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Vaginal Yeast Infection by Mary Calvagna, MS

Definition

A vaginal yeast infection is caused by a yeast fungus. The fungus is called Candida albicans . While yeast is common in the vagina, it can cause problems when it grows excessively. This excess growth causes the uncomfortable symptoms.

Vagina

Causes

Yeast grows in conditions that are less acidic. Vaginal fluids are most often mildly acidic, but this can change. For example, acid levels can decrease during menstrual flow. "Good" bacteria also help keep vaginal secretions acidic and keep yeast levels in check. Conditions that decrease the good bacteria will also increase the chance of a yeast infection.

Risk Factors

These factors increase your chance of a yeast infection. Tell your doctor if you have any of these risk factors:

Situations that can cause hormonal changes:
- 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

If you have any of these symptoms do not assume it is due to a yeast infection. While typical of yeast infections, they may be caused by other conditions. Tell your doctor if you have any of these:

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. A pelvic exam will be done. Any vaginal discharge will be tested.

It is important to see a doctor the first time you have symptoms. Other vaginal infections may have symptoms similar to a yeast infection. These can include bacterial vaginosis and trichomoniasis .

If you have had a yeast infection, you may be able to recognize the signs of a new infection. In this case, it is safe to use over-the-counter medications. Talk to your doctor if you have any doubt.

Treatment

Medications

Various antifungal 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. Other may require a prescription (eg, Terazol).

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

If you are diagnosed with a yeast infection, follow your doctor's instructions .

Prevention

To help reduce your chance of getting a yeast infection, take the following steps:

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; it decreases vaginal acidity
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

RESOURCES:

American Congress of Obstetricians and Gynecologists http://www.acog.org /
Women's Health.gov http://www.womenshealth.gov/

CANADIAN RESOURCES:

The Society of Obstetricians and Gynaecologists of Canada http://www.sogc.org/index_e.asp/
Women's Health Matters http://www.womenshealthmatters.ca/index.cfm /

References:

American College of Obstetricians and Gynecologists. Practice bulletin: vaginitis. ACOG. May 2006; No. 72.
Candida vulvovaginitis. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php . Updated December 2008. Accessed January 19, 2008.
Vaginal infection. EBSCO Natural and Alternative Treatments website. Available at: http://www.ebscohost.com/thisTopic.php?marketID=15topicID=114 . Updated November 2008. Accessed January 19, 2008.
Vaginal yeast infection. National Institute of Allergy and Infectious Diseases website. Available at: http://www3.niaid.nih.gov/healthscience/healthtopics/vaginalYeastInfection/default.htm . Accessed July 11, 2008.
Vaginal yeast infections. American Academy of Family Physicians website. Available at: http://familydoctor.org/online/famdocen/home/women/reproductive/vaginal/206.html . Published September 2000. Updated May 2008. Accessed July 11, 2008.
Yeast infections. National Library of Medicine, Medline Plus website. Available at: http://www.nlm.nih.gov/medlineplus/ency/imagepages/17141.htm . Updated June 6, 2008. Accessed July 11, 2008.

Last reviewed August 2010 by Ganson Purcell Jr., MD, FACOG, FACPE

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