Vaginal yeast infection is a common fungal infection of the genitals causing inflammation, irritation, itching, and vaginal discharge.
Vaginal yeast infections, also called vaginal Candidiasis or vulvovaginal Candidiasis (VVC), are experienced by up to 3 out of 4 women during their lifetime, with most women experiencing at least two or more infections.
In this article, we will discuss the causes, symptoms, and diagnosis of yeast infections. We will also discuss medication and home remedies.
Fast facts on yeast infections
Here are some key points about yeast infections. More detail and supporting information is in the main article.
- Vaginal yeast infection occurs more frequently and more severely in people with weakened immune systems.
- Women with vulvovaginal Candidiasis (VVC) usually experience genital itching, burning, and sometimes a "cottage cheese-like" vaginal discharge.
- Several different antifungal medications are available to treat genital candidiasis. Antifungal vaginal suppositories or creams are commonly used.
- OTC treatments for VVC are available. As a result, more women are diagnosing and treating themselves.
- It is important to be sure of the diagnosis before treating a vulvovaginal candidiasis infection with OTC or other antifungal medications.
Causes of a yeast infection
Yeast infections are caused by a yeast species called Candida albicans.
Common yeast infections are caused by the yeast species Candida albicans. However, there are other species of Candida which can cause an infection and may, at times, require different treatments.
Balanced levels of yeast and bacteria are normally present in a woman's vagina; however, disturbances in this delicate balance can lead to the development of an infection.
Normally, the bacteria Lactobacillus creates an environment that does not encourage yeast overgrowth. However, at times, yeast will become dominant and cause symptoms of a yeast infection.
Yeast infections of the vagina are not sexually transmitted diseases; however, they can be spread through oral-genital contact or during intercourse.
There are certain factors that increase the risk of developing a vaginal yeast infection; these include:
- Use of antibiotics and/or corticosteroids
- Uncontrolled diabetes
- Being immunocompromised
- Any scenarios that can cause changes in normal vaginal flora, including douching
Symptoms of a yeast infection
Frequent symptoms of vaginal yeast infection include itching, burning, and vaginal discharge.
Symptoms of a vulvovaginal yeast infection include:
- Vaginal and vulvar itching or irritation
- Vaginal burning, pain, soreness
- Vaginal burning with intercourse or urination
- Vaginal discharge resembling cottage cheese (thick and white) that is odorless
Some women may experience a complicated yeast infection which includes more severe symptoms and involves the presence of four or more infections in a single year.
Symptoms of a complicated yeast infection include severe redness, swelling, and itching, that results in skin fissures or sores.
There are certain medical conditions that cause a complicated yeast infection and include pregnancy, uncontrolled diabetes, being immunocompromised, and the presence of an alternate Candida fungus, as opposed to Candida albicans.
Tests and diagnosis of a yeast infection
When diagnosing the presence of a vaginal yeast infection, a doctor will obtain a medical history, perform a pelvic exam to visualize the vulva, vagina, and cervix for signs of infection and, sometimes, a sample of vaginal discharge will be tested.
A swab of vaginal discharge may be studied under a microscope to determine if there is high levels of yeast present. Once a doctor has determined if it is an uncomplicated or complicated yeast infection, treatment will be recommended.
Treatments for a yeast infection
Treatment of the infection will depend on whether it is complicated or uncomplicated:
Treatment of uncomplicated yeast infection
Doctors treat yeast infections according to their severity and complications.
Uncomplicated yeast infections can be treated with one of two methods - direct vaginal therapy or oral treatment.
When treating an uncomplicated yeast infection, a short-course vaginal therapy is normally sufficient.
There are varying methods that may be recommended; these range from a one-time treatment of a 1-7 day prescription or an OTC regimen using medications such as butoconazole (Gynazole-1), clotrimazole (Gyne-Lotrimin), miconazole (Monistat 3), and terconazole (Terazol 3).
Since these medications are oil-based, they can weaken latex condoms and diaphragms, potentially making them less reliable.
Alternatively, an oral antifungal, fluconazole (Diflucan), can be used in one single dose.
Treatment of complicated yeast infection
When yeast infections are classified as complicated, treatment will change and include the use of long-course vaginal therapy or multi-dose oral formulations. At times, maintenance medications may be recommended (drugs which are taken regularly to prevent the infection returning).
Long-course vaginal therapy includes treatment with a vaginal cream, ointment, tablet, or suppository for approximately 7-14 days.
Sometimes, two to three doses of oral fluconazole may be recommended instead of direct vaginal therapy. If symptoms are severe enough, a doctor may prescribe a few days of topical steroids to help ease symptoms while the antifungal medication works.
Certain situations may require treatment with maintenance medications. These would begin after one of the above methods of treatment has finished; this may include weekly treatment with oral fluconazole for 6 months or treatment with vaginal clotrimazole weekly.
If your sex partner has yeast symptoms, it might be recommended that they have treatment, too. The use of condoms is often recommended.
Alternative therapies are sometimes used to treat vaginal yeast; these include a prescription boric acid vaginal suppository and the oral/vaginal application of yogurt. These alternative therapies are currently not supported by research studies. However, they may be effective in providing relief of Candida symptoms and, possibly, reduce the presence of yeast.
It is important to be sure that the symptoms are definitely due to a yeast infection; the overuse of antifungals can increase the chances of yeast resistance, which means that the medications may not work in the future when they are needed.
Preventing yeast infections
While there is no guaranteed way to prevent a Candida infection, there are certain things that can be done to reduce the risk of developing a vaginal yeast infection.
These include not douching, wearing cotton underwear, wearing loose fitting pants or skirts, avoiding tight underwear and pantyhose, promptly changing wet clothing, and avoiding hot tubs and hot baths.
Oral or intravaginal probiotics may be recommended in cases where a woman has more than three yeast infections annually.
If an individual believes they are experiencing a yeast infection and are displaying concerning symptoms, it is important to speak with a doctor for an accurate diagnosis as soon as possible.