Best things to know about vaginal yeast infection in 2021

Symptoms of a vulvovaginal yeast infection include:

• Itching, burning, or irritation of the vagina or vulva, which is the tissue surrounding the vagina
• Pain or soreness in the vagina or the vaginal opening
• Vaginal burning with intercourse or urination
• A thick, white, odorless discharge that resembles cottage cheese, or a watery discharge
• Rash

Sometimes a more complicated yeast infection may occur, with more severe symptoms. Four or more infections may arise in one year.

There may be severe redness, swelling, and itching, leading to skin fissures or sores.

Medical conditions that can cause a complicated yeast infection include pregnancy, uncontrolled diabetes, having a weakened immune system, and the presence of an alternate Candida fungus, as opposed to Candida albicans.

In men, it affects the head of the penis. Symptoms include redness, irritation, and discharge. It can also affect the skin or the mouth.

Treatment

Treatment of the infection depends on whether it is complicated or uncomplicated.

Uncomplicated yeast infection

There are two ways to treat an uncomplicated yeast infection: Direct vaginal therapy or oral treatment.

When treating an uncomplicated yeast infection, a short-course of vaginal therapy is normally sufficient.

One option is a one-time treatment of a prescription or an over-the-counter medication such as butoconazole (Gynazole-1), clotrimazole (Gyne-Lotrimin), miconazole (Monistat 3), and terconazole (Terazol 3). Some of these are available to buy online, including clotrimazole, Monistat 3, and terconazole.

Alternatively, an oral antifungal, fluconazole (Diflucan), can be used in one single dose.

Complicated yeast infection

In the case of a complicated yeast infection, treatment will include the use of long-course vaginal therapy or multi-dose oral formulations. A doctor can help to find a suitable treatment.

Maintenance medications may be recommended. These drugs 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 to 14 days.

Sometimes, two to three doses of oral fluconazole may be recommended instead of direct vaginal therapy.

If symptoms are severe, a doctor may prescribe a few days of topical steroids to help ease symptoms while the antifungal medication works.

Before using antifungals, it is important to be sure that the symptoms are due to a yeast infection. The overuse of antifungals can increase the chances of yeast resistance, so that the medications may not work in the future when they are needed.

If maintenance medications are necessary, these begin after one of the above methods of treatment has finished. It may include weekly treatment with oral fluconazole for 6 months or weekly treatment with vaginal clotrimazole.

If the patient’s sexual partner has yeast symptoms, they might want to consider treatment, too. The use of condoms is often recommended.

Home remedies

Alternative therapies are sometimes used to treat vaginal yeast.

These include a boric acid vaginal suppository, available to purchase online, and the oral or vaginal application of yogurt.

These alternative therapies are currently not supported by research studies, but they may provide relief from Candida symptoms and, possibly, reduce the presence of yeast.

Causes

Doctors treat yeast infections according to their severity and complications.

Common yeast infections are caused by the yeast species Candida albicans, but other species of Candida can also cause an infection. They may need different treatment.

Balanced levels of yeast and bacteria are normally present in a woman’s vagina, but 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, but if yeast becomes dominant, symptoms of a yeast infection may emerge.

Yeast infections of the vagina are not sexually transmitted infections (STIs), but they can spread through oral-genital contact or during intercourse. They are more common in women who are sexually active.

Factors that increase the risk of a vaginal yeast infection include:

• Use of antibiotics, corticosteroids, or both
• Pregnancy
• Use of hormonal contraceptives or contraceptive devices
• Uncontrolled diabetes
• Being immunocompromised

Any activity that can cause changes in normal vaginal flora, including douching, can contribute to a yeast infection. Poor diet and lack of sleep may also increase the risk.

Diagnosis

When diagnosing a vaginal yeast infection, a doctor will start by asking questions about sexual practices and any history of any STIs or previous yeast infections.

They might also perform a pelvic exam to inspect the vulva, vagina, and cervix for signs of infection. A sample of vaginal discharge may be sent to a laboratory to confirm the diagnosis.

Laboratory tests are usually ordered if an infection does not go away or keeps returning.

Examining a swab of vaginal discharge under a microscope can reveal if high levels of yeast are present.

Once it is clear whether the infection is uncomplicated or complicated, treatment can begin.

Prevention

While there is no guaranteed way to prevent a Candida infection, certain actions can reduce the risk of developing a vaginal yeast infection.

Women who are susceptible are advised to:

• Avoid douching
• Do not use feminine deodorant or deodorant pads or tampons
• Wear underwear made from cotton or other natural fibers
• Wear loose fitting pants or skirts
• Wash underwear at a high temperature
• Avoid tight underwear and pantyhose
• Eat a healthy, varied diet
• Promptly change wet clothing, for example bathing suits
• Avoid hot tubs and hot baths

Oral or intravaginal probiotics may be recommended if a woman has more than three yeast infections annually.

Anyone who believes they have symptoms of a yeast infection should speak with a doctor for an accurate diagnosis as soon as possible.

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