What is a yeast infection?
A yeast infection is caused by an overgrowth of yeast in the vagina, usually the fungus Candida albicans. This overgrowth causes irritation, itching, and swelling of the vagina and the area around it (called the vulva).
Some key characteristics of a vaginal yeast infection include:
- Itching and burning around the vagina
- Soreness and redness of the vulva and vagina
- Thick, white, odorless vaginal discharge
- Pain or discomfort during sex or when urinating
Yeast infections produce a distinctive white, cottage cheese-like discharge. The tissues of the vagina can become inflamed and painful. Symptoms range from mild to moderate, and infections can cause complications if left untreated.
Common causes
The most common causes of vaginal yeast infections include:
An imbalance in vaginal pH which allows the candida fungus to grow out of control. The vagina normally maintains an acidic environment with a healthy pH between 3.8 and 4.5. Certain products, medical conditions, and lifestyle factors can disrupt the pH balance and promote yeast overgrowth.
Antibiotics killing off the beneficial lactobacillus bacteria that keep candida under control. Antibiotics reduce protective bacteria in the vagina, disrupting the natural balance and enabling yeast to thrive. [1]
Poor genital hygiene and irritation. Not properly cleaning the vaginal area or using scented products can alter pH levels and encourage fungal growth. Tight clothing, douches, vaginal intercourse, and more can also irritate the vagina and increase susceptibility.
Weakened immune system which is unable to regulate yeast growth. Conditions like HIV/AIDS, cancer treatments, steroids, and stress compromise the immune system’s ability to control candida. Infections like yeast thrive under a weakened immune system.
Hormonal changes from pregnancy, menstruation, or oral contraceptives may impact pH levels and bacteria in the vagina. The influx of hormones enables candida to flourish.
Diabetes resulting in excess sugar which promotes yeast growth. Those with uncontrolled blood sugar levels are at higher risk for all fungal infections including vaginal yeast infections.[2]
Risk Factors
Some women are at a greater risk of developing yeast infections compared to others [1].
Women in general are more susceptible to yeast infections than men due to anatomical differences. The short urethra in women makes it easier for bacteria and yeast to enter the bladder. Additionally, the close proximity of the rectum to the vagina allows yeast from the GI tract to colonize the vagina [2].
Pregnancy can increase the risk of yeast infections due to increased estrogen levels and changes to the immune system. Pregnant women are even more susceptible if they have uncontrolled gestational diabetes [1].
Certain medications like antibiotics, oral contraceptives, and corticosteroids can increase the risk of yeast infections. Antibiotics kill off good bacteria needed to keep yeast in check, while oral contraceptives and steroids may throw off the body’s hormonal balance [3].
Uncontrolled diabetes, especially in those with consistently high blood sugar, allows yeast to grow more abundantly. Those with weakened immune systems, such as from HIV/AIDS or chemotherapy, are also at greater risk as their bodies have difficulty fighting off infections [1].
[1] https://www.mayoclinic.org/diseases-conditions/yeast-infection/symptoms-causes/syc-20378999
[2] https://www.uptodate.com/contents/vaginal-yeast-infection-beyond-the-basics
[3] https://my.clevelandclinic.org/health/diseases/5019-vaginal-yeast-infection
Transmission
While yeast infections are not sexually transmitted diseases, the infection can be passed between sexual partners. During intercourse, the yeast present in the vagina may be spread to the penis. The yeast could then lead to infections such as balanitis (inflammation of the head of the penis) in uncircumcised males.
The Candida fungus that leads to yeast infections can also be transmitted from a mother to her newborn baby during vaginal childbirth. The infant may develop oral thrush or diaper rash as a result. Proper hygiene and prevention measures can help reduce transmission.
Sources:
https://www.mayoclinic.org/diseases-conditions/yeast-infection/symptoms-causes/syc-20378999
https://my.clevelandclinic.org/health/diseases/5019-vaginal-yeast-infection
Prevention
There are several steps you can take to prevent yeast infections and maintain vaginal health:
Maintain vaginal pH balance. The vagina normally contains a balance of yeast and bacteria. Lactobacillus bacteria keep the vagina slightly acidic, which prevents an overgrowth of yeast. Avoid douching, which can kill off good bacteria. Be cautious about taking antibiotics, which can also disrupt flora balance.
Practice good hygiene. Wipe front to back after using the bathroom. Change out of damp clothing like bathing suits or sweaty gym clothes. Avoid prolonged use of panty liners, which can trap moisture.
Wear breathable fabrics. Choose underwear made of cotton or another breathable fabric. Yeast thrives in moist environments. Tight pants or underwear can trap heat and moisture.
Don’t use douches or scented products. Douches disturb the vagina’s healthy balance. Scented soaps, bubble baths, tampons, pads, and laundry detergents can also irritate the vagina.
When to see a doctor
You should see a doctor if your symptoms don’t improve after using over-the-counter antifungal treatments. According to Duke Health, symptoms that persist after a week of OTC treatment may indicate a more resistant infection that requires prescription medication. You should also see a doctor if you experience more than four yeast infections per year. Frequent infections could mean an underlying medical issue is making you prone to infection.
See a doctor right away if you have severe irritation, redness, swelling, sores, or itching. Mayo Clinic advises seeking emergency care for symptoms like fever, chills, nausea, vomiting or foul-smelling discharge, as these can indicate a more serious infection. In severe cases, yeast infections may spread to the bloodstream. Your doctor can perform diagnostic tests to identify the type of infection and provide appropriate treatment.
Diagnosis
To diagnose a yeast infection, a doctor will first perform a pelvic exam to look for signs of infection. The doctor will examine the vulva and vagina for redness, swelling, discharge, and other symptoms. Next, the doctor may take a sample of vaginal discharge and examine it under a microscope. Finding an overgrowth of Candida yeast under the microscope can confirm the diagnosis of a yeast infection.
As the Mayo Clinic explains, “Your doctor examines your external genitals for signs of infection. Next, your doctor places an instrument (speculum) into your vagina to hold the vaginal walls open to examine the vagina and cervix. Your doctor collects some of the discharge and examines it under a microscope for signs of yeast.”1
According to Uptodate, “To diagnose a vaginal yeast infection, a health care provider will do an examination. He or she can take a sample of the vaginal discharge and look at it under a microscope. If yeast is seen in the microscopic examination, this confirms the diagnosis of a yeast infection.”2
Treatment
The most effective treatment for a yeast infection is antifungal medication. Antifungals stop the growth and reproduction of yeast. They come in oral pill form as well as creams or suppositories that can be applied vaginally.[1]
For mild to moderate symptoms, a patient can purchase an antifungal cream over-the-counter, such as miconazole (Monistat) or tioconazole (Vagistat).[2] These are inserted vaginally with an applicator. It may take 1-3 days for relief of itching and other symptoms.
For more severe symptoms, oral antifungal pills may be prescribed by a doctor, such as fluconazole (Diflucan) or itraconazole. These pills are taken by mouth and work throughout the body to clear the infection. It is important to take the full course as prescribed, usually 1-3 doses.
Stopping treatment early can allow the infection to come back. Patients should refrain from sexual activity until the infection has cleared up.
[1] https://www.mayoclinic.org/diseases-conditions/yeast-infection/diagnosis-treatment/drc-20379004
[2] https://www.webmd.com/women/remedies-yeast-infections
Alternative remedies
Some women try home remedies and alternative medicine to treat yeast infections. Common natural remedies include:
Yogurt and probiotics. There is some evidence that probiotics or consuming yogurt with live cultures may help treat yeast infections. Yogurt contains Lactobacillus acidophilus, a probiotic bacteria that may inhibit yeast growth. Applying plain yogurt with active cultures to the vagina may provide relief from symptoms. However, the evidence for yogurt’s effectiveness is limited and inconclusive according to Medical News Today.[1]
Tea tree oil. Diluted tea tree oil may have antifungal properties, but there is little research on its effectiveness and safety for yeast infections specifically. It should always be diluted and never applied directly. Potential side effects include irritation. There is no conclusive evidence that it can cure a yeast infection according to Healthline.[2]
There are several limitations to home remedies and alternative medicine. While some women find relief through natural remedies, they do not work for everyone. The research on many alternative treatments is limited, and they may not be as effective as prescription medications. It’s important to see a doctor if symptoms persist despite home treatment.
When to seek emergency care
You should seek emergency medical care if the yeast infection spreads beyond the vagina or is accompanied by concerning symptoms like:
Fever above 101°F (Source: Mayo Clinic)
Lower abdominal pain or back pain (Source: WebMD)
Nausea, vomiting, or diarrhea, which can be signs the infection has spread to the bloodstream (Source: Mayo Clinic)
These symptoms suggest the yeast infection may have developed into a more serious condition like a systemic infection, so prompt medical care is recommended. Let a doctor examine you and determine if antibiotics or other intensive treatments are required.