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Vaginal Yeast Infection (Candidiasis)

By

Oluwatosin Goje

, MD, MSCR, Cleveland Clinic, Lerner College of Medicine of Case Western Reserve University

Last full review/revision Sep 2019| Content last modified Sep 2019
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The vagina is infected by a yeast called Candida, usually Candida albicans, resulting in a yeast infection called candidiasis.

  • Being pregnant or having diabetes or a weakened immune system increases the risk of yeast infections.

  • The vagina and vulva may itch, and women often have a thick, white discharge resembling cottage cheese.

  • 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.

  • Antifungal drugs—creams, vaginal suppositories, tablets, or capsules—are effective.

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

  • Are pregnant

  • Have diabetes

  • Have a weakened immune system—suppressed by drugs (such as corticosteroids or chemotherapy drugs) or impaired by a disorder (such as AIDS)

  • Wear tight undergarments that do not let air circulate

  • 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

The vagina and vulva may itch or burn, particularly during sexual intercourse. The genital area may become red and swollen. Women may have a white discharge, often thick and resembling cottage cheese.

Yeast infection symptoms may worsen the week before a menstrual period begins.

Did You Know...

  • Yeast infections are not sexually transmitted.

  • Taking antibiotics increases the risk of yeast infections.

Diagnosis

  • A doctor's evaluation

  • Examination of a sample of the discharge and/or fluid from the cervix

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:

  • Diabetes

  • A need to take antibiotics for a long time

  • Repeated yeast infections, particularly in women with a weakened immune system

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

  • Antifungal drugs

Yeast infections are treated with antifungal drugs. They may be used in the following ways:

  • Applied as a cream to the affected area

  • Inserted into the vagina as a suppository

  • Taken by mouth

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.

Table
icon

Some Drugs Used to Treat Vaginal Yeast Infections

Drug

Dosage

Creams, gels, or suppository, available without a prescription

Butoconazole

A sustained-release cream that is applied once

Clotrimazole

Applied as a cream once a day for 7 to 14 days or for 3 days, depending on the strength (concentration)

Miconazole

Applied as a cream once a day for 7 days or for 3 days, depending on the strength (concentration)

Also available as a vaginal suppository inserted once a day for 7 days, for 3 days, or only once, depending on the strength (concentration)

Terconazole

Creams or suppositories, available by prescription

Tioconazole

Applied as an ointment only once

Drugs taken by mouth, available by prescription

Fluconazole

One tablet taken only once

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