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Differences Between BV and Trich

By: Author Health Guide's Editorial

Posted on Last updated:

This article reveals the differences between bacterial vaginosis and trichomoniasis:

BV

It is an abnormal vaginal condition that results from an overgrowth of atypical bacteria in the vagina and is characterized by vaginal discharge. BV isn’t a sexually transmitted infection.

It is the most frequent vaginal infection in women ages 15 to 44. There are over 1 million pregnant women getting bacterial vaginosis each year, according to the Centers for Disease Control and Prevention.

Trich

It is a sexually transmitted disease that is caused by the protozoan parasite Trichomonas vaginalis, usually found in the vagina and urethral tissues.

In the US, the annual incidence has been estimated to be 3 to 5 million cases. Worldwide, over 174 million people are infected with this parasite every year.

Causes

Bacterial vaginosis is usually caused by Gardnerella vaginalis, the most common type of bacteria in the vagina.

Trichomoniasis is spread through sexual contact with an infected partner. This includes genital-to-genital contact or penis-to-vagina intercourse. In men, the infection occurs in the urethra, whereas in women, the parasite causes an infection in the urethra, vagina, or both.

Risk Factors

Common risk factors for BV include:

  • sexual activity that could lead to transmission;
  • recent antibiotic use;
  • douching regularly;
  • having an intrauterine device;
  • decreased estrogen production of the host.

Common risk factors for trich include:

  • sex without a condom;
  • multiple sexual partners;
  • previous trich infection;
  • a history of other STIs.

Symptoms

Bacterial vaginosis symptoms may include:

  • burning during urination;
  • vaginal itching;
  • foul-smelling “fishy” vaginal odor;
  • thin, gray, white or green vaginal discharge.

Trichomoniasis symptoms may include:

For men:

  • soreness and redness around the head of the penis or foreskin;
  • thin white discharge from the penis;
  • needing to urinate more frequently than usual;
  • pain during ejaculation or urination.

For women:

  • pain after urination;
  • frothy, yellow-green discharge with a foul odor;
  • itching or pain in the vagina.

Note – most women found to have trich reported no symptoms. But, when symptoms do occur, they usually start 5 to 28 days after a female is infected.

When to Call the Doctor

Bacterial Vaginosis

You should call your doctor when:

  • sex is uncomfortable;
  • it burns when you urinate;
  • you experience itching or soreness outside or around your vagina;
  • your vaginal discharge smells different.

Trichomoniasis

You should call your doctor when you experience:

  • discharge or burning during urination;
  • vaginal or urethral itching;
  • pain with sexual intercourse.

Complications

Bacterial vaginosis can increase your risk for pelvic inflammatory disease. Also, women with bacterial vaginosis are more prone to infection during abortion, hysterectomy, and curettage. If you develop BV in pregnancy, there is a small risk of miscarriage or premature birth.

Complications for people with trich may include:

  • tubo-ovarian abscess;
  • pelvic inflammatory disease;
  • infection of the endometrium, adnexa, and Skene and Bartholin glands;
  • vaginitis.

Note – if you are infected with trich while you are pregnant, it may cause your baby to either:

  • have a low birth weight;
  • be born prematurely.

Diagnosis

To diagnose bacterial vaginosis, your healthcare provider may:

  • test your vaginal pH;
  • take a sample of vaginal secretions;
  • perform a pelvic exam;
  • ask several questions about your medical history.

To diagnose trichomoniasis, your doctor may:

  • do a lab test, like – a fluid culture or a DNA test;
  • use a cotton swab to take a fluid sample from your vagina;
  • do a pelvic exam.

Treatment

Bacterial Vaginosis

It is typically cured with antibiotics — either a pill that you swallow or a cream or gel which you put in the vagina. If you are pregnant, then you will be prescribed antibiotic treatment with oral metronidazole.

Note – you should refrain from sexual activity or use condoms correctly during the treatment regimen.

Trichomoniasis

It can be treated with antibiotic medications. The drugs most commonly used to fight trich is either tinidazole (Tindamax) or metronidazole (Flagyl).

Notes – your current sexual partner and any other recent partners should also be treated. To avoid severe nausea and vomiting, do not drink alcoholic beverages for 72 hours after taking tinidazole or 24 hours after taking metronidazole.

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Prognosis

Bacterial Vaginosis

Proper treatment can resolve a bacterial vaginosis infection. However, if a pregnant woman has BV, it can increase the likelihood of premature delivery.

Trichomoniasis

The recommended therapy regimens have produced about a 95 percent cure rate. The condition is usually not cured since the infected person’s sex partner has not been treated.

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Prevention

BV

Lower your risk of getting bacterial vaginosis with the following steps:

  • use warm water only and no soap to clean the outside of your vagina;
  • don’t douche;
  • use a condom every time you have sex;
  • limit the number of sex partners you have;
  • don’t have sex.

Trichomoniasis

Lower your risk of getting this infection with the following steps:

  • not having sex with multiple partners;
  • do not abuse alcohol or drugs;
  • using condoms correctly during sex;
  • do not douche;
  • avoiding sex for 7 to 10 days after treatment for trichomoniasis;
  • limit your number of sex partners;
  • be monogamous.

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Bottom Line – BV vs Trich

Bacterial vaginosis is the most common cause of abnormal vaginal discharge in reproductive-aged women. It is caused by an excess of bad bacteria. Untreated, it can lead to serious complications.

Trichomoniasis is a sexually transmitted disease caused by a parasite. It is the most common curable sexually transmitted disease, according to the Centers for Disease Control and Prevention. Many people who have the infection have no symptoms, however, when symptoms do occur, they usually include:

  • itching in the genital area;
  • discomfort during sex;
  • burning on urination;
  • vaginal or urethral (in men) discharge which may appear frothy and greenish.

Key Differences

  • bacterial vaginosis is not the same thing as an STD;
  • trichomoniasis is a sexually transmitted disease;
  • BV affects only women, Trich affects women and men;
  • the most common bacterial vaginosis symptom is a thin vaginal discharge with a smell of fish;
  • the vaginal discharge from trich can be gray, yellow, white, or green with an unpleasant smell.

Despite these differences, both BV and trich can be treated with antibiotics. However, it’s important to see a healthcare professional for an accurate diagnosis, as self-medicating can lead to drug-resistant strains of bacteria.

Sources

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5621139/
http://www.jlponline.org/article.asp?issn=0974-2727;year=2017;volume=9;issue=1;spage=16;e