unchecked > hormone imbalance > less lactobacilli bacteria to control vaginal pH > vaginal dysbiosis (BV).


  • Antibiotic use


  • Cigarette smoking


  • Vaginal douching


  • Multiple sexual partners


  • New sex partners


  • Unprotected oral, vaginal & anal sex


  • Intrauterine Device usage


  • Vaginal products: deodorants, washes


  • Oral contraceptives



What is vaginal thrush?


Otherwise known as Candida Vaginitis (CV) or Vulvovaginal candidiasis it is a type of yeast infection. This is caused by an overgrowth of the fungi, candida. Candida albicans normally resides in a healthy vaginal microbiome (the microorganisms that normally live there), but it is when it decides to dominate & take over the real estate in the vagina that is leads to issues downstairs (i.e. in your vagina). 


Symptoms of vaginal thrush (you may have some or all of these)


  • A yeasty smell downstairs (at the vulva)

  • Scaly or red rash

  • Painful burning or stinging when you do a wee

  • Pain during sex

  • Vaginal discharge that is white & clumpy (resembling cottage cheese)

  • Soreness & redness

  • Itchy vulva & vagina


What contributes or causes vaginal thrush?


  • Eating too much sugar or sugary foods

  • Diabetes

  • Low oestrogen

  • Poor gut health & gut bacteria overgrowth

  • Antibiotic use

  • Vaginal products: deodorants, washes

  • Oral contraceptives

  • Vaginal douching




  • Pain or stinging when you do a wee

  • Itchy vagina or vulva

  • Sore, red vagina and vulva

  • Pain or discomfort during sex




  • Smell – Thrush (A yeasty smell), BV (Fishy, unpleasant odour) – you can smell yourself.

  • Discharge – Thrush (Thick, white, cottage cheese like), BV (Thin, colour: grey, white or green)


What should I do if I am experiencing discomfort or irritation in my vagina?


It is important to get diagnosed by a doctor or head to a sexual health clinic and they will do a vaginal swab to confirm whether you have BV or thrush. Unfortunately, I hear of doctor’s just diagnosing on symptoms alone & it is commonly misdiagnosed because as you can see there are a lot of similarities.


The medical treatment is totally different: antifungals are used for thrush & antibiotics are used for BV.


My other additional suggestion is to see a Naturopath. Have a Naturopath on your health care team that specialises in Periods & Hormones like myself; to help support you in a wholistic way both for treatment & prevention with:


– Natural medicine: including herbal medicine & nutritional medicine, diet & lifestyle to address the root causes of thrush or BV


  • Assessing hormone imbalance (pathology testing)

  • Assessing gut health (microbiome testing)

  • Assessing vaginal microbiome (microorganisms that live there – bacteria, fungi etc.)

This is very thorough & it looks at: all different species of bad bacteria, STDs, fungi, beneficial bacteria & BV.


 I also recommend seeing a Naturopath because sometimes the best way moving forward isn’t just to simply eradicate the BV or thrush and that’s it which is more the medical model. Yes of course that is part of it, but if you are just simply addressing the symptoms it doesn’t address why it is happening in the first place & this can increase risk of reinfection.


I use a combination of herbal medicine, nutritional medicine, NER (Naturopathic Emotional Release) to look at underlying emotional contributors, diet & lifestyle advice to treat each individual based on the clues gained from the pathology testing.


If you are experiencing bacterial vaginosis or thrush (or perhaps both of them), I would love to help you, go ahead and book a FREE 15 min discovery call to find out more about how we would work together and if we are a good fit. Click on the button below.

Thank you so much for watching. If you have any questions or comments please pop them in the comments box below 🙂