Vaginal yeast infections are caused by a fungus, usually Candida albicans, a common organism that may or may not cause symptoms. It is estimated that approximately 75% of all women will have a symptomatic yeast infection at some point in their lives. It is normal to have yeast and other bacteria in the vagina. However, in certain women, symptoms can occur.

What can cause a symptomatic infection? Proposed causes include:

1. Antibiotics—the exact mechanism is unclear
2. Increased warmth and moisture in the genital area
3. Douching and use of feminine hygiene products, which may make it easier for yeast to cause an infection
4. Sexual practices: possibly oral sex, use of spermacides, oral contraceptives
5. The cause is unknown in at least half of cases and may be due to a genetic susceptibility which causes a response to yeast that lays the groundwork for the next infection. This may be the main cause in women with recurrent infections

What are the symptoms of a yeast infection?
 
1. Itching in the vaginal area is the most common symptom
2. Vulvar/vaginal redness, swelling, irritation
3. Thick white discharge—may be present but often there is no discharge
4. Burning after urination
5. Painful intercourse or burning after intercourse

How is a yeast infection diagnosed?

1. Examination of the vaginal area by a clinician to look for signs of infection.
2. Microscopic evaluation of cells collected with a swab from the vagina to look for yeast and rule out other possible causes of infection
3. Culture—very effective and identifies the specific type of yeast in order to determine the best treatment
4. Self- diagnosis—based on usual symptoms: itching and irritation. This may be surprisingly inaccurate

How is a yeast infection treated?

1. Oral medication—fluconazole by prescription
2. Vaginal medication—various creams, suppositories by prescription or over the counter

Is it OK to self diagnose and self treat?

Many women can diagnose and treat their yeast infections based on symptoms. However, there are other infections that can have the same or similar symptoms: trichomoniasis (trich), bacterial vaginosis (BV), genital herpes, and many benign vulvar skin conditions.

Symptoms that do not go away after treatment with over-the-counter (OTC) medications need to be evaluated further.

Recurring or complicated yeast infections

There some women whose symptoms persist or recur after treatment. It is important to prove that these women truly have an infection, and to find out what type of yeast is causing it. Some recurrent infections may be caused by a different type of Candida (ex. Candida glabrata) that does not respond to the usual yeast medications, or the infection may be complicated and require treatment for a longer period of time. Women who have frequent yeast infections may also require longer treatment to suppress the growth of yeast and prevent symptoms.

Comfort measures during treatment

1. Sitz baths—warm or lukewarm water with 4-5 tablespoons of baking soda can soothe vulvar itching and burning
2. Cool gel pack or compresses to the vulvar area, helpful at night to sleep
3. A and D ointment or Crisco—apply small amount to protect the skin

What about sex?

Sex during treatment is OK as long as it is comfortable. Sometimes sex will cause irritation or burning so it may be necessary to delay sexual activity until after treatment. It is important to remember that medications used in the vagina may break down latex condoms, causing breakage.

Common misconceptions about yeast infections

• Sexual partners need treatment—untrue. It is not necessary to treat sexual partners as there is no evidence that treating a partner is helpful. Oral sex may, however, be a contributing factor.
• Eating yogurt or applying it to the vagina will prevent or treat yeast infections—no. Yogurt containing live yeast cultures will not treat or prevent yeast infections, whether eaten or applied to the vagina.
• All vaginal itching is a yeast infection—untrue. Other infections and conditions may cause itching. Any persistent itching that does not respond to treatment needs to be evaluated.

Written by Cynthia Bayer, CRNP, MS 5/08
Reviewed by Paul Nyirjesy, MD 5/08

The information on these pages is provided for educational purposes only and should not be used for diagnosis or as a substitute for consultation with a physician or healthcare professional. If you have specific questions or concerns about your health, you should consult your healthcare provider.