Vaginal Yeast Infection

Candidal organisms (yeasts) are normally found in the vagina in small numbers. Their number is kept in check by the normal bacteria that also live there. Certain factors (discussed below) can disrupt this balance and allow a vaginal yeast infection to develop.

The most common symptoms of vaginal yeast infections include:

• burning with urination or sexual intercourse
• redness and inflammation of the vulva and vagina
• vaginal discharge which is typically thick and white, with a "cottage cheese" consistency
• vaginal or vulvar itching

Vaginal yeast infections are caused by Candidal organisms. Some diseases and conditions that increase a woman's risk for vaginal yeast infection include:

• diabetes that is poorly controlled
• HIV infection
• immunodeficiency disorders, which weaken the woman's response to infection
• pregnancy

Other factors that increase the risk for a vaginal yeast infection include:

• a diet high in sugar
• antibiotic therapy
• corticosteroid use
• oral contraceptive use
• sexual activity, which can change the acid-base balance in the vagina
• wearing tight clothing or nylon underwear

Helpful measures to prevent vaginal yeast infections include:

• controlling blood glucose levels if the woman has diabetes
• limiting intake of dietary sugars
• limiting time spent in wet or damp clothing
• using antifungal creams, such as miconazole, clotrimazole, or nystatin when taking oral antibiotics
• wearing loose clothing and cotton underwear
• wiping the buttocks from front to back after bowel movements

Diagnosis of a vaginal yeast infection begins with a medical history and physical exam. The healthcare professional may do a pelvic exam and Pap smear to rule out other infections. A sample of the vaginal discharge may be analyzed in the office under the microscope or sent to the lab to check for Candida and other organisms. A newer test called polymerase chain reaction (PCR) is very sensitive and specific in diagnosing yeast infections.

With proper treatment, the infection should resolve in a few days to a week.

Vaginal yeast infections are not believed to be transmitted from one person to another.

A woman may choose to use an over-the-counter antifungal medicine, although resistance to these agents has increased with excessive use. These medicines are inserted into the vagina. Some examples include miconazole, clotrimazole, and nystatin. The healthcare professional can prescribe stronger antifungal creams, or an oral medicine called fluconazole.

Vaginal creams may cause vulvar burning. Fluconazole may cause stomach upset or allergic reaction.

Women should avoid sexual intercourse until the symptoms are gone and the course of treatment has been completed. Douching, bubble baths, hygiene sprays, or scented soaps around the vulva may irritate the skin.

Women who have repeated yeast infections that persist despite treatment should see a healthcare professional. HIV and blood sugar testing should be done in this case. Any new or worsening symptoms should be reported to the healthcare professional.