Vaginal Yeast Infection (Candidiasis)
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Being pregnant or having diabetes or a weakened immune system increases the risk of yeast infections.
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The vagina and vulva may itch, and women often have a thick, white discharge resembling cottage cheese.
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If symptoms suggest a vaginal infection, doctors examine a sample of the discharge and may test it or fluid from the cervix for microorganisms that can cause infection.
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Antifungal drugs—creams, vaginal suppositories, tablets, or capsules—are effective.
(See also Overview of Vaginal Infections.)
Causes
In women of child-bearing age, yeast infections due to Candida albicans are particularly common. This yeast normally resides on the skin or in the intestine. From these areas, it can spread to the vagina. Yeast infections are not transmitted sexually.
Vaginal yeast infections are more likely to occur in women who
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Are pregnant
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Have diabetes
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Have a weakened immune system—suppressed by drugs (such as corticosteroids or chemotherapy drugs) or impaired by a disorder (such as AIDS)
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Use an intrauterine device
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Wear tight undergarments that do not let air circulate
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Are taking antibiotics
Antibiotics taken by mouth tend to kill the bacteria that normally reside in the vagina and that prevent yeast from growing. Thus, using antibiotics increases the risk of developing a yeast infection.
Yeast infections are more likely to occur just before menstrual periods.
After menopause, yeast infections are uncommon except in women who take hormone therapy.
Male sex partners of women with a vaginal yeast infection rarely become infected.
Symptoms
Diagnosis
If women have a vaginal discharge that is unusual or that lasts for more than a few days or have other vaginal symptoms, they should see a doctor.
Doctors suspect a yeast infection based on symptoms, such as a thick, white discharge that often resembles cottage cheese. They then ask questions about the discharge, other symptoms, possible causes (such as diabetes, other disorders, and use of antibiotics or hormones), and hygiene.
To confirm the diagnosis, doctors do a pelvic examination. While examining the vagina, the doctor takes a sample of the discharge with a cotton-tipped swab. The sample is examined under a microscope and sometimes cultured (placed in a substance that allows microorganisms to grow). With information from these examinations, the doctor can usually identify the microorganism causing the symptoms.
Usually, the doctor also uses a swab to take a sample of fluid from the cervix (the lower part of the uterus that opens into the vagina). This sample is tested for sexually transmitted diseases.
Prevention
Women who are at high risk of a yeast infection may need to take an antifungal drug by mouth to help prevent yeast infections. Such women include those with the following:
Keeping the vulva clean and wearing loose, absorbent cotton clothing that allows air to circulate can reduce moisture, which encourages the growth of yeast, and thus help prevent yeast from growing.
Treatment
Yeast infections are treated with antifungal drugs. They may be used in the following ways:
Butoconazole, clotrimazole, miconazole, and tioconazole are available without a prescription. Oils in these creams and ointments weaken latex-based condoms (but not diaphragms), so women cannot rely on condoms for birth control.
Antifungal drugs (such as fluconazole and itraconazole) taken by mouth require a prescription. A single dose of fluconazole is as effective as the creams and ointments. However, if infections recur often, women may need to take several doses.
