Vaginal Yeast Infection in Women

• Most vaginal yeast infections are caused by the organism Candida albicans.
• Yeast infections are very common and affect up to 75% of women at some point in their lifetime.
• The main symptom of a vaginal yeast infection is itching, but burning, discharge, and pain with urination or intercourse can also occur.
• Treatment involves topical or oral antifungal medications.
• It is possible for a woman to transmit a yeast infection to a male sex partner, even though yeast infection is not considered to be a true sexually-transmitted disease (STD) because it can occur in women who are not sexually active.
• Treatment of yeast infection in men, like in women, involves antifungal medications.
• Keeping the vaginal area dry and avoiding irritating chemicals can help prevent yeast infections in women. Consuming foods with probiotics also may help.

A vaginal yeast infection is an infection caused by yeast (a type of fungus). Vaginal yeast infection is sometimes referred to as yeast vaginitis, Candidal vaginitis, or Candidal vulvovaginitis. The scientific name for the yeast that causes vaginitis is Candida. Over 90% of vaginal yeast infections are caused by the species known as Candida albicans. Other Candida species make up the remainder of yeast infections.

Candida species can be present in healthy women in the vagina without causing any symptoms. In fact, it is estimated that 20% to 50% of women have Candida already present in the vagina. For an infection to occur, the normal balance of yeast and bacteria is disturbed, allowing overgrowth of the yeast. While yeast can be spread by sexual contact, vaginal yeast infection is not considered to be a sexually-transmitted disease because it can also occur in women who are not sexually active, due to the fact that yeast can be present in the vagina of healthy women.

Vaginal yeast infections are very common, affecting up to 75% of women at some point in life.

Symptoms can include:

• a vaginal discharge that is typically thick,
• odorless, and
• whitish-gray in color.

The discharge has been described as having a cottage-cheese-like consistency.

Other symptoms of a vaginal yeast infection include:

• Intense itching of the vaginal or genital area
• Irritation and burning
• Pain during sexual intercourse
• Pain or burning during urination
• Redness, irritation, or soreness of the vagina or vulva in women; swelling of the vagina

Vaginal yeast infections occur when new yeast is introduced into the vaginal area, or when there is an increase in the quantity of yeast already present in the vagina relative to the number of normal bacteria. For example, when the normal, protective bacteria are eradicated by antibiotics (taken to treat a urinary tract, respiratory, or other types of infection) or by immunosuppressive drugs, the yeast can multiply, invade tissues, and cause irritation of the lining of the vagina (vaginitis).

Vaginal yeast infections can also occur as a result of injury to the inner vagina, such as after chemotherapy. Also, women with suppressed immune systems (for example, those taking cortisone-related medications such as prednisone) develop vaginal yeast infections more frequently than women with normal immunity.

Other conditions that may predispose women to develop vaginal yeast infections include

• diabetes,
• pregnancy, and
• taking oral contraceptives.

The use of douches or perfumed vaginal hygiene sprays may also increase a woman's risk of developing a vaginal yeast infection.

A vaginal yeast infection is not considered to be a sexually transmitted disease (STD), since Candida may be present in the normal vagina, and the condition does occur in celibate women.

However, it is possible for men to develop symptoms of skin irritation of the penis from a yeast infection after sexual intercourse with an infected partner, although this is not always the case.

Women who have conditions that result in decreased immune function are more likely than others to develop yeast infections. These include women with cancer or receiving cancer chemotherapy, those with diabetes, and women taking steroid medications.

Pregnant women and women taking oral contraceptives are also at increased risk.

Taking antibiotics for any reason can alter the normal bacterial populations in the vagina and predispose to the overgrowth of yeast.

Taking steps to reduce moisture in the genital area can reduce the chances of developing a yeast infection. Wearing cotton underwear or underwear with a cotton crotch, wearing loose-fitting pants, and avoiding prolonged wearing of wet workout gear or bathing suits are all measures that can help control moisture, and may help reduce the chance of getting a yeast infection.

Primary care practitioners, including family practice physicians, internists, and pediatricians, may all treat yeast infections. In women, a gynecologist may also treat yeast infections.

Even though the signs and symptoms of yeast infection may point to the cause, vaginal itching and discharge can be caused by other conditions including bacterial vaginosis and Trichomonas infections. To most accurately make the diagnosis, a sample of the discharge is tested in the laboratory, either by culture or by direct examination under a microscope, to identify the yeast organisms and to help rule out other causes such as bacterial vaginosis or sexually-transmitted diseases.

Yeast infection is treated using antifungal drugs. Both prescription and over-the-counter (OTC) remedies are available that are effective in treating vaginal yeast infections. Nonprescription drugs are the best home remedy for yeast infections, and they can cure most yeast infections. However, homeopathic methods have not been adequately studied for doctors and other health care professionals to recommend them, and anti-itch medications treat only the itching symptoms, but do not treat the underlying cause (yeast infection).

Topical antibiotic (antifungal) treatments (applied directly to the affected area) are available without a prescription. These include vaginal creams, tablets, or suppositories. Regimens vary according to the length of treatment and are typically 1- or 3-day regimens. Recurrent infections may require even longer courses of topical treatment. These topical treatments relieve symptoms and eradicate evidence of the infection in up to 90% of those who complete treatment.

Examples of over-the-counter drugs for yeast infections include:

• clotrimazole (Gyne-Lotrimin, Mycelex)
• miconazole (Micatin, Monistat)
• terconazole (Terazol)

Oral prescription medications, taken in pill or tablet form, can be used to treat recurrent yeast infections or infections that do not respond to topical treatment. Fluconazole (Diflucan) is typically used as the first-choice oral antifungal medicine.

Fluconazole also may be taken as weekly or monthly maintenance for women who have recurrent yeast infections, but it is first necessary to prove by a culture that recurrent infections are occurring.

Oral antifungal medications should not be used by pregnant women.

Oral medications also have more side effects, including

• nausea,
• headache, and
• abdominal pain, then topical medicines.

Yeast infections are common during pregnancy. Pregnant women who develop signs of a yeast infection should see a health care professional. He or she can recommend medications and treatments that are safe during pregnancy. Oral antifungal medications are not recommended for use during some states of pregnancy.

Most experts do not consider yeast infection to be a sexually-transmitted disease, but cases of irritation and itching of the penis in men have been reported after sexual contact with a woman with a yeast infection, so it is possible for an infected woman to spread the infection to her male sex partner. Treatment of male sexual partners is not considered necessary unless the man develops symptoms.

Symptoms in men may include itching, burning, and pain at the tip of the penis. Discomfort during urination can also occur. The area may appear reddened or irritated. Symptoms may resemble those of other diseases, including some sexually-transmitted infections (STDs), so testing should always be carried out to determine the cause of symptoms in men.

Treatment for men, like for women, is based upon antifungal medications. These may be applied as topical creams or taken by mouth in pill or tablet form.

Because yeast can be present normally in the vagina of healthy women, not all yeast infections can be prevented. However, it is possible to take preventive measures that may reduce your risk of getting a yeast infection. These include always cleaning the genital area from front to back and changing out of wet bathing suits or damp clothes as soon as possible. Wearing loose-fitting cotton underwear can help reduce moisture and prevent yeast infections. Since chemical irritants can influence the balance of bacteria in the vagina, avoiding products with potential irritants like douches or scented tampons can also help. Regular baths or showers are an adequate way to cleanse the vagina, and douching is not recommended and may actually increase your risk of yeast infection.

Some evidence shows that consumption of foods with probiotics (healthy bacteria that are normally found in the body) like probiotic-containing yogurt may help prevent yeast infections.

A recurrent yeast infection occurs when a woman has four or more infections in one year that are not related to antibiotic use. Recurrent yeast infections may be related to an underlying medical condition such as impaired immunity and may require more aggressive treatment. This can include longer courses of topical treatments, oral medications, or a combination of the two.

Condoms may help prevent transmission of a yeast infection from women to men, but they are not completely effective since there may be contact with areas of the body not covered by the condom.

Avoiding intercourse when a woman has symptoms of a yeast infection is the best way to prevent spreading of the infection.