If you’re experiencing unusual vaginal symptoms, like unusual vaginal odor or changes in discharge, it could be a sign of hormonal changes due to the Genitourinary Syndrome of Menopause (GSM) or a vaginal infection due to Bacterial Vaginosis (BV). They share some similar symptoms, which can make it confusing to tell them apart. We’ll break down the differences and help you understand when to seek help. At Interlude, we offer an easy online consult for common concerns like GSM or BV. So if you’re not sure, don’t wait. We can help you get clarity and relief.
Overlapping Symptoms of GSM and BV
Common symptoms of both conditions include:
- Vaginal dryness or irritation
- Burning sensations
- Discharge that doesn’t seem normal
- Pain during sex
- Elevated vaginal pH
- Unusual vaginal odor
Key Differences Between GSM and BV
GSM: GSM stems from low estrogen, especially after menopause, which can impact the health of the vagina, urethra, and bladder. Without estrogen, the vaginal environment tends to have less good bacteria, and this can mimic the symptoms of BV.
BV: BV stems from an increase in bad bacteria, caused by an imbalance in the vaginal environment. While not an STI, it can increase the risk of getting one. Factors like douching or having multiple sexual partners increase BV risk by disturbing the vaginal flora balance.
Additional GSM-Specific Symptoms
With GSM, you might also experience:
- Tissue thinning in and around the vagina
- Lack of natural vaginal moisture
- Frequent, urgent trips to the bathroom, or even incontinence
- Recurring urinary tract infections (UTIs)
- Persistent dryness that doesn’t go away
Additional BV-Specific Symptoms
BV is more likely to show up with:
- Thin, grayish-white discharge
- Strong fish-like odor, especially after intercourse
How Do I Know I Have GSM?
GSM is commonly diagnosed based on symptoms alone, especially when a person reports issues like vaginal dryness, irritation, discomfort during sex, and urinary symptoms like frequent UTIs or incontence that tend to persist over time.
A lab test or exam is not required to confirm GSM. However, when you get your regular pap smear, you may notice atrophic vaginitis or vaginal atrophy on your lab test results. This is another term for GSM, but the key takeaway is that if you're curious what vaginal atrophy looks or feels like, you most likely won't need a lab test to find out if you have it.
Do You Always Need a Test for BV?
Not necessarily. Usually, healthcare providers can diagnose BV based on symptoms alone if they are clear-cut. However, if symptoms overlap with other issues or keep recurring, a vaginal swab can confirm BV by detecting a bacterial imbalance in a lab setting.
The genitourinary syndrome of menopause is often treated with vaginal estrogen to restore beneficial bacteria in the vaginal microbiome, relieve dryness, and improve tissue health. Plus, it can help address other GSM symptoms, like painful urination or constant urinary urgency, that might also be driving you nuts. Available as an estradiol pill, suppository, or ring, vaginal estrogen can be prescribed by a medical provider, like a board-certified doctor here at Interlude.
BV is usually treated with antibiotics like metronidazole or clindamycin to reduce the overgrowth of bad bacteria. It’s crucial to finish the antibiotic course since BV often recurs if treatment is not completed.
If you’re not sure what’s going on, don’t wait. Both GSM and BV are treatable, so reach out to a healthcare provider or request treatment through our medical team at Interlude - for quick relief and guidance on how to prevent future issues.