Vaginal yeast infection

What is it?

Vaginal yeast infections, also called "Candida vaginal infections," typically are caused by the Candida albicans fungus. During a lifetime, 75% of all women are likely to have at least one vaginal Candida infection, and up to 45% have two or more. Women tend to be more likely to get vaginal yeast infections if their bodies are under stress from poor diet, lack of sleep, illness, or when they are pregnant or taking antibiotics. Women with diabetes or immune-suppressing diseases such as HIV infection also are at increased risk.

Symptoms

The symptoms of a vaginal yeast infection include:

• Vaginal itch or soreness
• Thick, white, cheese-like discharge
• "Burning" discomfort around the vaginal opening, especially if urine touches the area
• Pain or discomfort during sexual intercourse.

Diagnosis

Your doctor will suspect an infection based on your symptoms. Your doctor will do a pelvic examination to look for inflammation and a white discharge in your vagina and around the vaginal opening. Your doctor may also take a sample of the vaginal discharge for quick examination under a microscope in the office.

Expected duration

Proper treatment cures up to 90% of vaginal yeast infections within 2 weeks or less, often within a few days. A small number of people will have repeat infections. Usually, these will improve with repeated treatment. However, patients with unexplained, repeat episodes should be tested for diabetes or HIV – 2 conditions that increase the risk of Candida vaginitis.

Prevention

To help prevent vaginal yeast infections, you can try the following suggestions:

• Keep the external genital area clean and dry.
• Avoid irritating soaps (including bubble bath), vaginal sprays and douches.
• Change tampons and sanitary napkins frequently.
• Wear loose cotton (rather than nylon) underwear that doesn't trap moisture.
• After swimming, change quickly into your dry clothing instead of sitting in your wet bathing suit for prolonged periods.
• Take antibiotics only when prescribed by your doctor, and never take them for longer than your doctor directs.
• If you are diabetic, try to keep tight control over your blood sugar levels.

Treatment

The simplest and most convenient treatment of a vaginal Candida infection is a single dose of oral fluconazole (Diflucan Oral, generic versions). It should not be used in pregnant women.

Vaginal yeast infections also can be treated with over-the-counter or prescription antifungal medicines that are inserted directly into the vagina as tablets, creams, ointments or suppositories. These medications include butoconazole, clotrimazole, miconazole, tioconazole and terconazole.

Treatment of sex partners is not usually necessary, since most vaginal yeast infections are not transmitted sexually. However, if a male sex partner shows symptoms of Candida balanitis (redness, irritation and/or itching at the tip of the penis), he may need to be treated with an antifungal cream or ointment.

Any woman who experiences symptoms of a vaginal infection for the first time should visit a doctor. This is important to be sure that the vaginal discharge and discomfort is caused by yeast and not sexually transmitted infections such as gonorrhea, chlamydia or trichomoniasis.

About 5% of women with vaginal yeast infections develop recurrent vulvovaginal candidiasis (RVVC), which is defined as 4 or more vaginal yeast infections in a 1-year period. Although RVVC is more common in women who have diabetes or weakened immune systems, most women with RVVC have no underlying medical illness that would predispose them to recurrent Candida infections.

Medical experts continue to explore the most effective way to treat RVVC.  One suggested therapy is 10 days of daily oral fluconazole or daily application of a topical agent, followed by one dose of oral fluconazole once per week for six months. An alternative is to use clotrimazole cream twice weekly for six months following the initial 10 day course.

When to call a professional

Call your doctor whenever you have vaginal discomfort or an abnormal vaginal discharge, especially if you are pregnant.

Prognosis

Medications cure most vaginal yeast infections. About 5% of women develop RVVC and may require further treatment with prolonged antifungal therapy.

Additional info

Centers for Disease Control and Prevention
https://www.cdc.gov