Yeast infection (vaginal)

Overview

A vaginal yeast infection is a fungal infection. It causes irritation, discharge and itching of the vagina and the vulva. Vaginal yeast infection also is called vaginal candidiasis.

Vaginal yeast infection affects most people assigned female at birth at some point in life. Many have at least two infections.

People who don't have sex can get a vaginal yeast infection. So it isn't though of as a sexually transmitted infection. But you can get vaginal yeast infections through sex.

There's a higher risk of vaginal yeast infection when you start having sex. And some vaginal yeast infections may be linked to sexual contact between the mouth and genital area, called oral-genital sex.

Medicines can treat vaginal yeast infections. Yeast infections that happen four times or more a year may need a longer treatment course and a plan to prevent them.

Causes

The fungus Candida albicans causes most vaginal yeast infections.

Most often, the vagina has a balance of yeast, including candida, and bacteria. Certain bacteria called lactobacillus work to prevent too much yeast.

But some factors can affect the balance. Too much candida or the fungus growing deeper into vaginal cells causes symptoms of a yeast infection.

Too much yeast can result from:

• Antibiotic use.
• Pregnancy.
• Diabetes that isn't well-managed.
• A weakened immune system.
• Use of birth control pills or hormone therapy that raises levels of the hormone estrogen.

Candida albicans is the most common type of fungus to cause yeast infections. When other types of candida fungus cause yeast infections, they can be harder to treat.

Prevention

To lower your risk of vaginal yeast infections, wear underwear that has a cotton crotch and doesn't fit too tightly.

Also, these tips might help prevent a yeast infection:

• Do not wear tight pantyhose, underwear or jeans.
• Do not douche. This removes some of the good germs in the vagina that protect from infection.
• Do not use scented products in the vaginal area. For instance, don't use scented bubble bath, soap, menstrual pads and tampons.
• Do not use hot tubs or take hot baths.
• Do not use antibiotics you don't need. For instance, don't take antibiotics for colds or other viral infections.
• Do not stay in wet clothes, such as swimsuits and workout clothes, for longer than needed.

Treatment

Treatment for yeast infections depends on how bad the infections are and how often they happen.

If you have mild to moderate symptoms and don't get infections often, treatment options include:

• Short-course vaginal therapy. Using an antifungal medicine for 3 to 7 days most often clears a yeast infection. Antifungal medicines come in the form of creams, ointments, tablets and small objects you put into your vagina, called suppositories. They include miconazole (Monistat 3) and terconazole. You can get these medicines with or without a prescription.
• One dose of medicine taken by mouth. Your healthcare professional might prescribe one dose of fluconazole (Diflucan). To manage severe symptoms, you might take two doses three days apart. Oral medicine is not used often in pregnancy, especially in the first trimester.

The U.S. Food and Drug Administration recently approved two medicines to treat vaginal yeast infections. One is oteseconazole (Vivjoa), taken by mouth. This medicine is only for people who can't get pregnant and who have infections that keep coming back.

The other medicine is ibrexafungerp (Brexafemme). This also is taken by mouth. Studies show that these medicines might work for vaginal yeast infections that don't respond to other treatments.

See your healthcare professional again if treatment doesn't clear your symptoms or if your symptoms return within two months.

Treatment for yeast infections that have severe symptoms or that happen often might include:

• Long-course vaginal therapy. You use an antifungal medicine daily for up to two weeks. Then you take it once a week for six months.
• More than one dose of medicine taken by mouth. You take 2 to 3 doses of an antifungal medicine by mouth instead of having vaginal therapy. But this therapy isn't for pregnant people.
• Boric acid therapy. A capsule that has boric acid is put into your vagina. This medicine may be fatal if taken by mouth. It only treats candida fungus that doesn't respond to other treatments. It is not recommended for use in pregnancy.

Preparing for an appointment

If you've been treated for a yeast infection in the past, your healthcare professional may prescribe a treatment over the phone without seeing you. If not, you likely need to see your primary care professional or gynecologist.

What you can do

Don't use tampons or douche before your appointment.

Make a list of:

• Your symptoms and when they began.
• Other medical conditions you have.
• All medicines, vitamins or supplements you take, including doses.
• Questions to ask your healthcare professional.

Some questions to ask about vaginal yeast infections include:

• What can I do if my symptoms return after treatment?
• How can I prevent yeast infections?
• What symptoms should I watch out for?

Be sure to ask all the questions you have.

What to expect from your doctor

Your healthcare professional is likely to ask you questions, such as:

• Do you notice a strong vaginal odor?
• Have you ever been treated for a vaginal infection?
• Have you tried products you can get without a prescription to treat your condition?
• Have you recently taken antibiotics?
• Are you sexually active?
• Are you pregnant?
• Do you use scented soap or bubble bath?
• Do you douche or use feminine hygiene spray?