What Is A Yeast Infection? Symptoms, Causes And Treatment

A vaginal yeast infection, also known as vaginal candidiasis, is an infection caused by a yeast called Candida.

Candida is a type of fungus that is normally found on the skin and inside the body. However, when too much Candida is allowed to grow, it can cause an infection. A vaginal yeast infection occurs when there is Candida overgrowth in the vagina.

There are several possible causes of Candida overgrowth. They include:

• Being in warm or humid conditions
• Having a weak immune system
• Taking antibiotics

The main symptom of a vaginal yeast infection is itchiness in and around the vagina.

Other vaginal yeast infection symptoms include:

• Abnormal vaginal discharge that is white, looks like cottage cheese and does not have a bad smell
• Burning, redness and swelling of the vulva and vagina
• Pain during sexual intercourse
• Pain when urinating

You may not have all of these symptoms. Symptoms can range from mild to severe.

To diagnose a vaginal yeast infection, your doctor will perform a pelvic exam to check for swelling and discharge. Your doctor may take a sample of the discharge from your vagina to be looked at under a microscope. When a lab technician looks at the discharge under a microscope, they will be able to see if there is an overgrowth of Candida.

There is normally a balance between Candida and other microorganisms in the vagina. When this balance is disrupted, Candida is able to overgrow.

There are several risk factors for developing a vaginal yeast infection. They include:

Hormones. High levels of sex hormones (such as during pregnancy, hormone-replacement therapy or oral contraceptive use) increase the likelihood that Candida will adhere to the vagina and overgrow. High levels of sex hormones also decrease vaginal immune responses.

Antibiotic use. Taking antibiotics kills the good bacteria in the vagina. Elimination of these beneficial microbes means there is less competition for resources, which allows Candida to overgrow.

Weakened immune system. If a person has a weakened immune system – (e.g., HIV), the body does not produce an immune response strong enough to prevent the overgrowth of Candida.

High blood sugars. Uncontrolled diabetes and glucocorticoid (a type of steroid medication) use can lead to high blood sugar levels, which can impair the ability of the body to prevent Candida overgrowth. It can also increase the likelihood that Candida will adhere to the vagina, allowing it to overgrow.

Genetics. Some people are genetically predisposed to getting vaginal yeast infections.

Intrauterine devices. Intrauterine devices (a form of birth control that is inserted into the uterus) act as a reservoir for Candida where they can adhere and form biofilms. Biofilms are a community of microorganisms held together and protected by glue-like materials. They are highly resistant to medications, immune responses and stress.

Spermicide use. Candida are able to feed off one of the compounds used in spermicides, which allows them to adhere to the vagina and overgrow.

Using douches or vaginal sprays. Douching or using vaginal sprays can introduce allergy-causing substances into the vagina. They also wash away the good bacteria in the vagina, which can lead to Candida overgrowth.

Vaginal yeast infections are typically treated using anti-fungal medications, explains Alex Polyakov, M.D., associate professor at the University of Melbourne and a senior gynecologist in Melbourne, Victoria. These medications are available in a variety of formulations, such as creams, ointments, suppositories and oral tablets, he says. They are available over-the-counter (OTC, without a prescription) or with a prescription. The length of treatment depends on the severity of the infection, he explains.

OTC medications: OTC medications used to treat vaginal yeast infections include clotrimazole, miconazole and tioconazole. They are typically used to treat mild to moderate infections, with treatment taking anywhere from one to seven days, says Dr. Polyakov.

Prescription medications: In cases of more severe infections, prescription-strength medications such as fluconazole may be necessary. Oral medications such as fluconazole often involve a single dose, explains Dr. Polyakov.

In the case of recurrent or persistent infections, longer treatment courses or alternative medications may be warranted, says Dr. Polyakov. It’s important to complete the prescribed course of medication to completely clear the infection and reduce the risk of developing anti-fungal resistance, he adds.

There are several steps a person can take to prevent vaginal yeast infections.

Maintain good hygiene: “Maintaining good hygiene, wearing breathable cotton underwear and avoiding tight-fitting clothing can help keep the vaginal area dry and discourage fungal growth,” explains Dr. Polyakov. It’s also important to promptly change out of wet or sweaty clothes to prevent infections, he adds.

Avoid using personal care products in the vaginal area: Personal care products can also increase your risk of getting a vaginal yeast infection. Avoid using heavily scented soaps, bubble baths or douches, as these can disrupt the natural balance of vaginal flora, which could lead to an infection, says Dr. Polyakov. Lubricants and other intravaginal products containing glycerin can also increase the risk of a vaginal yeast infection, adds Karyn S. Eilber, M.D., a urogynecologist at Cedars-Sinai in Los Angeles.

Try a boric acid suppository: Some women can be prone to changes in their vaginal pH at different times during their menstrual cycle, Dr. Eilber explains. Using a boric acid suppository at certain times of the month may help prevent a vaginal yeast infection from occurring, she adds. Boric acid can be an effective preventative treatment because it prevents Candida (the yeast that causes yeast infections) from growing out of control by preventing hyphae formation. Hyphae are branching filaments of fungi that can form a network that is difficult to get rid of. Preventing hyphae formation prevents this network from forming, thereby preventing a yeast infection from occurring.^[2]Pointer BR, Boyer MP, Schmidt M. Boric acid destabilizes the hyphal cytoskeleton and inhibits invasive growth of Candida albicans. Yeast. 2015;32(4):389-98.

Dietary choices: Dietary choices may play a role in preventing vaginal yeast infections. “Consuming probiotic-rich foods, like yogurt and kefir, can help maintain a healthy balance of bacteria in the body. Limiting sugar intake may further reduce the risk of infection, as high sugar levels can encourage yeast growth,” explains Dr. Polyakov.

If you think you have a yeast infection, it’s important to see a doctor before starting treatment, especially if this is the first time you’ve had symptoms of a yeast infection or if the symptoms are severe, explains Dr. Polyakov. He also recommends seeing a doctor if OTC treatments are ineffective or if the infection comes back within a short time period (one to four weeks). A recurrent infection could mean the infection is being transmitted by a sexual partner. If this is the case, both parties need to be treated to ensure the infection does not come back.

The symptoms of a vaginal yeast infection are similar to other, more serious vaginal infections. They can also be a sign of other underlying health issues, such as diabetes or a weakened immune system, says Dr. Polyakov. It’s important to see a doctor who can accurately diagnose the infection, rule out other potential causes and prescribe the appropriate treatment.