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Normal vaginal bacteria compared to vulvovaginal candidiasis.

Illustration by Marta Pucci

Reading time: 5 min

Yeast infection 101: Symptoms & Treatment

Top things to know

  • Yeast is commonly found in the vagina, but when it overgrows it can cause a yeast infection

  • Symptoms of a vaginal yeast infection often include itching and abnormal discharge that is typically thick and white

  • Vaginal yeast infections can be treated with over-the-counter or prescription medications

What is a yeast infection?

Yeast is a single-celled microorganism which can live in the vagina. Yeast is found in the vaginas of most people at some point in their lives, and also lives on the skin, in the mouth, and intestines (1).

Yeast can be present in the vagina and cause no problem or symptoms, but occasionally it overgrows and invades the vaginal tissue, leading to a yeast infection (2). Vaginal yeast infections are called vulvovaginal candidiasis because Candida is the species of yeast that causes almost all vaginal yeast infections (3).

It is often reported that 3 in 4 women will experience at least one vaginal yeast infection in their lifetime and 1 in 2 will have more than one. Data, though, is actually lacking to determine the true rate of vaginal yeast infections (4). It’s difficult to determine exactly how prevalent they are because it is commonly self-diagnosed and treated with over-the-counter medications (2).

Yeast infection symptoms

The most common symptoms of a yeast infection are:

  • Burning or itching of the vulva and/or the vagina

  • Abnormal vaginal discharge (5)

  • Thick, white discharge, like cottage cheese (5).

  • Burning during urination

  • Pain during sex (2)

The discomfort caused by a yeast infection can range from mild to severe, and can impact a person’s ability to go about their daily life.

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What causes a yeast infection?

It’s often impossible to pinpoint the reason someone gets a yeast infection. But there are some things that may increase the chance of developing a yeast infection, including pregnancy, uncontrolled diabetes, taking estrogen, and being in an immunocompromised state due to something like HIV or cancer (2,5).

Using antibiotics, oral contraceptive pills, and IUDs may increase the risk of getting a yeast infection for some people but not in others (5). Some studies suggest that the use of pads and tampons, or wearing tight synthetic clothing increases the risk for yeast infections, while other studies suggest there is no link between these and yeast infections (2,5).

Yeast infections are not considered to be sexually transmitted—someone can get a yeast infection without ever having had sex— but frequent and recent penis-in-vagina or oral-vulva sex may increase the risk of getting a yeast infection (5). A sex partner of someone diagnosed with a yeast infection does not need to be treated, unless they are experiencing symptoms of a yeast infection themself (6).

How is a yeast infection diagnosed?

Many people may self-diagnose a yeast infection when they are experiencing symptoms. One small study showed that among women who believed they had a yeast infection, only 1 out of 3 of them actually had one, and women who had been diagnosed in the past by a healthcare provider weren’t any better at correctly making the diagnosis (7).

The symptoms of a yeast infection can be similar to other common vaginal infections such as bacterial vaginosis and trichomoniasis, so talking to a healthcare provider is a good idea to make sure the proper treatment is provided.

To diagnose a yeast infection, a healthcare provider will ask about symptoms and do a pelvic exam. They will examine the vulva (external genitalia) and may perform a speculum exam to examine the inside walls of the vagina. They will look to see if the vulva or vagina appear red, swollen, or if any discharge is present (6). They may swab the inside of the vagina and either send it to a lab or look under a microscope to determine if yeast is present (6).

How is a yeast infection treated?

Treating a yeast infection is usually simple and straightforward with over-the-counter or prescription antifungal medication.

Someone who is experiencing symptoms of a yeast infection can try an over-the-counter vaginal cream or suppository, such as:

  • clotrimazole

  • miconazole

  • tioconazole (6).

These medications are used vaginally for 1-7 days.

If the symptoms don’t go away after treatment, it may be a different kind of infection and should be checked by a healthcare provider. The prescription medication, fluconazole, is a single pill that is taken by mouth (6). While the pill is less messy, the creams start relieving symptoms faster. It’s important to know that the creams may weaken latex condoms, causing them to break. Both the vaginal and oral treatments have similar cure rates— around 80-90% (6,8).

Alternative yeast infection treatments

There are alternative approaches to treating a yeast infection.

Boric acid capsules used vaginally for 2 weeks are about 70% effective at curing a yeast infection, but can cause irritation (6,9).

The use of probiotics in the vagina or by mouth along with using an antifungal medication may slightly increase the chance of curing a yeast infection, compared to using an antifungal medication alone (10).

Tea tree oil and garlic both have antifungal properties, but there is not enough research to show that they are effective at treating a yeast infection (9,11).

Consuming yogurt also lacks enough research to say whether it is helpful in fighting yeast, but it’s unlikely to be harmful (9,11).

Douching is not effective for treating yeast, and can actually increase the risk of getting STIs, HIV, pelvic inflammatory disease (PID) and other vaginal infections like bacterial vaginosis (9,11,12).

After yeast infection treatment

It can take 1-2 days before someone feels relief from their symptoms. In the meantime, wearing loose fitting clothing and trying to stay cool may help soothe the itch and discomfort. Avoid scratching, because this can cause breaks in the skin which can become infected. It’s best to not have sex until a yeast infection is gone because sex can cause more discomfort, and the vaginal creams and suppositories may weaken latex condoms.

Article was originally published July 26, 2018

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