Condition Basics

What is a vaginal yeast infection?

Yeast is a fungus that normally lives in the vagina in small numbers. A vaginal yeast infection means that too many yeast cells are growing in the vagina. These infections are very common. They may bother you a lot, but they usually aren't serious. A yeast infection is not a sexually transmitted infection (STI).

What causes it?

A healthy vagina has many bacteria and a few yeast cells. When something changes the balance of these organisms, yeast can grow too much and cause symptoms. Taking antibiotics sometimes causes this imbalance. Other causes include certain health problems, like diabetes, and high estrogen levels from pregnancy or hormone therapy.

What are the symptoms?

A yeast infection causes itching or soreness in the vagina. It sometimes causes pain or burning when you urinate or have sex. Some women also have a thick, clumpy, white discharge that has no odour and looks a little like cottage cheese.

How is it diagnosed?

It's easy to guess wrong about a vaginal infection. See your doctor if you aren't sure what you have, if this is the first time you have had symptoms, or if you're pregnant. Your doctor may be able to diagnose you based on your medical history and a vaginal examination.

How is a vaginal yeast infection treated?

If you're not pregnant and you know you have a yeast infection, you can treat yourself with over-the-counter antifungal medicine. If you're pregnant, don't use these medicines without talking to your doctor first. If you have more than four infections in a year, see your doctor for testing and treatment.

How can you help prevent a vaginal yeast infection?

Practicing good genital hygiene can help prevent yeast infections. For example, keep your vaginal area clean. After using the toilet, wipe from front to back. Avoid tight-fitting clothing. Wear cotton underwear. Change out of a wet swimsuit right away. Change pads or tampons often. Don't douche or use feminine deodorants.

Cause

A healthy vagina has many bacteria and a small number of yeast cells. The most common bacteria, Lactobacillus acidophilus, help keep yeast and other organisms under control. When something happens to change the balance of these organisms, yeast can grow too much and cause symptoms.

Things that may cause an overgrowth of vaginal yeast include:

• Taking antibiotics.
• Having a high estrogen level. This may occur during pregnancy, hormone therapy (HT or ET) use, high-dose birth control pill use, and the menstrual cycle.
• Having diabetes, especially if your blood sugar tends to be high.
• Having a disease that weakens the immune system, such as HIV.
• Using steroid medicines, such as prednisone.
• Being overweight.

Most yeast infections are caused by a type of yeast called Candida albicans. Yeast infections that keep coming back tend to involve other types of yeast. These are harder to treat.

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Prevention

The following actions can help prevent a vaginal yeast infection.

• Eat a balanced diet.

  A balanced diet includes vegetables and fruits, whole grain foods, and protein foods.

  Some women think that eating foods with lactobacillus organisms, such as yogurt or acidophilus milk, will help prevent yeast infections. So far there is no evidence for this connection. But eating foods that contain lactobacillus can be part of a healthy diet.

• Control diabetes.

  Good control of blood sugar levels decreases the risk of yeast infections anywhere on your body.

• Avoid unnecessary use of antibiotics.

  Antibiotics can change the normal balance of vaginal organisms, allowing excess growth of yeast.

• Practice good genital hygiene.
  • Keep your vaginal area clean. Use mild, unscented soap and water. Rinse well.
  • After using the toilet, wipe from front to back to avoid spreading yeast or bacteria from your anus to the vagina or urinary tract.
  • Wear underwear that helps keep your genital area dry and doesn't hold in warmth and moisture. One good choice is cotton underwear.
  • Avoid tight-fitting clothing, such as panty hose and tight jeans. These may increase body heat and moisture in your genital area.
  • Change out of a wet swimsuit right away. Wearing a wet swimsuit for many hours may keep your genital area warm and moist.
  • Change pads or tampons often.
  • Don't douche or use deodorant tampons or feminine sprays, powders, or perfumes. These items can change the normal balance of organisms in your vagina.

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Symptoms

The symptoms of vaginal yeast infection include:

• Vaginal itching. It's often severe.
• Thick, clumpy, white vaginal discharge. It has no odour. It looks a little like cottage cheese.
• Red, irritated skin around the opening to the vagina (labia).
• Pain while urinating. This occurs when urine touches irritated skin.
• Pain in the vagina during sexual intercourse.

Symptoms are more likely to occur during the week before your menstrual period.

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What Happens

Vaginal yeast infections often clear up on their own without treatment, usually when menstruation begins. Menstrual blood raises the vaginal pH, causing the number of yeast cells to decrease because they can't grow in the pH present during menstruation.

There are significant differences between occasional, easily treatable yeast infections and recurrent infections that seriously affect a woman's life. Recurring vaginal yeast infections can be difficult to prevent or cure. Women who have recurring yeast infections should be evaluated for other causes (such as diabetes, hormone therapy, or treatment-resistant strains of yeast) so that the cause can be treated or reversed.

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When to Call a Doctor

Call your doctor now if you:

• Have pain in your lower belly along with a fever and vaginal discharge. This may point to pelvic inflammatory disease (PID).
• Are pregnant and have symptoms of a vaginal infection or a urinary tract infection (UTI).

Call your doctor for an appointment if you:

• Have an unusual vaginal discharge with an unusual or foul odour.
• Have unusual vaginal itching.
• Have pain during sex or urination.
• Have any other symptoms that may point to a vaginal infection.
• Still have symptoms after trying home treatment with a non-prescription medicine.
• Have symptoms return within 2 months, and you have not been taking antibiotics.

Watchful waiting

If your symptoms are mild and you are sure they are caused by a vaginal yeast infection, waiting several days to see if the symptoms clear up on their own isn't harmful, especially if you expect your menstrual period within that time. Sometimes a menstrual period will relieve the symptoms of a mild yeast infection. If your symptoms continue, you can use non-prescription medicine. If you still have symptoms after treatment, see your doctor.

Examinations and Tests

It's easy to guess wrong about a vaginal infection. See your doctor if you aren't sure what you have, if this is the first time you have had symptoms, or if you're pregnant. Your doctor may be able to diagnose the problem based on your medical history and a vaginal examination.

If your symptoms aren't typical of a yeast infection, your doctor can do a wet mount test to look for signs of yeast or other organisms.

If you have vaginal yeast infections that are severe or that keep coming back (recur), you may have other tests. Tests include:

• A vaginal culture. This can confirm that you have a yeast infection.
• A blood test to find out if you have a health problem that makes you more likely to get yeast infections.

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Treatment Overview

A mild vaginal yeast infection may go away without treatment. If your symptoms are mild, you may want to wait to see if they clear up on their own.

If you're not pregnant and you know that your symptoms are caused by a yeast infection, you can treat yourself at home with over-the-counter medicines. You can use an antifungal cream or vaginal suppositories.

Don't use over-the-counter treatment without talking to your doctor if you:

• Are pregnant.
• Are not sure that your symptoms are caused by a yeast infection.
• Have been exposed to a sexually transmitted infection (STI).
• Are having a repeat (recurrent) infection.
• Have pelvic pain or fever.

Treatment options also include prescription antifungal pills or vaginal medicine.

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Self-Care

Here are some things you can do at home to ease symptoms of a vaginal yeast infection.

• Keep these things in mind when using a vaginal medicine.
  • Follow the directions on the package insert on how to use the medicine.
  • Use pads instead of tampons. Do this while you are using the medicine. Tampons can absorb the medicine.
  • Know that the oil in antifungal creams or suppositories can weaken latex. This means that condoms and diaphragms may break, and you may not be protected from sexually transmitted infections or pregnancy.
  • Avoid sex while using a vaginal medicine.
• Avoid using soap.

  When you clean your vaginal area, rinse with water only.

• Sit in warm water.
  • Do this in a bathtub or sitz bath, not a hot tub.
  • If the genital area is swollen or painful, sitting in warm water may help. Or you can try putting a cool, damp cloth on the area.
• Don't rub to try to relieve itching.
• Report your symptoms to your doctor.

  Tell your doctor if your self-treatment isn't working after one complete course of therapy.

• Talk to your doctor before you try unproven home treatment methods.
  • These include applying tea tree oil in the vagina or taking garlic supplements. These treatments have not been well studied. They may even cause other problems, such as allergic reactions, in some women.
  • Douching is not recommended. It can make some infections worse.

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