Females only: gonorrhea versus bacterial vaginosis (BV)

Bacterial vaginosis , unlike gonorrhea, is not considered a sexually transmitted infection (STI). It affects only females and can be induced by sex but not transmitted by a sexual partner. Sexual activity can change the vaginal pH changing vaginal flora and can induce bacterial vaginosis symptoms.

Other common things (aka risk factors) that can lead to BV are low immunity and pregnancy. BV is linked to an imbalance of “good” and “harmful” bacteria that are normally found in the vagina. BV can increase the chances of getting an STDs (Sexually transmitted diseases) including HIV acquisition.

Gonorrhea versus Bacterial vaginosis: similarities and differences

Similarities	Differences
Pain with urination Pain during sex	Discharge color Bacterial vaginosis: thin, whitish discharge Gonorrhea: thick, abundant, yellowish discharge Discharge smell Bacterial vaginosis discharge has a specific fishy smell Vaginal symptoms Bacterial vaginosis causes significant vaginal itch Gonorrhea rarely causes itch

Similarities

Differences

Pain with urination
Pain during sex

Discharge color

Bacterial vaginosis: thin, whitish discharge Gonorrhea: thick, abundant, yellowish discharge

Discharge smell

Bacterial vaginosis discharge has a specific fishy smell

Vaginal symptoms

Bacterial vaginosis causes significant vaginal itch
Gonorrhea rarely causes itch

Gonorrhea versus Bacterial vaginosis in photographs

In the photos below, pay attention to the color of the vaginal discharge and its consistency: greenish and thick for gonorrhea versus whitish and thin for Bacterial vaginosis. The vagina opening and vulva are red and mildly swollen with Bacterial Vaginosis

Gonorrhea

Image source: https://klinikstd.com/gonorrhea/

Bacterial vaginosis

Image source: https://www.slideshare.net/deepak15/19infection-of-vaginal

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Frequently Asked Questions

I am a 25-year-old female and I have itching and burning around the vaginal opening and a “fishy” odor. Is it BV (Bacterial vaginosis) or gonorrhea?

It’s challenging to establish a diagnosis based on the signs and symptoms alone. However, with this information, you’re more likely experiencing bacterial vaginosis. Let’s see what’s suggesting bacterial vaginosis over gonorrhea.

More vaginal symptoms with BV

Unlike Neisseria gonorrhoeae bacteria (which affects the cervix, which is deeper in the body), Gardnerella vaginalis (bacterial vaginosis causing infection) affects the outer portion of vagina. For that reason, BV creates more obvious vaginitis symptoms of itch around the vaginal opening, redness, and burning. Cervicitis (gonorrhea) causes fewer vaginal symptoms.

Fishy smell

Any vaginal fluid can be smelly, but certain conditions are well known for a specific smell. BV is well known for a fishy smelling discharge. This odor is the result of an altered pH level in the vagina caused by the interaction between healthy vaginal bacteria and “unhealthy” bacteria.

Other vaginal infections that can cause inflammation are trichomoniasis (aka trichomonas) and yeast infection. They need to be ruled out too.

The table below summarizes the most important differences that helps a health care provider decide which condition the patient is more likely to have, gonorrhea or bacterial vaginosis.

	Bacterial vaginosis	Gonorrhea
Lower abdominal pain
A “fishy” odor from the vagina (especially after sexual intercourse)
Bleeding between periods
Pain during sex
Bleeding during sex
Scanty, clear discharge
Thin, whitish discharge
New partner or unprotected sex
Itching around the vaginal opening

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Females only: gonorrhea versus bacterial vaginosis (BV)

Gonorrhea versus Bacterial vaginosis: similarities and differences

Gonorrhea versus Bacterial vaginosis in photographs

Frequently Asked Questions

I am a 25-year-old female and I have itching and burning around the vaginal opening and a “fishy” odor. Is it BV (Bacterial vaginosis) or gonorrhea?

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