What you need to know about vaginal yeast infection

As many as three-quarters of all women will develop at least one vaginal yeast infection during their lives, and around half will experience at least two. Fortunately, vaginal yeast infections are treatable. There are also ways of reducing the risk of future infections.

Some people use the terms yeast infection and vaginitis interchangeably, but the terms don’t mean the exact same thing. Vaginitis is inflammation of the vagina. You may also hear healthcare providers use the term vulvovaginitis, which is inflammation of the vagina and the vulva, the female external genitalia.

Vaginitis can arise due to a variety of causes, including imbalances in the good and bad bacteria that live in the vagina, irritation due to personal care products, tight-fitting clothes, skin conditions and low estrogen levels due to conditions such as menopause. Vaginal yeast infection is one of the most common types of vaginitis.

Also known as vaginal candidiasis and vulvovaginal candidiasis, a vaginal yeast infection is caused by a type of fungus called Candida. This form of fungus is naturally present on the skin and in the mouth, digestive tract and vagina. It doesn’t usually cause symptoms. However, when the amount of Candida overgrows in the vagina or goes into deeper cell layers of the vagina, a yeast infection can occur.

Several factors can lead to an overgrowth of Candida and a resulting yeast infection, including:

• Taking antibiotic medications that disrupt the natural balance of microorganisms in the vagina
  
• Pregnancy
• Uncontrolled diabetes
• Medical conditions that weaken the immune system
• Taking medications that suppress the immune system
• Taking certain oral contraceptives and hormone-based medications that raise estrogen levels
• Prolonged exposure to moisture, which can occur from wearing a wet bathing suit or sweaty gym clothes for extended periods
• Scented tampons and other feminine care products

Although most women who develop a yeast infection do not acquire it from another person, vaginal candidiasis may be contagious. It may be possible to transmit a vaginal yeast infection to a partner during oral, vaginal or anal intercourse.

In men, the risk of a yeast infection is relatively low. Around 15% of men develop a rash on their penis after having unprotected vaginal intercourse with a woman who has a yeast infection. Women have a higher risk of developing a yeast infection from a sexual partner with an infection.

While you can spread Candida infections through sexual activity, yeast infections aren’t considered sexually transmitted infections (STIs) because it’s possible to develop a yeast infection without having sex with someone who has an infection.

A vaginal yeast infection can cause a variety of symptoms, including:

• A burning sensation, particularly while urinating or during sexual intercourse
  
• Itching inside the vagina and/or around the vulva
• Swelling and redness of the vulva
• Thick, odorless, clumpy white vaginal discharge that looks similar to cottage cheese
• Vaginal pain and tenderness

Women may develop just one or two of the above symptoms, and these symptoms can range from mild to severe.

Keep in mind that the symptoms of yeast infections are very similar to vaginitis symptoms that develop due to other causes, such as bacterial imbalances and skin sensitivity. As a result, it’s a good idea to see your healthcare provider for a diagnosis when you experience yeast infection symptoms.

To treat a yeast infection, you’ll need an antifungal medication that can kill excess Candida and inhibit its growth. There are a few types of antifungal medications available, including:

Over-the-counter yeast infection treatments

For mild yeast infections, over-the-counter (OTC) yeast infection treatments, such as miconazole or clotrimazole, are often effective and come in several different forms, including:

• Creams
  
• Ointments 
• Suppositories

Each type of medication is inserted into the vagina. Depending on the product, you’ll typically need to use the medication for one to seven days. Some treatment kits include a cream or ointment for external use to relieve itching and inflammation of the vulva.

Prescription topical medications

Healthcare providers may recommend prescription-strength topical medications for women who have tried over-the-counter treatments without success, as well as for more severe infections, and for people with compromised immune systems. Like over-the-counter products, these topical medications are inserted into the vagina. Please be aware that some of these OTC products may contain certain types of oils that may weaken latex-based condoms and diaphragms. 

Prescription oral medications

In some cases, healthcare providers may prescribe oral antifungal medication to treat yeast infections. A single dose of fluconazole (Diflucan) can be effective at treating mild infections. For more severe infections, you may be prescribed two pills to take three days apart.

While it may not be possible to prevent yeast infections completely, these tips can help you lower your risk:

• Avoid using douches, feminine deodorants and scented tampons
  
• Change out of wet or damp clothing as soon as possible
• Don’t use hot tubs or soak in very hot baths
• Keep your blood sugar under control if you have diabetes
• Only take antibiotic medications when prescribed by a healthcare provider
• Opt for loose-fitting clothing 
• Use water-based lubricants 
• Wear breathable cotton underwear

If you suspect you have a yeast infection, see your healthcare provider. They can evaluate you, recommend treatment if necessary and work with you to help reduce your risk of future infections.

Published January 2024.