BV or Thrush? How to Tell the Difference, What Treatment Works and When to See an Online Doctor
Bacterial vaginosis, or BV, and thrush are the 2 most common causes of unusual vaginal discharge, and they need different treatments, which is why guessing so often fails. BV usually causes a thin, watery, grey or white discharge with a strong fishy smell, often noticed after sex, and it does not usually itch. Thrush usually causes a thick white discharge, often described as like cottage cheese, with itching, soreness and stinging, and little or no smell. BV is treated with antibiotics prescribed by a doctor, while thrush is treated with antifungal medicine, which you can buy at a pharmacy if you have had thrush diagnosed before. Both often come back. In a 2006 study from Melbourne, more than half of women treated for BV had it again within a year, and a trial published in the New England Journal of Medicine in 2025 found that treating a male partner at the same time cut recurrence within 12 weeks from 63% to 35%. The NHS advises seeing a doctor if it is your first time, if you are pregnant, if thrush returns more than 4 times in 12 months, or if treatment has not worked. Most cases can be assessed by video from your symptoms and history. At The Wellness you can see a doctor by video the same day from £150, with any prescription sent to a pharmacy near you. Fees appear further down this page.
Reviewed by the medical team at The Wellness. Last updated 14 October 2026.
Speak to a doctor today on WhatsApp or email team@thewellnesslondon.com or call 020 3951 3429.
Key facts about BV and thrush
BV usually causes a fishy-smelling, thin grey or white discharge, without itching.
Thrush usually causes a thick white discharge with itching and soreness, and little smell.
BV needs antibiotics from a doctor, and thrush is treated with antifungal medicine.
About half of women with BV have no symptoms, according to the NHS.
Treating a male partner reduced BV recurrence from 63% to 35% in a 2025 trial.
See a doctor the first time, in pregnancy, after more than 4 episodes of thrush a year, or if treatment fails.
How do you tell BV from thrush
Smell is the most useful clue. BV typically causes a strong fishy smell, which is often stronger after sex or during a period, with a discharge that is thin, watery and greyish white. Itching and soreness are not typical.
Thrush typically causes itching, irritation and soreness around the vulva and vagina, stinging when you pass urine or during sex, and a thick white discharge with little or no smell.
Some symptoms point to something else. A green or yellow discharge, pelvic pain, bleeding after sex or between periods, blisters or sores, or a new partner in recent months can suggest a sexually transmitted infection, which needs testing rather than treatment by guesswork.
What causes BV and thrush
BV is caused by a change in the balance of bacteria in the vagina. It is not classed as a sexually transmitted infection, but sex can trigger it, and it is more likely after a change of partner, with a coil, or with perfumed products used in or around the vagina.
Thrush is caused by an overgrowth of a yeast called Candida. Common triggers include antibiotics, pregnancy, HRT, diabetes that is not well controlled, a weakened immune system and skin irritation.
Ask a doctor which one it is on WhatsApp or email team@thewellnesslondon.com.
How are BV and thrush treated
BV is treated with antibiotic tablets, a gel or a cream prescribed by a doctor. A female partner may also need treatment. When BV keeps returning, more than 4 times a year, a longer preventive course of treatment can be used for a few months.
Thrush is treated with an antifungal tablet, pessary or cream, and symptoms usually clear within 7 to 14 days. The NHS advises not using antifungal treatment more than twice in 6 months without speaking to a pharmacist or doctor. Recurrent thrush can need treatment for up to 6 months. Antifungal creams can damage condoms and diaphragms.
Should my partner be treated for BV
New evidence says it can help. In a trial of 164 couples published in the New England Journal of Medicine in 2025, BV returned within 12 weeks in 63% of women whose male partner was not treated, and in 35% of women whose partner took an oral antibiotic and used an antibiotic cream for 7 days. The trial was stopped early because the benefit was clear. Whether partner treatment suits you is a decision to make with a doctor.
What can an online doctor do by video
A doctor can take a careful history, which is how most cases of BV and thrush are recognised, and prescribe treatment to a pharmacy near you. When the picture is unclear, when it keeps coming back, or when there is any chance of a sexually transmitted infection, swabs and tests are arranged, and an in-person examination is offered the same day.
For recurrent thrush, blood tests such as HbA1c, which checks for diabetes, can find a trigger that would otherwise be missed.
When should you see a doctor rather than a pharmacist
The NHS advises seeing a doctor if you have symptoms for the first time, if you are under 16 or over 60, if you are pregnant or breastfeeding, if thrush returns more than 4 times in 12 months, if treatment has not worked, or if you have a weakened immune system or diabetes.
Seek same-day care for a high temperature, pelvic or lower tummy pain, or unusual bleeding.
How to reduce the chance of BV and thrush coming back
Wash the vulva with water or a plain emollient and avoid perfumed soaps, washes, deodorants and douches. Shower rather than bathe. Wear cotton underwear and avoid tight clothing. Use condoms with new partners. If thrush follows each course of antibiotics, tell the doctor prescribing them.
What does a private doctor for vaginal symptoms cost in London
Private gynaecology consultations in central London commonly sit at £250 to £400 before any tests, and membership practices charge annual retainers running into thousands.
Confirm the appointment fee and inclusions before booking. Prescriptions depend on clinical assessment; medicine costs are paid separately at the pharmacy.
Signature Membership: enquire for current fees, access and inclusions.
Enquire for Comprehensive Blood Panel tests, doctor interpretation fees and inclusions for recurrent thrush.
Enquire for sexual health screening fees, tests and consultation inclusions.
In-person consultation: enquire for examination, swab fees and inclusions.
Same-day video GP consultation from £150. Any prescription depends on clinical assessment; pharmacy costs are separate.
Appointments are available 7 days a week by video, at our London clinics, including Marylebone and Belgravia, or at home.
Why women choose The Wellness for BV and thrush
Because you can speak to a doctor by video today, privately, from home.
Because the doctor works out which infection it is before treating, so the treatment works.
Because recurrence is taken seriously, with partner treatment, tests and triggers considered.
Because swabs and an examination are arranged the same day when they are needed.
And because prescriptions go to a pharmacy near you.
Related reading
Recurrent UTI covers urinary symptoms, STI testing in London covers sexual health screening, coil fitting and contraception covers contraception, and do I need antibiotics covers when antibiotics help.
Book a video consultation on WhatsApp or call 020 3951 3429.
Frequently asked questions
How do I know if I have BV or thrush
BV usually causes a thin grey or white discharge with a fishy smell and little itching. Thrush usually causes a thick white discharge with itching and soreness and little smell. A doctor can confirm which one from your history and, if needed, swabs.
Can I get BV treatment online
Yes. A doctor can assess BV by video and prescribe antibiotics to a pharmacy near you. Tests are arranged if the picture is unclear or it keeps coming back.
Does BV go away on its own
Sometimes, but it often persists or returns, and treatment is recommended if you have symptoms, are pregnant or are having a procedure such as a coil fitting.
Why does my BV keep coming back
BV often returns, and more than half of women have it again within a year. Treating a male partner reduced recurrence from 63% to 35% within 12 weeks in a 2025 trial. A doctor can also discuss a longer preventive course.
When should I see a doctor about thrush
The first time you have symptoms, if you are pregnant, under 16 or over 60, if it returns more than 4 times in 12 months, or if treatment has not worked.
How much does a private video consultation cost
Video GP consultations from £150. Enquire for in-person consultation and swab fees and inclusions. Any prescription depends on clinical assessment; pharmacy costs are separate.
The Wellness is a doctor-led private healthcare group providing medical care from our London clinics, including Marylebone and Belgravia. All doctors are GMC-registered. Prescriptions are issued only following a consultation and clinical assessment. In an emergency call 999. This article is general information and not a substitute for medical advice about your own health.
Enquire now on WhatsApp or email team@thewellnesslondon.com or call 020 3951 3429.
References
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