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Lizzie De La Cruz - November 12, 2020

BV vs. Trichomoniasis

If you've ever experienced BV, then you know it's no picnic. It's pretty easy to treat BV, but if you're experiencing some especially stubborn symptoms or it seems to keep coming back even after taking prescription antibiotics for BV, then there could be another culprit.

Trichomoniasis, aka "trich," is a common STI that can be easily mistaken for BV, especially when you don't consider the possibility of having an STI. Don't worry, though, because whether it's BV or trich, both of these pesky infections are easy to treat. Wisp provides online STI consultation to help guide you to the appropriate treatment to get rid of BV and trich.

What's the Difference Between Trichomoniasis and BV?

First of all, let's talk about the main differences between BV and trichomoniasis. The biggest difference between the two is that BV is a buildup of the anaerobic bacteria found naturally in your vagina. Trich, on the other hand, is an STI that's caused by a tiny parasite spread through sexual contact, including vaginal intercourse, oral sex and anal sex. The other main difference between trich and BV is that BV isn't considered an STI. However, different aspects of sex, like a new partner or type of lube, can increase your chances of getting BV.

How Do I Know If I Have Trich or BV?

Since trich can "trick" you into thinking you have BV, the only 100% effective way to tell if you have it is to get an STI test. The sooner you get tested, the sooner you can take the appropriate antibiotics. Though a trich infection tends to stay within the vagina, vaginal canal and vulva, it spreads easily to your partner(s), especially if you're not aware you have it. 

Ultimately, if you have symptoms that resemble either BV, trich or both, you can ask your doctor to test you for both so you know for sure. They'll probably also ask you a few questions to see which infection you're likely to have. For example, they may ask if you've had unprotected sex, or sex with multiple partners, if they suspect you have trich.

Can BV Be Mistaken for Trichomoniasis?

BV can sometimes be mistaken for trich, particularly if you're experiencing symptoms that both BV and trich share. This is why it's extremely important to visit your doctor to get screened so you know for sure. To properly identify a trich infection, a doctor will swab the walls of your vagina and either look at the sample under a microscope or send the sample to a lab for testing. 

Doctors can usually spot trich under a microscope, but if they can't find it, they'll see if they can "grow" your trich sample in a lab. Once your doctor identifies trich, they'll immediately put you on a round of antibiotics to clear it. This is somewhat similar to how your doctor would test you for BV. However, BV can be a little bit harder to see under a microscope, so you may have to wait for results from a lab test. 

There's also a new way to screen for trich and all other STIs and infections, for that matter. Nucleic acid amplification tests prove pretty accurate in diagnosing trich versus BV and even a yeast infection since this screening spots the unique characteristics of the parasite.

When Is It Safe To Have Sex?

Any individual with an active BV or trich infection is at an increased chance of acquiring another sexually transmitted infection, like HIV. Further, if you have undiagnosed trich and sleep with someone, you'll likely pass the infection without them knowing.

With the risk of passing an STD, as well as the increased risk of acquiring a new infection due to inflammation, it is highly recommended to avoid sex until you completely finish all appropriate treatment.

BV vs. Trich Symptoms

Trichomoniasis shares many symptoms with BV, although only some humans with trich will experience "obvious" symptoms, which means you can go months (or years) without knowing you have it. About 3.7 million people in the United States have trich, with just 30% of this population ever showing symptoms—pretty crazy. If you have unprotected sex, it doesn't hurt to get screened every 3 months for STIs, including trich, even if you don't have symptoms. 

Since trich and BV do share some pretty similar symptoms, women with trich could be misdiagnosed with BV initially. Additionally, having trich can increase your chances of getting BV, which is quite the double-whammy. Luckily, both infections are easily curable. 

It's also worth noting that even with some overlap in symptoms between BV and trich, you could be the in the 30% of people who don't have trich symptoms. This isn't usually the case with BV — you'll almost always have symptoms with BV. If you have an inkling that you might have trich, here are some symptoms to look out for:

  • Thinner, greenish vaginal discharge

  • Very noticeable foul-smelling odor 

  • Discomfort or pain when you urinate

  • Pain during sexual intercourse

  • Soreness, redness, itchiness or burning around the genital area

Here are the most common symptoms of BV:

  • Thinner gray, white or green discharge

  • Foul-smelling odor (fishy)

  • Burning during urination

  • Itchiness in and around your vagina

The symptoms are pretty similar, right? That's why it's pretty easy to mistake trich for BV. If you think it's possible that you have trich, make sure you tell your doctor so they can test for it in addition to BV.

How Is Trich Treated?

To treat trich, your doctor will probably prescribe an oral medication, like metronidazole or tinidazole, to help kill the infection. However, about one in five people will get reinfected with this sneaky STI, so it's important to take a little break from sexual activity during your treatment. It's also important to talk to your partner about your treatment so they can also get screened and treated for trich if they have it.

Follow your doctor's instructions to the "T", and you can usually see a trich infection go away within a week. Keep up with regular screenings every few months to make sure you haven't been reinfected, especially if you notice a recurrence of any of the common symptoms.

Essentially, there is no clear-cut at-home-method to tell the difference between infection with BV or trich since they have pretty similar symptoms. When you visit your doctor and get regular screenings, you can stay on top of your vaginal health and lead a happy, healthy sex life.