Vaginal yeast infection

  • Definition
    • Vaginal yeast infection is an infection of the vagina. It is most commonly due to the fungus Candida albicans.

  • Alternative Names
    • Yeast infection - vagina; Vaginal candidiasis; Monilial vaginitis

  • Causes
    • Most women have a vaginal yeast infection at some time. Candida albicans is a common type of fungus. It is often found in small amounts in the vagina, mouth, digestive tract, and on the skin. Most of the time, it does not cause infection or symptoms.

      Candida and the many other germs that normally live in the vagina keep each other in balance. However, sometimes the number of Candida increases, leading to a yeast infection.

      This can happen if:

      • You are taking antibiotics used to treat another infection. Antibiotics change the normal balance between germs in the vagina.
      • You are pregnant
      • You are obese
      • You have diabetes

      A yeast infection is not spread through sexual contact. However, some men will develop symptoms such as itching and a rash on the penis after having sexual contact with an infected partner.

      Having many vaginal yeast infections may be a sign of other health problems. Other vaginal infections and discharges can be mistaken for a vaginal yeast infection.

  • Symptoms
    • Symptoms include:

      • Abnormal vaginal discharge. Discharge can range from slightly watery, white discharge to thick, white, and chunky (like cottage cheese).
      • Itching and burning of the vagina and labia
      • Pain with intercourse
      • Painful urination
      • Redness and swelling of the skin just outside of the vagina (vulva)
  • Exams and Tests
    • You will have a pelvic exam. It may show:

      • Swelling and redness of the skin of the vulva, in the vagina, and on the cervix
      • Dry, white spots on the vaginal wall
      • Cracks in the skin of the vulva.

      A small amount of the vaginal discharge is examined using a microscope. This is called a wet mount and KOH test.

      Sometimes, a culture is taken when the infection does not get better with treatment or comes back many times.

      Your health care provider may order other tests to rule out other causes of your symptoms.

  • Treatment
    • Medicines to treat vaginal yeast infections are available as creams, ointments, vaginal tablets or suppositories and oral tablets. Most can be bought without needing to see your provider.

      Treating yourself at home is probably OK if:

      • Your symptoms are mild and you do not have pelvic pain or a fever
      • This is not your first yeast infection and you have not had many yeast infections in the past
      • You are not pregnant
      • You are not worried about other sexually transmitted infections from recent sexual contact

      Medicines you can buy yourself to treat a vaginal yeast infection are:

      • Miconazole
      • Clotrimazole
      • Tioconazole
      • Butoconazole

      When using these medicines:

      • Read the packages carefully and use them as directed.
      • You will need to take the medicine for 1 to 7 days, depending on which medicine you buy. (If you do not get repeated infections, a 1-day medicine might work for you.)
      • Do not stop using these medicines early because your symptoms are better.

      You doctor can also prescribe a pill that you only take by mouth once.

      If your symptoms are worse or you get vaginal yeast infections often, you may need:

      • Medicine for up to 14 days
      • Clotrimazole vaginal suppository or fluconazole pill every week to prevent new infections

      To help prevent and treat vaginal discharge:

      • Keep your genital area clean and dry. Avoid soap and rinse with water only. Sitting in a warm, but not hot, bath may help your symptoms.
      • Avoid douching. Although many women feel cleaner if they douche after their period or intercourse, it may worsen vaginal discharge. Douching removes healthy bacteria lining the vagina that protect against infection.
      • Eat yogurt with live cultures or take Lactobacillus acidophilus tablets when you are on antibiotics. This may help to prevent a yeast infection.
      • Use condoms to avoid catching or spreading other infections.
      • Avoid using feminine hygiene sprays, fragrances, or powders in the genital area.
      • Avoid wearing tight-fitting pants or shorts, which may cause irritation.
      • Wear cotton underwear or cotton-crotch pantyhose. Avoid underwear made of silk or nylon, because they can increase sweating in the genital area, which leads to growth of more yeast.
      • Keep your blood sugar level under good control if you have diabetes.
      • Avoid wearing wet bathing suits or exercise clothing for long periods of time. Wash sweaty or wet clothes after each use.
  • Outlook (Prognosis)
    • Most of the time, symptoms go away completely with proper treatment.

  • Possible Complications
    • A lot of scratching may cause the skin to crack, making you more likely to get a skin infection.

      Repeat infections that occur right after treatment, or a yeast infection that does not respond well to treatment, may be an early sign of diabetes or rarely, HIV.

  • When to Contact a Medical Professional
    • Call your provider if:

      • This is the first time that you have had symptoms of a vaginal yeast infection.
      • You are not sure if you have a yeast infection.
      • Your symptoms don't go away after using over-the-counter medicines.
      • Your symptoms get worse.
      • You develop other symptoms.
      • You may have been exposed to an STD.
  • References
    • Eckert LO, Lentz GM. Infections of the lower genital tract. In: Lentz GM, Lobo RA, Gershenson DM, Katz VL, eds. Comprehensive Gynecology. 6th ed. Philadelphia, PA: Elsevier Mosby; 2012:chap 23.

      Habif TP. Superficial fungal infections. In: Habif TP, ed. Clinical Dermatology. 6th ed. St. Louis, MO: Elsevier; 2016:chap 13.

      Hoefgen HR, Merritt DF. Vulvovaginitis. In: Kliegman RM, Stanton BF, St Geme JW, Schor NF, eds. Nelson Textbook of Pediatrics. 20th ed. Philadelphia, PA: Elsevier; 2016:chap 549.

      Kauffman CA. Candidiasis. In: Goldman L, Schafer AI, eds. Goldman's Cecil Medicine. 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 338.