Vaginal Yeast Infection 101: Causes, Diagnosis, and Care -

Vaginal Yeast Infection 101: Causes, Diagnosis, and Care

Last updated on August 20, 2024

Summary

Vaginal yeast infections are annoying, messy, and very common! Yeast infections are caused by Candida yeasts, but it’s important to note that having Candida in your vaginal microbiome doesn’t always mean you have an infection. These yeasts can actually be harmless members of a healthy vaginal microbiome.

So why do they make a mess down there sometimes? It’s probably a combination of several factors, such as your vaginal microbiome composition, other diseases, and hormonal changes

What we know is that certain things can increase your risk of getting a yeast infection if you have Candida as part of your vaginal microbiome, including:

When the conditions are right, Candida may overgrow, build up an army, and trigger immune cells, leading to inflammation.

And voila, you have a yeast infection.

This condition is also known as vulvovaginal candidosis, vulvovaginal candidiasis, or vaginal thrush. The main species that causes vaginal yeast infections is Candida albicans. Other Candida species like C. glabrata, C. tropicalis, C. krusei, and C. parapsilosis can also cause infections, but this is more common in women with chronic conditions like type 2 diabetes.

Have a yeast infection? You’re not alone

Yeast overgrowth is the second most common vaginal infection in women (the first one is bacterial vaginosis). Here are some statistics:

What does a vaginal yeast infection feel like?

The most common symptoms of a yeast infection include:

These symptoms usually range from mild to moderate and tend to be worse before the start of the menstrual period because of hormonal changes. Itching is one of the most reported symptoms. However, for species other than C. albicans, the symptoms may be negligible.

Apart from these physical symptoms, having a yeast infection can also negatively impact quality of life, especially if recurrent. This situation may create stress and anxiety, decrease self-esteem and confidence, and affect partner relationships.

Why proper diagnosis is important

As with other vaginal infections, looking at symptoms alone may not be sufficient for an accurate diagnosis, especially if you have mild symptoms that don't fit well with the typical description of a yeast infection.

That’s why a pelvic exam, microscopic examination, and other tests to rule out other infections may be helpful. Measuring vaginal pH can also provide useful information. If a yeast infection is present, pH tends to be less than 5.

If it isn’t possible to visit your provider, they may prescribe you an over-the-counter antifungal based on symptoms. If symptoms persist after one round of treatment, consult your provider as you may have a resistant yeast.

Your provider may conduct a lab test to identify which Candida species is causing the infection and check for antifungal resistance, especially in cases of recurrent yeast infections.

Lactobacillus may not be very protective against Candida

Lactobacillus are considered protective bacteria for vaginal health overall. High numbers of these species provide protection against infections like bacterial vaginosis and aerobic vaginitis. However, for yeast infections, the effectiveness is not clear.

Women with yeast infections often have high numbers of vaginal Lactobacillus, comparable to healthy women. Most women with yeast overgrowth have L. iners as the dominant Lactobacillus species. This may indicate less protective efficacy than other Lactobacillus and is frequently detected along with bacterial vaginosis.

However, some studies found that C. albicans detection was more frequent in women with a vaginal microbiome dominated by L. crispatus.

Vaginal yeast infection while pregnant

There may be an association between yeast infection or asymptomatic carriage of vaginal Candida and preterm birth, but it’s not as clear as for other vaginal infections. Clinical trials suggested that treating asymptomatic women positive for vaginal Candida with clotrimazole may reduce the risk of preterm birth.

Apart from this potential association with preterm birth, mothers with vaginal Candida may pass these yeasts to their baby during birth, possibly increasing the risk of oral candidiasis or diaper rash during the first year of life.

Having Candida as part of your vaginal microbiome doesn’t necessarily mean you have a yeast infection. Furthermore, detection in the absence of symptoms, such as with a vaginal microbiome test, may not require treatment with medications. If you wish to decrease your chances of passing Candida to your baby, always discuss your concerns with your provider to see if a treatment would be suitable.

The standard treatment for yeast infection

For symptomatic cases of vaginal yeast infections, the standard treatment is antifungals. These medications come as creams, vaginal suppositories, and pills. Some examples include:

The treatment duration depends on the severity of your symptoms and whether or not you are pregnant. Treatment generally lasts from one to seven days.

If you’re pregnant, it’s advisable to avoid oral antifungals like fluconazole, as some studies suggested it may increase the risk of malformations in the baby. Therefore, vaginal creams or suppositories are more appropriate for pregnant women. If breastfeeding, fluconazole is considered safe for the baby.

Recurrent yeast infections require longer treatment. Following a maintenance regimen with fluconazole for a year resulted in 77% of women remaining free of infection.

Candida species different from C. albicans are often resistant to antifungals. For instance, C. krusei is intrinsically resistant to fluconazole and others. Thus, it’s crucial to always consult your provider before taking any of these medications. If you have antifungal-resistant Candida, using the wrong medication may lead to treatment failure and recurrence.

Home remedies for yeast infection

If you search online, you’ll find alternative treatments for yeast infections. After several failed antifungal treatments, you may be tempted to explore these remedies. But are they safe? Do they work?

Let’s take a brief look at some of these treatments:

Things you can do to keep yeasts under control

There are some general guidelines to help maintain a healthy vaginal microbiome. Regularly check for any changes in the color and quantity of your vaginal discharge, itching, and any other unpleasant symptoms. It’s normal for your vaginal microbiome to vary during your menstrual cycle, but any significant change or unpleasant smell should be evaluated and treated if necessary.