BV and Yeast Infections

The following section is a guide if you are experiencing vaginal discharge and would like to proceed with a self swab at a local laboratory.

Only order a self swab if:

• You are experiencing new vaginal discharge or vaginal odour

• You do not have any abdominal pain, fevers, or chills or feel unwell

• You have an up-to-date normal pap test

In the event, you have a normal swab result and your symptoms are persistent, we advise you to proceed to a local walk-in clinic for a cervical assessment, as vaginal discharge can be associated with more serious conditions (see below - Other Causes of Vaginal Discharge).

If you are concerned about STI exposure or partner infidelity, we suggest adding an STI screen as a vaginal swab WILL NOT show chlamydia or gonorrhea.

When you order a self-swab (Swab Instructions)

• Proceed to the laboratory and the lab technician will supply you with a vaginal swab you can complete in the on-site bathroom. Instructions are included below.

• If your swab confirms BV or a yeast infection, you will be notified and offered treatment in an included follow-up phone call with our doctor.

Vaginal Discharge

Bacterial Vaginosis (BV) and Yeast Infections (Vulvovaginal Candidiasis) are two common causes of changes in vaginal discharge. These are not considered sexually transmitted infections. Most yeast infections and bacterial vaginosis self-resolve without medical intervention.

Vaginal discharge can also be related to transmissible infections like chlamydia, gonorrhea or trichomoniasis. With new partner exposure and new-onset vaginal discharge, we recommend completing both STI screening and a vaginal self-swab to clarify the cause of the discharge. If you are in a mutually monogamous relationship, usually only a vaginal swab is necessary, unless there are concerns about partner infidelity or you were never screened at the onset of the relationship.

Bacterial Vaginosis (BV)

Bacterial vaginosis is a clinical condition characterized by a change in the vaginal flora towards a diverse set of species. Lactobacillus is a common vaginal organism that maintains an acidic vaginal pH. Changes away from lactobacillus can lead to a rise in the pH of the vagina causing a change in vaginal discharge and vaginal odor. Discharge is often off-white, thin, and often has a “fishy smell” that can be more notable after intercourse and menses.

Yeast Infections (Vulvovaginal Candidiasis)

Yeast infections or vulvovaginal candidiasis is one of the most common causes for changes in vaginal discharge, often associated with intense itching. It is caused by inflammation attributable to the Candida species. Risk factors for recurrent yeast infections include diabetes, antibiotic usage, increased estrogen levels (post-menopausal estrogen therapy/pregnancy), or immunosuppression. Common symptoms include vulvar redness and a thick curd-like or cottage cheese-like discharge with no or little odor.

Other Causes of Vaginal Discharge

It is important to note that vaginal discharge can also less commonly be a symptom related to a more serious medical condition. If you complete screening through TeleTest and have normal results (a normal STI screen and a normal swab) we recommend you proceed to a local walk-in clinic for a speculum exam to assess your cervix and an in-person assessment. Rare and less common causes of discharge include cervical and endometrial cancer, and your health care provider can determine if further investigations are necessary.

About PAP Testing

PAP testing (cervical cancer screening) is recommended in Ontario starting at the age of 25 or 3 years after becoming sexually active, whichever comes later. The Ontario Cervical Screening Program recommends that women who are or have been sexually active have a Pap test every 3 years. Abnormal pap results often require earlier follow-up. Your provider will notify you of an abnormal Pap test result and notify you of earlier required follow-up. An abnormal pap might prompt your provider to refer you for a special exam called colposcopy, or simply repeat the test in 6 months.

Regular screening should continue until at least age 70 or when advised by a doctor or nurse practitioner to stop. Pap tests can stop at the age of 70 if a woman has had 3 or more normal tests in the previous 10 years.

Eligible people need to get cervical screening even if they:

• feel healthy and have no symptoms

• are no longer sexually active

• have only had 1 sexual partner

• are in a same-sex relationship

• have been through menopause

• have no family history of cervical cancer

• have received the HPV vaccine

Swab Instructions

Common Questions

How does the vaginal swab test for BV work?

The vaginal swab test for BV (Bacterial Vaginosis) and/or yeast infection is a self-collected swab test. Once you receive your lab requisition from TeleTest, you’ll need to visit a LifeLabs location and request the Self collected vaginal swab - Charcoal C & S swab.

No appointments are typically needed at the lab for this test. You’ll collect the sample yourself in the washroom at the lab—LifeLabs staff do not perform the swab collection for you.

If the lab doesn’t have the swabs available due to supply issues, you can either:

• Visit a different LifeLabs location, or

• Ask the lab staff to notify you once the swabs are back in stock (they can order them on request).

The usual turnaround time for these results are 6-8 business days. If your swab confirms BV or a yeast infection, you will be notified by email to book a follow up appointment and offered treatment.

My partner tested positive for BV or yeast. Do I need treatment?

No - partner(s) do not require treatment. Bacterial vaginosis is caused by changes in a person's vaginal pH, and is not caused by bacteria transmitted by a male or female partner. When the pH of the vagina returns to normal, Bacterial Vaginosis disappears.

Antibiotics can help a woman clear Bacterial Vaginosis, but BV often disappears on its own without medications.

Can I get a prescription to treat BV without a test?

Yes, it is possible to receive a prescription for bacterial vaginosis (BV) without a test, especially if you have had it before and are familiar with the symptoms. However, the doctor will make the final decision during your consultation.

Is Bacterial Vaginosis an STI?

Bacterial vaginosis not not a sexually transmitted infection. Many women who have never been sexually active in their lifetime can have BV. Additionally, women who are sexually active who do not have an STI can also have bacterial vaginosis.

Can my sexual partners get prescriptions for BV, if I suspect they are also infected?

Bacterial Vaginosis is not a transmissible infection, so parters do not require treatment to prevent you from reacquiring it.

Some sexual practices like the use of sex toys, anal sex, exposure to semen and some lubricants can trigger BV episodes. You should try to avoid any obvious triggers.

If your partner is female, they can request BV treatment if they are experiencing symptoms by selecting that panel and completing the intake form.

If your partner is male, no treatment is required as treating males with metronidazole does not prevent bacterial vaginosis in females.

Do vaginal swabs test for all strains of yeast?

A vaginal smear test(swab) typically detects the presence of bacterial vaginosis (BV) and yeast infections. However, this standard test does not differentiate between specific Candida strains, such as Candida albicans, Candida glabrata, or other non-albicans species.

Order testing or treatment through TeleTest