BV vs UTI: What’s the Difference?

Written by Kathleen Morrison
Medically Reviewed by Andrea Sleeth WHNP-BC, MSCP

Key takeaways:

• BV is a vaginal bacterial imbalance; UTIs are infections in your urinary tract. Different cause, different treatment.
• BV and UTI symptoms can overlap. Burning, irritation, or weird discharge can happen in both—testing is the only way to know for sure.
• You can have both at the same time. BV can make UTIs sneak in more easily, especially with recurrent BV or hormonal shifts.
• Quick treatment matters! BV and UTIs are both treated with antibiotics; don’t guess, get tested.
• Stay hydrated, pee after sex, skip douches and scented products, and wear breathable underwear.

Bacterial vaginosis (BV) and urinary tract infections (UTIs) are two of the most common causes of discomfort “down there,” but they’re not the same, and neither of them are a sexually transmitted infection.

BV happens when your vaginal bacteria get out of balance, leading to unusual discharge with a fishy odor, mild itching, and sometimes a twinge of burning when you pee. UTIs are all about your urinary system—bladder, urethra, and sometimes kidneys—causing frequent urges, that unmistakable burn, and cloudy or strong-smelling pee.

Getting checked matters. Fever, back pain, blood in urine, or symptoms that linger more than a couple of days are signs to see a healthcare provider. Accurate testing makes sure you get the right treatment—so whether it’s BV or a UTI, you can feel better quickly and confidently.

What is Bacterial Vaginosis?

Bacterial vaginosis (BV) is a vaginal infection that happens when your good bacteria in the vagina get outnumbered by others that normally hang out in smaller numbers.

Think of your vagina like a little garden—usually full of thriving flowers (good bacteria), but sometimes there's a little overgrowth of “weeds." BV is super common, affecting millions of people every year, and is also (thankfully) pretty easy to identify and treat.

Common symptoms of BV

• Fishy odor, often stronger after sex or during your period
• Thin, watery discharge that’s gray or white
• Mild itching around the vaginal opening
• Burning when you pee
  

What causes BV?

• Sexual activity with new or multiple sex partners (even though BV isn’t an STI)
• Douching, which disrupts your natural bacterial balance
• Smoking or using scented soaps and bubble baths
• Menstrual cycles, which can shift vaginal pH
• Individual body chemistry or immune system factors that make some people more prone to recurring BV
  

What is a Urinary Tract Infection?

A urinary tract infection, or UTI, happens when bacteria sneak into your urinary system and start multiplying where they shouldn’t. Your urinary system includes your kidneys, ureters, bladder, and urethra. Most UTIs stick to the lower tract—your bladder and urethra—but if they travel upward, your kidneys can get involved.

Most UTIs are caused by E. coli, bacteria that normally live harmlessly in your intestines. But when they hitch a ride to the urethra and bladder... Things get uncomfortable.

Women get UTIs way more often than men because the female urethra is much shorter, making it easier for bacteria to reach the bladder. This explains why UTIs affect women so much more.

Common symptoms of a UTI

• Feeling like you constantly need to pee, even after just going
• Burning or stinging when you urinate
• Producing only a few drops at a time
• Cloudy, dark, or even slightly bloody urine
• Strong-smelling urine
• Lower belly pressure or discomfort, right above the pubic bone
• Fever, chills, nausea, or side/back pain if the infection reaches your kidneys
  

What causes UTIs?

• Bacteria from the bowel area moving toward the urethra
• Sex, which can push bacteria closer to the bladder
• Wiping back to front after using the bathroom
• Holding your pee for too long
• Certain birth control methods like diaphragms or spermicides
• Hormonal changes like menopause altering the vaginal environment
• Diabetes or immune system changes
• Using catheters
• Tight-fitting clothes or non-breathable underwear creating a warm, moist environment
  

Can you have BV and a UTI at the same time?

Yep—you can totally have both BV and a UTI at once, and it actually happens more often than you’d think. BV messes with your vaginal bacteria, and that can make UTIs sneak in easier. When both show up together, symptoms can feel extra annoying or confusing. That’s why using a tool like our Symptoms Quiz can help you figure out what’s going on and get the right treatment without the guesswork.

Why they often overlap

Your vagina and urethra are basically neighbors, just a couple of inches apart. When BV tips the bacterial balance in your vagina, it’s easy for troublemakers to wander over to your urethra.

Plus, irritation and inflammation from BV can make the area more welcoming to other infections.

What ups your chances of having both?

• Being sexually active, which introduces new bacteria to both areas
• Recurrent BV, which can make UTIs more likely
• Hormonal shifts from periods, pregnancy, or menopause
• Using douches, spermicides, or some lubricants
• Long bubble baths or hanging out in wet swimsuits for too long
  

Why does BV make it easier to get a UTI?

• BV knocks out your protective lactobacilli, the “good bacteria” that normally keep troublemakers in check
• Without enough good bacteria, E. coli and friends stick around longer and find their way to your bladder
• Inflammation from BV makes local defenses weaker, giving UTI-causing bacteria an easier time moving in
  

Diagnosis and treatment

Getting the right diagnosis is super important. UTIs and BV can sometimes feel similar, but they’re not the same—and treating the wrong one just drags out your discomfort.

For UTIs, providers usually check your urine for bacteria and white blood cells, and sometimes do a culture to figure out which antibiotic will work best. BV is diagnosed a little differently—think pelvic exams, pH checks, and the classic “whiff test” (yeah, literally).

The good news? You don’t always have to go in person. Online options let you chat with a licensed provider online, get the right testing lined up, and even get prescriptions sent straight to your pharmacy or door.

Treating BV

If your symptoms are acting up or you’re in a higher-risk situation, BV usually calls for prescription antibiotics.

The usual suspects are metronidazole or clindamycin, which come as pills or vaginal creams/gels. Most people feel relief pretty quickly. If BV keeps coming back, your provider can help you figure out strategies to keep it from taking over your life again.

Wisp treatment options are available only after consultation with a licensed medical professional. You should consult with your healthcare provider before starting a new supplement or treatment regimen. Individual results may vary.

Treating UTIs

You'll also need prescription antibiotics for a UTI to clear things up fast, because ignoring them can let the infection move to your kidneys.

Common options include nitrofurantoin, trimethoprim-sulfamethoxazole, or fosfomycin, usually for a few days. You’ll often feel better within a day or two, but finishing your prescription is key.

Drinking plenty of water can help flush out the bacteria, and some people find supplements like D-Mannose handy alongside treatment. If you're struggling with recurrent UTIs, your provider can talk through options like post-sex antibiotics or other strategies to keep you feeling more in control.

What your body's really telling you

BV and UTIs might share some bathroom drama, but they’re different infections with different needs. BV is about your vaginal balance getting thrown off, while UTIs are about bacteria sneaking into your urinary tract. Knowing which is which means you can stop guessing, skip unnecessary treatments, and start feeling better faster.

The good news? Getting clarity is easier than ever. Wisp connects you with licensed providers for same-day consultations, prescriptions, and guidance, all without the in-person waiting room hassle. You can also explore supportive options like gentle washes or boric acid suppositories to help you feel more comfortable while your treatment works.

The key takeaway: your symptoms are signals, not mysteries. Listen to your body, act early, and take control—because vaginal and urinary health should never slow you down.

Take charge today. Start a Wisp same-day consult and get the answers, tests, and treatment you need.

This blog post is for informational and educational purposes only and should not be taken as professional advice. Always consult with a qualified professional before making any decisions based on the information provided here.