Yeast Infection (Vaginal): Symptoms, Causes, Diagnosis, Treatment

Written by WebMD Editorial Contributors

• What Are Vaginal Yeast Infections?
• Symptoms of Vaginal Yeast Infections
• Causes of Vaginal Yeast infections
• Treatments for Vaginal Yeast Infections
• Can Probiotics Help?

They’re itchy and uncomfortable, and no one really likes to talk about them. But vaginal yeast infections are very common in women. It’s estimated that 75% of women will have at least one yeast infection in their lifetime.

Though yeast infections can happen to anyone at any time, there are certain things that make getting them more likely. Most infections can be cleared up quickly and easily.

The vagina normally contains a healthy balance of bacteria and yeast. The hormone estrogen helps bacteria called lactobacilli to grow. These bacteria kill harmful organisms in the vagina and keep you healthy. But when something happens to tip that balance, a fungus called candida can grow out of control and cause a yeast infection.

Itchiness and discomfort are the main symptoms of a yeast infection, but there are others. You may also experience any or all of the following:

• Burning, redness, and swelling of the vagina and the vulva (the outer part of the female genitals)
• Pain or burning when you pee
• Pain during sex
• A thick, white, odorless discharge, similar to cottage cheese

If you think you have a yeast infection, see your doctor before treating yourself. The symptoms of yeast infections are similar to other, more serious conditions, including sexually transmitted infections and bacterial vaginosis (bacterial overgrowth in the vagina). An accurate diagnosis is important so you can get the best treatment.

There are many reasons you could get a yeast infection, including:

• Hormones: Changes during pregnancy, breast-feeding or menopause (or if you’re taking birth control pills) can change the balance in your vagina.
• Diabetes: If your diabetes is not well-controlled, the increase in sugar in the mucus membranes (moist linings) of your vagina can create a place for yeast to grow.
• Antibiotics: These drugs can kill off many of the good bacteria that live in your vagina.
• Douches and vaginal sprays: The use of these products can change the balance in your vagina.
• A weakened immune system: If you are HIV-positive or have another immune system disorder, the yeast may also grow uncontrolled.
• Sex: Though a yeast infection is not considered a sexually transmitted infection, it can be passed from person to person through sexual contact.

Over-the-counter antifungal creams, ointments or suppositories (with clotrimazole or miconazole) are the most common ways to treat yeast infections. These can take from 1 to 7 days. Your doctor may also choose to prescribe an oral antifungal medication, such as fluconazole (Diflucan) or ibrexafungerp (Brexafemme). 

If you’re pregnant, it’s safe to use creams or suppositories but avoid oral medications. 

It’s important for you to know that some yeast infection medications weaken condoms or diaphragms. That makes it easier for you to get pregnant or contract a sexually transmitted disease. Be sure to read instructions and warnings before using.

If you have diabetes or a weakened immune system, you may get yeast infections over and over again. It’s a condition called recurrent vulvovaginal candidiasis (RVVC). If you get yeast infections at least four times a year, your doctor may recommend that you take a weekly fluconazole pill for 6 months to fight them. Oteseconazole (Vivjoa) has been approved for those with recurring problems with infections who will not be reproducing.

Some studies have shown that eating probiotic yogurt or taking Lactobacillus acidophilus supplements may slow the growth of yeast in the vagina, lowering the risk for infections. But more research is needed before a clear connection can be made.

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Vaginal yeast infection Information | Mount Sinai

Yeast infection – vagina; Vaginal candidiasis; Monilial vaginitis

Vaginal yeast infection is an infection of the vagina. It is most commonly due to the fungus Candida albicans.

This microscopic film shows a fluorescent stain of Candida. Candida is a yeast (fungus) that causes mild disease, but in immunocompromised individuals it may cause life-threatening illness. (Image courtesy of the Centers for Disease Control and Prevention.)

External structures of the female reproductive anatomy include the labium minora and majora, the vagina and the clitoris. Internal structures include the uterus, ovaries, and cervix.

Yeast infections may follow a course of antibiotics that were prescribed for another purpose. The antibiotics change the normal balance between organisms in the vagina by suppressing the growth of protective bacteria that normally have an antifungal effect.

Secondary infection occurs during or after treatment of a primary infection because the normal bacterial flora is destroyed, allowing yeast to flourish.

The uterus is a hollow muscular organ located in the female pelvis between the bladder and rectum. The ovaries produce the eggs that travel through the fallopian tubes. Once the egg has left the ovary it can be fertilized and implant itself in the lining of the uterus. The main function of the uterus is to nourish the developing fetus prior to birth.

The uterus is a muscular organ with thick walls, two upper openings to the fallopian tubes and an inferior opening to the vagina.

Causes

Most women have a vaginal yeast infection at some time. Candida albicans is a common type of fungus. It is often found in small amounts in the vagina, mouth, digestive tract, and on the skin. Most of the time, it does not cause infection or symptoms.

Candida and the many other germs that normally live in the vagina keep each other in balance. Sometimes the number of candida increases. This leads to a yeast infection.

This can happen if:

• You are taking antibiotics used to treat another infection. Antibiotics change the normal balance between germs in the vagina.
• You are pregnant
• You are obese
• You have diabetes
• You are taking medicines or have an illness that suppresses your immune system.

A yeast infection is not spread through sexual contact. However, some men may develop symptoms after having sexual contact with an infected partner. These symptoms may include itching, rash or irritation of the penis.

Having many vaginal yeast infections may be a sign of other health problems. Other vaginal infections and discharges can be mistaken for a vaginal yeast infection.

Symptoms

Symptoms include:

• Abnormal vaginal discharge. Discharge can range from slightly watery, white discharge to thick, white, and chunky (like cottage cheese).
• Itching and burning of the vagina and labia
• Pain with intercourse
• Painful urination
• Redness and swelling of the skin just outside of the vagina (vulva)

Exams and Tests

Your health care provider will do a pelvic exam. It may show:

• Swelling and redness of the skin of the vulva, in the vagina, and on the cervix
• Dry, white spots on the vaginal wall
• Cracks in the skin of the vulva

A small amount of the vaginal discharge is examined using a microscope. This is called a wet mount and KOH test.

Sometimes, a culture is taken if:

• The infection does not get better with treatment
• The infection recurs

Your provider may order other tests to rule out other causes of your symptoms.

Treatment

Medicines to treat vaginal yeast infections are available as creams, ointments, vaginal tablets or suppositories and oral tablets. Most can be bought without needing to see your provider. If you do need to see your provider, you may wish to ask them about the use of boric acid for yeast infections.

Treating yourself at home is probably OK if:

• Your symptoms are mild and you do not have pelvic pain or a fever
• This is not your first yeast infection and you have not had many yeast infections in the past
• You are not pregnant
• You are not worried about other sexually transmitted infections (STI) from recent sexual contact

Medicines you can buy yourself to treat a vaginal yeast infection are:

• Miconazole
• Clotrimazole
• Tioconazole
• Butoconazole

When using these medicines:

• Read the packages carefully and use them as directed.
• You will need to take the medicine for 1 to 7 days, depending on which medicine you buy. (If you do not get repeated infections, a 1-day medicine might work for you.)
• Do not stop using these medicines early because your symptoms are better.

You doctor can also prescribe a pill that you only take by mouth once.

If your symptoms are worse or you get vaginal yeast infections often, you may need:

• Medicine for up to 14 days
• Azole vaginal cream or fluconazole pill every week to prevent new infections

To help prevent and treat vaginal discharge:

• Keep your genital area clean and dry. Avoid soap and rinse with water only. Sitting in a warm, but not hot, bath may help your symptoms.
• Avoid douching. Although many women feel cleaner if they douche after their period or intercourse, it may worsen vaginal discharge. Douching removes healthy bacteria lining the vagina that protect against infection.
• Eat yogurt with live cultures or take Lactobacillus acidophilus tablets when you are on antibiotics. This may help to prevent a yeast infection.
• Use condoms to avoid catching or spreading other infections.
• Avoid using feminine hygiene sprays, fragrances, or powders in the genital area.
• Avoid wearing tight-fitting pants or shorts. These may cause irritation and sweating.
• Wear cotton underwear or cotton-crotch pantyhose. Avoid underwear made of silk or nylon. These can increase sweating in the genital area, which leads to growth of more yeast.
• Keep your blood sugar level under good control if you have diabetes.
• Avoid wearing wet bathing suits or exercise clothing for long periods of time. Wash sweaty or wet clothes after each use.

Outlook (Prognosis)

Most of the time, symptoms go away completely with proper treatment.

Possible Complications

A lot of scratching may cause the skin to crack, making you more likely to get a skin infection.

A woman may have diabetes or weak immune system (such as in HIV) if:

• The infection recurs right after treatment
• The yeast infection does not respond well to treatment

When to Contact a Medical Professional

Call your provider if:

• This is the first time that you have had symptoms of a vaginal yeast infection.
• You are not sure if you have a yeast infection.
• Your symptoms don’t go away after using over-the-counter medicines.
• Your symptoms get worse.
• You develop other symptoms.
• You may have been exposed to an STI.

Dinulos JGH. Superficial fungal infections. In: Dinulos JGH, ed. Habif’s Clinical Dermatology: A Color Guide to Diagnosis and Therapy. 7th ed. Philadelphia, PA: Elsevier; 2021:chap 13.

Eckert LO, Lentz GM. Genital tract infections: vulva, vagina, cervix, toxic shock syndrome, endometritis, and salpingitis. In: Gershenson DM, Lentz GM, Valea FA, Lobo RA, eds. Comprehensive Gynecology. 8th ed. Philadelphia, PA: Elsevier; 2022:chap 23.

Kauffman CA, Pappas PG. Candidiasis. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 318.

Oquendo Del Toro HM, Hoefgen HR. Vulvovaginitis. In: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Nelson Textbook of Pediatrics. 21st ed. Philadelphia, PA: Elsevier; 2020:chap 564.

Last reviewed on: 7/13/2021

Reviewed by: John D. Jacobson, MD, Department of Obstetrics and Gynecology, Loma Linda University School of Medicine, Loma Linda, CA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

Thrush (vaginal candidiasis) – opinion and recommendations of gynecologists of the MediArt clinic

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Thrush (vaginal candidiasis)

Thrush or in medical terms vaginal candidiasis is an inflammatory disease caused by fungal microorganisms of the genus Candida.

Characteristic features – white, cheesy plaque on the mucosa. In 70-75% of women, exacerbations of thrush occur repeatedly and are one of the most common reasons for visiting a gynecologist.

Causes and symptoms of vaginal candidiasis

The causative agent of thrush is a microscopic yeast-like fungus of the genus Candida. In 80-90% of cases, this is a variety of Candida albicans, although there are about 20 other species of this genus of fungi. Candida is an opportunistic fungus that normally lives in the human body.

Normally, the natural suppression of the activity of Candida fungi is provided by a healthy microflora of the vagina. The problem with active growth can arise with a decrease in immunity and from the influence of external factors.

Lead to aggravation:

• taking antibiotics and hormonal drugs;

• infectious diseases, immunodeficiencies;

• unbalanced diet;

• synthetic, tight underwear;

• diabetes;

• stress;

• infection with atypical fungi – Candida tropicalis species or others;

• pregnancy – fungal growth occurs in a third of women, due to increased acidity of the vagina and hormonal changes;

• mucosal injuries during gynecological manipulations, during childbirth;

• chemotherapy.

If the balance of the microflora of the vagina is disturbed, fungi begin to actively multiply and cause inflammation of the mucous membranes. Formed white plaque can be in the mouth or on the genitals (the most common manifestation in women).

The inflammatory reaction is explained by a change in the pH level of the mucosa and the immune response to the ingestion of the waste products of Candida fungi into the blood.

Typical symptoms of vaginal candidiasis are:

• copious white discharge;

• itching, discomfort in the genitals;

• painful intercourse, urination;

• reddened, edematous mucosa of the vulva.

Manifestations may intensify in the heat, weaken in the chronic course (after 7-10 days of the acute phase).

In this case, relapses can occur 3-4 times a year, provoke the appearance of other infections on the inflamed mucosa.

How to treat vaginal candidiasis

Diagnosis is carried out by a gynecologist. The doctor makes a preliminary diagnosis according to the patient’s complaints and external signs that are noticeable during a gynecological examination.

For accurate diagnosis use:

• microscopic examination of secretions to assess the number of microorganisms and the degree of inflammation;

• bacterial culture of secretions to identify the type of pathogen and its sensitivity to medicines.

Based on the results of the examination, the gynecologist will prescribe a comprehensive treatment regimen to relieve inflammation, normalize the microflora, cure concomitant diseases and eliminate the causes of relapses.

With an exacerbation of thrush, attention is also paid to diet. It is recommended to exclude sweets and alcohol from the diet, increase the amount of fruits, vegetables, and lactic acid products.

Treatment of vaginal candidiasis by folk methods will not work. They are suitable for strengthening immunity, alleviating the symptoms of inflammation, but do not affect the fungus itself.

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Itching of the vulva with thrush

Vaginal candidiasis is characterized by mucosal lesions caused by fungi of the genus Candida. Itching of the vulva with thrush is permanent or periodic, accompanied by white curdled discharge, painful sensations during urination and sexual intercourse.

Causes of thrush

Candidiasis is not classified as a sexually transmitted infection. Intrauterine and oral contraception, endocrine diseases (diabetes mellitus, metabolic disorders, hypothyroidism), anorexia, and pregnancy contribute to the imbalance of vaginal microbiosis and intensive reproduction of pathogenic microflora. One of the important factors is a decrease in immunity against the background of somatic diseases of an inflammatory and infectious nature. Active growth of pathogenic microflora can be observed with a sharp change in climate, during pregnancy, against the background of stressful situations. The disease is characterized by a long course and a tendency to frequent relapses, while the main risk factors are distinguished:

• neglect of hygiene rules;
• tampons and scented pads;
• regular use of antibacterial gels and soaps;
• wearing wet clothes;
• hypothermia;
• visits to swimming pools and open water;
• excessive consumption of carbohydrates.

An adverse effect on the vaginal biocenosis is exerted by antibacterial drugs prescribed for the relief of inflammatory processes in the digestive tract, nasopharynx, urogenital and broncho-pulmonary systems. Intestinal dysbacteriosis leads to the spread of the fungus in a downward type and the development of vaginal candidiasis.

Characteristic symptoms

Thrush accompanied by severe itching and burning in the vulva. Characteristic are cheesy discharges of heterogeneous consistency. After intimacy, water procedures and at night, an increase in symptoms is observed: the amount of discharge increases, the itching becomes intolerable. During a gynecological examination, redness and swelling of the labia minora and labia majora are observed.

Quite often, vaginal candidiasis occurs with mild symptoms, which spontaneously disappear after menstruation. Chronization of thrush contributes to the addition of inflammatory and infectious lesions, can disrupt the normal course of pregnancy and labor.