A vaginal yeast infection is a type of vaginitis — inflammation of the vagina — characterized by vaginal irritation, intense itchiness and vaginal discharge. A vaginal yeast infection affects your vagina and the tissues at the opening to your vagina (vulva).
Vaginal yeast infection — also called vaginal candidiasis — is very common. As many as 3 out of 4 women experience a yeast infection at some point in their lifetimes. Many women experience two or more yeast infections.
A vaginal yeast infection isn’t considered a sexually transmitted infection, although the fungus that causes the condition can be spread through oral-genital contact. Simple treatment is usually effective, unless you have recurrent yeast infections — four or more in a single year. In that case, you may need a longer course of therapy and a maintenance plan.
Yeast infection symptoms can range from mild to moderate and include:
- Itching and irritation in the vagina and at the entrance to the vagina (vulva)
- A burning sensation, especially during intercourse or while urinating
- Redness and swelling of the vulva
- Vaginal pain and soreness
- Thick, white, odor-free vaginal discharge with a cottage cheese appearance
Complicated yeast infection
You might have a complicated yeast infection if:
- You have severe signs and symptoms, such as extensive redness, swelling and itching that leads to the development of tears or cracks (fissures) or sores
- You have recurrent yeast infections — four or more in a single year
- Your infection is caused by a type of candida other than Candida albicans
- You’re pregnant
- You have uncontrolled diabetes
- You have lowered immunity due to use of certain medications or a condition such as HIV infection
When to see a doctor
Make an appointment with your doctor if:
- This is the first time you’ve experienced yeast infection symptoms
- You’re not sure whether you have a yeast infection
- Your symptoms don’t go away after self-treating with over-the-counter antifungal vaginal creams or suppositories
- You develop other symptoms
A vaginal yeast infection is caused by the fungus candida. Candida is a microorganism that’s normally present in your vagina, along with bacteria. Your vagina naturally contains a balanced mix of yeast and bacteria. Lactobacillus bacteria produce acid, which discourages overgrowth of yeast in the vagina. But disruption of the healthy balance can result in an overgrowth of yeast. Too much yeast in your vagina can lead to vaginal itching, burning, and other classic signs and symptoms of a yeast infection.
Overgrowth of yeast can result from:
- Antibiotic use, which leads to a decrease in the amount of lactobacillus bacteria in your vagina and a change in your vaginal pH that allows yeast to overgrow
- Uncontrolled diabetes
- Impaired immune system
- Anything that changes the type and amount of bacteria normally present in the vagina, such as douching or irritation from inadequate vaginal lubrication
Most often, yeast infection results from a type of candida fungus known as Candida albicans. Sometimes, however, a different type of candida fungus might be the cause of symptoms. Candida albicans responds well to typical treatments for yeast infections. Other types of candida, however, sometimes respond poorly to conventional therapies and may require more aggressive treatment.
A yeast infection can be sexually transmitted, especially through oral-genital sexual contact. However, yeast infection isn’t considered a sexually transmitted infection because it happens in women who aren’t sexually active and the candida fungus is naturally present in the vagina.
Factors that increase your risk of developing a yeast infection include:
- Antibiotic use. Yeast infections are common in women who take antibiotics. Broad-spectrum antibiotics — those that are effective against a wide range of bacteria — kill healthy bacteria in your vagina, which can lead to the overgrowth of yeast.
- Increased estrogen levels. Yeast infections appear to occur more frequently in women with increased estrogen levels — for instance, in women who are pregnant, those taking high-dose estrogen birth control pills or those taking estrogen hormone therapy.
- Uncontrolled diabetes. In women who have diabetes, those with poorly controlled blood sugar levels are more likely to develop yeast infections than are women who have diabetes under control.
- Impaired immune system. Women with lowered immunity — such as from corticosteroid therapy or HIV infection — are more likely to get yeast infections.
- Sexual activity. Although yeast infections aren’t considered sexually transmitted infections, one way the candida organism can be introduced into your vagina is through sexual contact.
Treatments and drugs
Uncomplicated yeast infection
For mild to moderate symptoms and infrequent episodes of yeast infection, your doctor might recommend:
- Short-course vaginal therapy. A one-time application or one-to-three-day regimen of an antifungal cream, ointment, tablet or suppository effectively clears a yeast infection in most cases. The medication of choice is from a class of drugs called the azoles; these include butoconazole (Gynazole-1), clotrimazole (Gyne-Lotrimin), miconazole (Monistat 3) and terconazole (Terazol 3). These medications are available by prescription or over-the-counter. The oil-based nature of these agents in cream and suppository form could potentially weaken latex condoms and diaphragms. Side effects might include slight burning or irritation during application.
- Single-dose oral medication. Your doctor might prescribe a one-time single dose of the antifungal medication fluconazole (Diflucan) to be taken by mouth.
Make a follow-up appointment with your doctor if you’ve finished your treatment and your symptoms haven’t gone away or if your symptoms return within two months of being treated.
Complicated yeast infection
Treatment for a complicated yeast infection might include:
- Long-course vaginal therapy. Vaginal treatment for complicated yeast infections includes an azole medication in the form of a vaginal cream, ointment, tablet or suppository. The duration of treatment is usually seven to 14 days.
- Multidose oral medication. Instead of vaginal therapy, your doctor might prescribe two or three doses of fluconazole to be taken by mouth. However, this therapy isn’t recommended for pregnant women.
- Maintenance plan. For recurrent yeast infections, your doctor might recommend a medication routine to keep yeast overgrowth in check and prevent future infections. Maintenance therapy starts after the initial treatment clears the yeast infection and may include fluconazole tablets taken by mouth once a week for six months. Some doctors prescribe clotrimazole as a vaginal tablet (suppository) used once a week instead of an oral medication.
Usually, your sex partner doesn’t also need to be treated for a yeast infection. If you have recurrent yeast infections, your doctor might recommend treating your partner if your partner has signs or symptoms of a genital yeast infection — for instance, jock itch in a male partner — or using condoms during intercourse.
To reduce your risk of vaginal yeast infection:
- Avoid douching.
- Wear cotton underwear and loosefitting pants or skirts.
- Avoid tight-fitting underwear or pantyhose.
- Change out of wet clothes, such as swimsuits or workout attire, as soon as possible.
- Stay out of hot tubs or very hot baths.
Originally Published on Mayo