Yeast Infection

What is a yeast infection? 

A vaginal yeast infection, also known as vaginal candidiasis or vaginal thrush, is a fungal infection that causes itching, burning and abnormal discharge [1-3]. 

How common is it?

If the description above sounds familiar, it’s because an estimated 75% of all women will have a yeast infection at some point in their lives.

What causes yeast infections and what are the risk factors?

A yeast infection is caused by an overgrowth of yeast – no surprise here. Yeast, which is actually a type of fungus, is a naturally occurring organism and can exist as part of your vaginal microbiome without causing any issues [3]. However, if the vaginal microbiome is disrupted, that small amount of yeast can start to overtake the protective bacteria like lactobacillus and result in the symptoms of a yeast infection. The main type of yeast associated with this type of infection is Candida albicans [3]. 

There are a number of things that can disrupt the balance of your vaginal microbiome and create a favorable environment for yeast growth. Risk factors include [1-4]:

• A low or weakened immune system 
• Pregnancy, since estrogen levels are much higher than usual
• Use of hormonal birth control, which affects estrogen levels the same way as pregnancy
• Medications or treatments like antibiotics, hormone therapy, steroids, or chemotherapy
• Uncontrolled diabetes 
• Stress 
• Douching, use of perfumed soaps, wearing tight underwear, etc.
  

What are the symptoms?

Symptoms are usually mild to moderate but can worsen a few days before your period begins. They include:

• Vaginal itching or irritation 
• Pain during sex or urination
• Abnormal discharge that is usually odorless, thick, white and described as having cottage cheese -like consistency. It can also sometimes be watery.
  

A yeast infection might be considered “complicated” if you experience four or more yeast infections in a year or you have more severe symptoms [4]. The infection can also be complicated if it is caused by another type of fungus other than Candida albicans or is due to a weakened immune system [3].

How is it diagnosed?

A yeast infection is usually easily diagnosed by your doctor through a description of symptoms or a pelvic exam. Laboratory testing of vaginal discharge can also be done to identify the species of yeast if necessary [2]. 

What are the treatment options?

For sporadic or first-time yeast infections, short-course anti-fungal cream or an oral antifungal like fluconazole can be prescribed [1]. 

If infection is recurrent or persistent, the same medications are used for a longer period of time or additional antifungals can be used. In addition, your doctor might suggest boric acid treatment via a vaginal suppository. Please keep in mind that boric acid should never be taken orally as it can be fatal [2].

Can a yeast infection lead to other complications?

Thankfully, complications are very rare in healthy women.

What can be done to prevent yeast infections?

Even though yeast infections are not STIs, they are often linked with sexual activity. To reduce your chances of getting an STI, practice safe sex by always discussing sexual health with your partner, using barrier protection correctly (such as a condom or dental dam), and getting tested regularly. Other ways to prevent a yeast infection include avoiding anything that disrupts the balance of bacteria within the vaginal microbiome such as douching or using scented tampons, pads, or soaps.

Finally, if you have a weakened immune system, your doctor might recommend antifungal medications as a precaution [4].