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Vaginal yeast infection

Definition

Vaginal yeast infection is an infection of the vagina. It is most commonly due to the fungus Candida albicans.

Alternative Names

Yeast infection - vagina; Vaginal candidiasis; Monilial vaginitis

Causes

Most women have a vaginal yeast infection at some time. Candida albicans is a common type of fungus. It is often found in small amounts in the vagina, mouth, digestive tract, and on the skin. Most of the time, it does not cause infection or symptoms.

Candida and the many other germs that normally live in the vagina keep each other in balance. However, sometimes the number of Candida increases, leading to a yeast infection.

This can happen if:

  • You are taking antibiotics used to treat another infection. Antibiotics change the normal balance between germs in the vagina.
  • You are pregnant
  • You are obese
  • You have diabetes

A yeast infection is not spread through sexual contact. However, some men will develop symptoms such as itching and a rash on the penis after having sexual contact with an infected partner.

Having many vaginal yeast infections may be a sign of other health problems. Other vaginal infections and discharges can be mistaken for a vaginal yeast infection.

Symptoms

  • Abnormal vaginal discharge. Discharge can range from slightly watery, white discharge to thick, white, and chunky (like cottage cheese).
  • Itching and burning of the vagina and labia
  • Pain with intercourse
  • Painful urination
  • Redness and swelling of the skin just outside of the vagina (vulva)

Exams and Tests

You will have a pelvic exam. It may show:

  • Swelling and redness of the skin of the vulva, in the vagina, and on the cervix
  • Dry, white spots on the vaginal wall
  • Cracks in the skin of the vulva.

A small amount of the vaginal discharge is examined using a microscope. This is called a wet mount and KOH test.

Sometimes, a culture is taken when the infection does not get better with treatment or comes back many times.

Your health care provider may order other tests to rule out other causes of your symptoms.

Treatment

Medicines to treat vaginal yeast infections are available as creams, ointments, vaginal tablets or suppositories. Most can be bought without needing to see your health care provider.

Treating yourself at home is probably OK if:

  • Your symptoms are mild and you do not have pelvic pain or a fever
  • This is not your first yeast infection and you have not had many yeast infections in the past
  • You are not pregnant
  • You are not worried about other sexually transmitted infections from recent sexual contact

Medicines you can buy yourself to treat a vaginal yeast infection are:

  • Miconazole
  • Clotrimazole
  • Tioconazole
  • Butoconazole

When using these medicines:

  • Read the packages carefully and use them as directed.
  • You will need to take the medicine for 1 - 7 days, depending on which medicine you buy. (If you do not get repeated infections, a 1-day medicine might work for you.)
  • Do not stop using these medicines early because your symptoms are better.

You doctor can also prescribe a pill that you only take by mouth once.

If your symptoms are worse or you get vaginal yeast infections often, you may need:

  • Medicine for up to 14 days
  • Clotrimazole vaginal suppository or fluconazole pill every week to prevent new infections

To help prevent and treat vaginal discharge:

  • Keep your genital area clean and dry. Avoid soap and rinse with water only. Sitting in a warm, but not hot, bath may help your symptoms.
  • Avoid douching. Although many women feel cleaner if they douche after their period or intercourse, it may worsen vaginal discharge. Douching removes healthy bacteria lining the vagina that protect against infection.
  • Eat yogurt with live cultures or take Lactobacillus acidophilus tablets when you are on antibiotics. This will help to prevent a yeast infection.
  • Use condoms to avoid catching or spreading infections.
  • Avoid using feminine hygiene sprays, fragrances, or powders in the genital area.
  • Avoid wearing tight-fitting pants or shorts, which may cause irritation.
  • Wear cotton underwear or cotton-crotch pantyhose. Avoid underwear made of silk or nylon, because they can increase sweating in the genital area, which can cause irritation.
  • Use pads and not tampons.
  • Keep your blood sugar levels under good control if you have diabetes.
  • Avoid wearing wet bathing suits or exercise clothing for long periods of time. Wash sweaty or wet clothes after each use.

Outlook (Prognosis)

Most of the time, symptoms go away completely with proper treatment.

Possible Complications

A lot of scratching may cause the skin to crack, making you more likely to get a skin infection.

Repeat infections that occur right after treatment, or a yeast infection that does not respond well to treatment, may be an early sign of diabetes or rarely, HIV.

When to Contact a Medical Professional

Call your health care provider if:

  • This is the first time that you have had symptoms of a vaginal yeast infection
  • You are not sure if you have a yeast infection
  • Your symptoms don't go away after using over-the-counter medicines
  • Your symptoms get worse
  • You develop other symptoms

References

Biggs WS, Williams RM. Common gynecologic infections. Prim Care. 2009 Mar;36(1):33-51,

Habif TP. Superficial fungal infections. In: Habif TP, ed. Clinical Dermatology. 5th ed. St. Louis, Mo: Mosby Elsevier; 2009:chap 13.

Eckert LO, Lentz GM. Infections of the lower genital tract. In: Lentz GM, Lobo RA, Gershenson DM, Katz VL, eds. Comprehensive Gynecology. 6th ed. Philadelphia, Pa: Mosby Elsevier; 2012:chap 23.

Merritt DF. Vulvovaginitis. In: Kliegman RM, Behrman RE, Jenson HB, Stanton BF, eds. Nelson Textbook of Pediatrics. 19th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 543.


Review Date: 11/10/2013
Reviewed By: Susan Storck, MD, FACOG, Chief, Eastside Department of Obstetrics and Gynecology, Group Health Cooperative of Puget Sound, Bellevue, Washington; Clinical Teaching Faculty, Department of Obstetrics and Gynecology, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Bethanne Black, and the A.D.A.M. Editorial team.
The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
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