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Vaginal Yeast Infection

(Candidiasis)

Definition

A vaginal yeast infection is a condition caused by a yeast fungus called Candida albicans . Although yeast is always present in the vagina in small numbers, it can overgrow and cause the uncomfortable symptoms of a yeast infection.

Vagina

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Causes

Yeast grows in conditions that are less acidic. Yeast infections occur when the vaginal fluids, which are usually mildly acidic, become less acidic. Yeast infections also result from any condition that causes a decrease in the "good" bacteria that help keep yeast levels in check.

Risk Factors

A risk factor is something that increases your chance of getting a disease. Your risk of getting a yeast infection increases when:

  • Situations that can cause hormonal changes, such as:
    • Birth control pills
    • Pregnancy
    • Menopause
    • Steroid use
  • Broad-spectrum antibiotics
  • Diabetes , especially when blood sugar is not well controlled
  • A compromised immune system, such as with HIV infection
  • Perfumed feminine hygiene sprays, deodorant tampons, or bubble bath
  • Tight jeans, synthetic underwear, or a wet swimsuit
  • Douching

Symptoms

Symptoms include:

  • Vaginal itching, ranging from mild to severe
  • A clumpy, vaginal discharge that may look like cottage cheese
  • Vaginal soreness, irritation, or burning
  • Rash or redness on the skin outside the vagina
  • Painful urination
  • Painful sexual intercourse

Diagnosis

Your doctor will take a history and perform a pelvic exam, during which any vaginal discharge will be analyzed (under a microscope). Once a yeast infection has been confirmed, you can buy an over-the-counter cream or suppository to treat it.

It is important to see a doctor the first time you have symptoms of a yeast infection. Other infections, including bacterial vaginosis and trichomoniasis , have similar symptoms to a yeast infection. If you have had a yeast infection in the past and are certain it is the same, it is safe to use over-the-counter antifungal medications. Consult your doctor if you have any doubt.

Treatment

Over-the-counter Medications

Various antifungal medications are available, such as Monistat (miconazole nitrate), Gyne-Lotrimin (clotrimazole vaginal), Fem-stat (butoconazole vaginal), Terazol (terconazole vaginal), and Mycelex (clotrimazole vaginal). These medications are available as intravaginal creams, tablets, or suppositories. The treatments come in a one-day, three-day, or seven-day pack. Some of these are over-the-counter, and some require a prescription (notably, Terazol).

Prescription Medications

The doctor can prescribe fluconazole (Diflucan), an oral medication. Diflucan is a single-dose treatment. If you are pregnant, talk with your doctor before using any treatment.

Prevention

  • Dry the outside vaginal area thoroughly after a shower, bath, or swim.
  • Change out of a wet bathing suit or damp workout clothes as soon as possible.
  • Wear cotton underwear.
  • Avoid tight-fitting clothing.
  • Don't douche unless your doctor tells you to do so. Douching may disturb the vaginal balance, decreasing the normal acidity of vaginal secretions.
  • If you have diabetes, try and control your blood sugar.
  • Avoid bubble baths, perfumed feminine hygiene sprays, and scented soap.
  • Avoid frequent or prolonged use of antibiotics if possible.
  • Consider adding yogurt to your diet. Some women find that eating yogurt daily prevents yeast overgrowth.
  • Some women with chronic yeast infections find that cutting down on alcohol, sugar, caffeine, and refined carbohydrates helps as well.

RESOURCES:

American College of Obstetricians and Gynecologists
http://www.acog.org

National Women's Health Information Center
http://www.4woman.gov

CANADIAN RESOURCES:

The Society of Obstetricians and Gynaecologists of Canada
http://sogc.medical.org/

Women's Health Matters
http://www.womenshealthmatters.ca/index.cfm

References:

American Academy of Family Physicians website. Available at: http://www.aafp.org/online/en/home.html .

National Institute of Allergy and Infectious Diseases website. Available at: http://www3.niaid.nih.gov/ .

National Library of Medicine, Medline Plus website. Available at: http://www.nlm.nih.gov/medlineplus/ency/imagepages/17141.htm .



Last reviewed January 2008 by Ganson Purcell Jr., MD, FACOG, FACPE

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.

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