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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. Although they can bother you a lot, they are not usually serious. And treatment is simple.
Most yeast infections are caused by a type of yeast called Candida albicans.
A healthy vagina has many bacteria and a small number of yeast cells. The most common bacteria, Lactobacillus acidophilus, help keep other organisms—like the yeast—under control.
When something happens to change the balance of these organisms, yeast can grow too much and cause symptoms. Taking antibiotics sometimes causes this imbalance. The high estrogen levels caused by pregnancy or hormone therapy can also cause it. So can certain health problems, like diabetes or HIV infection.
A yeast infection causes itching or soreness in the vagina and 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.
These symptoms are more likely to occur during the week before your menstrual period.
It's easy to guess wrong about a vaginal infection. See your doctor if you aren't sure what you have or if this is the first time you have had these symptoms. Also see your doctor if you are pregnant. Your doctor may want to do a vaginal examination.
If you have had a yeast infection before and can recognize the symptoms, and you aren't pregnant, you can treat yourself at home with medicines you can buy without a prescription. You can use an antifungal cream or a suppository that you put into your vagina. Or your doctor may prescribe a medicine to treat the infection.
If your symptoms are mild, you may want to wait to see if they clear up on their own.
Yeast infections are common during pregnancy. If you are pregnant, don't use medicine for a yeast infection without talking to your doctor first.
If you use a cream or suppository to treat the infection, don't depend on a condom or diaphragm for birth control. The oil in some medicines weakens latex, the material often used to make these devices.
Many women have infections that come back. If you have more than four yeast infections in a year, see your doctor. He or she may do some tests to see if your yeast infections are being caused by another health problem, such as diabetes.
If you practice good genital hygiene, you can help prevent infection.
A vaginal yeast infection is caused by an overgrowth of yeast organisms that normally live in small numbers in the vagina. Things that may encourage an excess growth of vaginal yeast include:
Most yeast infections involve Candida albicans ( C. albicans), a yeast that can be treated effectively with standard yeast infection medicine. Recurrent vaginal yeast infections tend to involve non– C. albicans types of yeast, which are more resistant to the standard treatments for C. albicans yeast infections.
The symptoms of vaginal yeast infection include:
Symptoms of a vaginal yeast infection are more likely to occur during the week before a menstrual period.
There are other conditions with similar symptoms, such as bacterial vaginosis or a sexually transmitted infection (STI). Itching and redness of the vulva can also be caused by a reaction to vaginal products such as soap, bath oils, spermicidal jelly, or douches. If you are unfamiliar with your symptoms, see your doctor for an accurate diagnosis.
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.
Your risk of getting a vaginal yeast infection can be increased by a number of medical and lifestyle factors.
Some of the common things that put you at risk for vaginal yeast infection include:
Vaginal yeast infections are not sexually transmitted. After having unprotected sex with a partner who has a yeast infection, you may have more than the normal amount of yeast in your vagina. But if after having sex you develop a yeast infection that causes symptoms, it is most likely because other things are also involved.
Use the following guidelines for seeking medical care when you have vaginal symptoms.
Call your doctor immediately if you:
Call your doctor for an appointment within 1 week if you:
If you are sure your symptoms are caused by a vaginal yeast infection, waiting several days to see if the symptoms clear up on their own is not 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 symptoms continue after treatment, see your doctor.
Your family doctor or general practitioner can diagnose and treat a vaginal yeast infection. If you have a recurrent yeast infection, you may be referred to a specialist, such as a gynecologist.
Your doctor may be able to diagnose your vaginal symptoms based on your medical history and a vaginal examination.
If your vaginal symptoms are not typical of a vaginal yeast infection, your doctor can look for signs of yeast or other organisms using a wet mount test of vaginal discharge.
You may have other tests if you have vaginal yeast infections that are severe or that keep coming back (recur), such as:
Although a yeast infection can be detected during a routine Pap test, this type of test is not typically done to diagnose vaginal infections.
You have a number of treatment options for a vaginal yeast infection, including non-prescription vaginal medicine, prescription oral or vaginal medicine, or non-prescription vaginal boric acid capsules.
Only use non-prescription vaginal yeast infection treatment without a doctor's diagnosis and advice if you:
The risk of self-treatment is that your symptoms may be caused by another vaginal infection, such as a sexually transmitted infection (STI), that requires different treatment. If you may have been exposed to an STI, it is best to discuss your symptoms with your doctor before using a non-prescription medicine. Your doctor may recommend testing for STI if you have risk factors for these infections.
Vaginal yeast infections are common during pregnancy, likely caused by elevated estrogen levels. If you are pregnant, don't assume you have a yeast infection until it is diagnosed, and don't use non-prescription medicines without discussing your symptoms with your doctor.
Vaginal medicine is the recommended treatment for vaginal yeast infections during pregnancy.footnote 1
For a vaginal yeast infection that recurs within 2 months of treatment, or four times in 1 year (recurrent vaginal yeast infection), see your doctor. Further testing or a different treatment may be needed. If you have been using a non-prescription medicine for your vaginal symptoms, be sure to tell your doctor. This information could affect what treatment is recommended.
Recurrent vaginal yeast infection can be treated with prescription oral medicine, non-prescription vaginal medicine, or vaginal boric acid capsules, followed by less frequent medicine for 6 months to prevent reinfection.footnote 1
A vaginal yeast infection is not a sexually transmitted infection (STI). After having unprotected sex with a partner who has a yeast infection, you may have more than the normal amount of yeast in your vagina. But if after having sex you develop a yeast infection that causes symptoms, it is most likely because other factors are also involved.
It is important to complete the entire recommended treatment to cure a yeast infection.
Vaginal infections caused by types of yeast other than Candida albicans may be more difficult to cure with standard antifungal medicine. For treatment-resistant infections, a culture of vaginal discharge is done to identify the type of yeast causing the infection.
Boric acid is usually effective for treating Candida albicans ( C. albicans) infection, and non– C. albicans yeast infections that don't respond to antifungal medicine.footnote 1
The following actions can help prevent a vaginal yeast infection.
If you practice good genital hygiene, you can also help prevent infection.
Do not self-treat a vaginal yeast infection if you:
When using a non-prescription vaginal medicine for a vaginal yeast infection, follow the directions on the package insert, as well as these guidelines:
Report your symptoms to your doctor if:
The risk of self-treatment is that your symptoms may be caused by a type of vaginal infection other than a yeast infection, such as bacterial vaginosis or a sexually transmitted infection (STI). If you have pelvic pain or fever, get an evaluation by a doctor.
If you are pregnant, it is important to be evaluated for vaginal symptoms. Some vaginal infections, such as bacterial vaginosis, gonorrhea, or chlamydia, may increase your risk of complications during pregnancy.
If you have risk factors for an STI, discuss your symptoms with your doctor before using a non-prescription medicine. Risk factors for an STI include having sex without a condom or having more than one sex partner.
Talk to your doctor before you try unproven home treatment methods, such as 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.footnote 2 Douching is not recommended, because it can make some infections worse.
Antifungal medicines are the standard treatment for a vaginal yeast infection. You can insert a cream or suppository antifungal cream into your vagina or take a pill by mouth. Vaginal boric acid capsules are sometimes used.
Antifungal medicines that you take as a pill by mouth affect the entire body (so it can also treat any yeast infection elsewhere in the body). Vaginal medicine only affects the area in which it is applied.
If you are thinking about using non-prescription treatment.
Antifungal creams and suppositories that you put into your vagina have fewer side effects than antifungal pills you take by mouth. This is because vaginal medicine isn't absorbed into your body and only affects the genital area. Antifungal pills that are taken by mouth affect your entire body. Side effects from these pills are rare with one treatment dose. Side effects can include nausea, headaches, and belly pain. But taking a pill is convenient and is not messy. Medicine put into the vagina can be uncomfortable. And it may seem like more of a hassle than taking a pill.
The oil in antifungal creams or suppositories can weaken latex. This means condoms and diaphragms may break, and you may not be protected from STI or pregnancy.
If you are taking the anticoagulant medicine warfarin and you use a non-prescription vaginal yeast-fighting medicine, you may have increased bruising and abnormal bleeding. Talk with your doctor before using an antifungal medicine along with warfarin.
You are more likely to use a treatment correctly and complete the treatment if you get to choose the type you prefer. Talk with your doctor about the advantages and disadvantages of vaginal and oral medicines, including:
Check with your doctor or pharmacist to see whether you can get a generic form of a prescription medicine. Many generic medicines are now available to treat vaginal yeast infections. They are often less expensive than brand-name medicines.
Some experts may recommend vaginal boric acid capsules as a treatment option for vaginal yeast infection, particularly infections that can't be cured by prescription or non-prescription antifungal yeast infection medicines.footnote 3 Boric acid is a white, crystalline chemical substance that has antifungal and antiviral properties. It is used in various pharmaceutical products and is also available without a prescription.
If you are pregnant, do not use vaginal boric acid treatment.
CitationsExpert Working Group on Canadian Guidelines for Sexually Transmitted Infections (2013). Canadian guidelines on sexually transmitted infections: Section 4—Management and treatment of specific syndromes. Public Health Agency of Canada. http://www.phac-aspc.gc.ca/std-mts/sti-its/cgsti-ldcits/section-4-8-eng.php. Accessed May 22, 2015.Lopez JEM (2015). Candidiasis (vulvovaginal). BMJ Clinical Evidence. http://clinicalevidence.bmj.com/x/systematic-review/0815/overview.html. Accessed April 15, 2016.Expert Working Group on Canadian Guidelines for Sexually Transmitted Infections (2013). Canadian guidelines on sexually transmitted infections: Section 4—Management and treatment of specific syndromes. Public Health Agency of Canada. http://www.phac-aspc.gc.ca/std-mts/sti-its/cgsti-ldcits/section-4-8-eng.php. Accessed May 22, 2015.Other Works ConsultedPappas PG, et al. (2009). Clinical practice guidelines for the management of candidiasis: 2009 update by the Infectious Diseases Society of America. Clinical Infectious Diseases, 48(5): 503–535.
Current as of: July 17, 2020
Author: Healthwise StaffMedical Review: Kathleen Romito MD - Family MedicineAnne C. Poinier MD - Internal MedicineAdam Husney MD - Family MedicineMartin J. Gabica MD - Family MedicineDeborah A. Penava BA, MD, FRCSC, MPH - Obstetrics and Gynecology
Current as of: July 17, 2020
Author: Healthwise Staff
Medical Review:Kathleen Romito MD - Family Medicine & Anne C. Poinier MD - Internal Medicine & Adam Husney MD - Family Medicine & Martin J. Gabica MD - Family Medicine & Deborah A. Penava BA, MD, FRCSC, MPH - Obstetrics and Gynecology
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