Vaginal Yeast Infections - Causes, Symptoms, and Treatment

What Is a Vaginal Yeast Infection?

A vaginal yeast infection causes irritation, discharge, and intense itchiness of the vagina and the vulva. This is a yeast infection also known as vaginal candidiasis. This is a common condition where there is a disruption of the balance of bacteria and yeast in a healthy vagina, and the yeast cells start to multiply. Vaginal yeast infection affects up to 75 % of women at some point in their lifetimes. It is not a sexually transmitted disease. However, there's an increased chance of contracting the infection after the first time of regular sexual activity.

There is some evidence associated with mouth to genital contact (oral-genital sex). In general, yeast infections can occur at any time and can resolve quickly. Medications can effectively treat vaginal yeast infections. If the yeast infection is recurrent, that is, if it occurs four or more times within a year, the patient may require a longer treatment course and a maintenance plan. The vagina normally maintains a healthy balance of bacteria and yeast. The estrogen hormone facilitates the growth of lactobacilli bacteria. These bacteria maintain the normal homeostasis of the bacterial environment. But when the balance is disrupted, a fungus called candida can grow out of control and cause a yeast infection.

How to Diagnose A Vaginal Yeast Infection?

The diagnosis of a vaginal yeast infection is made by the following methods:

• Understanding the History of the Patient: This might include gathering information about the past history of vaginal infections or sexually transmitted diseases.

• Performing a Pelvic Exam: A pelvic exam is performed by examining the external genitals for signs of infection and placing an instrument called a speculum to open and hold the vaginal walls to examine the vagina and cervix (the lower, narrower part of your uterus).

• Testing Vaginal Secretions: A sample of the vaginal fluid may be tested to determine the type of fungus causing the yeast infection.

What Are the Symptoms of A Vaginal Yeast Infection?

The symptoms of a yeast infection can range from mild to moderate and include:

• Irritation and itching sensation in the vagina and vulva.

• A burning sensation, especially while urinating or during intercourse.

• A vaginal rash.

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• Swelling and redness of the vulva.

• Pain and soreness in the vagina.

• Thick, white, vaginal discharge that is odor-free with a cottage cheese appearance.

• In some cases, a watery vaginal discharge can be seen.

A complicated yeast infection can occur if:

• The patient shows severe signs and symptoms, such as extensive redness, swelling, and itching leading to tears, cracks, or sores.

• The patient has four or more yeast infections in a year.

• The infection is caused by a less typical type of fungus.

• Pregnancy.

• Uncontrolled diabetes.

• Weakened immune system because of certain drugs or conditions such as HIV (human immunodeficiency virus) infection.

What Are the Causes of Vaginal Yeast Infections?

Vaginal yeast infections are primarily caused by the fungus Candida albicans. The vagina is a host to a balanced mix of yeast, including candida and a variety of bacteria. Certain bacteria like lactobacillus prevent the overgrowth of yeast. This balance can be disrupted at times and causes an overgrowth of candida. The fungus then penetrates into deeper vaginal cell layers causing the signs and symptoms of a yeast infection.

The events leading to the overgrowth of the yeast can result from:

• Excessive antibiotic use, which disrupts the balance in natural vaginal flora.

• Uncontrolled diabetes.

• Pregnancy.

• A compromised immune system.

• Usage of oral contraceptives or hormone therapy that causes an increase in estrogen levels.

What Are the Risk Factors for Vaginal Yeast Infections?

Factors that increase the risk of getting a vaginal yeast infection include:

• Usage of Antibiotics: Regular usage of antibiotics predisposes to yeast infections among women. Broad-spectrum antibiotics have a tendency to kill a range of bacteria, including the healthy bacteria in the vagina. This, in turn, leads to increased growth of candida.

• Elevated Levels of Estrogen: In women with increased estrogen levels (due to pregnancy, high-dose estrogen birth control pills, or those undergoing estrogen hormone therapy), yeast infections are more common.

• Uncontrolled Diabetes: Women with poorly controlled blood sugar are more prone to yeast infections.

• Compromised Immune System: Women with reduced immunity (due to corticosteroid therapy, HIV infection, or autoimmune diseases) are more likely to get yeast infections.

How Can Vaginal Yeast Infections be Prevented?

The risk of vaginal yeast infections can be reduced by:

• Wearing underwear that is made of cotton and does not fit too tightly.

• Avoid douching (the practice of washing the vagina with products that remove some of the normal bacteria). These bacteria protect the vagina from a potential infection.

• Avoid staying in wet clothes, such as swimsuits and workout attire, for long periods of time.

• Avoid scented feminine products, such as bubble baths, pads, and tampons.

• Reduce the unnecessary usage of antibiotics that are taken for colds or other bacterial infections.

What Are the Treatment Options for Vaginal Yeast Infections?

The treatment depends on the severity and frequency of the infections.

For infections with mild to moderate symptoms and infrequent episodes:

• Short-Course Vaginal Therapy: Taking an antifungal drug for a duration of three to seven days treats yeast infection. Antifungal medications are available as ointments, creams, suppositories, and tablets containing drugs like Miconazole and Terconazole.

• Single-Dose Oral Medication: A single oral dose of Fluconazole can be prescribed but must be avoided if the patient is pregnant. Severe symptoms are managed by taking two single doses three days apart.

If the treatment does not resolve the symptoms or if your symptoms return within two months, it is advised to visit the doctor. In case of severe symptoms, the following treatments can be considered:

• Long-Course Vaginal Therapy: An antifungal medication taken daily for up to two weeks which is followed by using the medication once a week for six months.

• Multi Dose Oral Medication: Two or three doses of antifungal medication are to be taken by mouth instead of vaginal therapy.

• Azole Resistant Therapy: If the candidal infections are resistant to the usual antifungals, boric acid, a capsule may be prescribed. It is inserted into the vagina and maybe fatal if taken orally.

Conclusion:

Preventive measures must be followed diligently. Vaginal yeast infections can be easily managed if the symptoms are noticed at the earliest. A physician must be consulted as soon as the symptoms are noted. Appropriate treatment is rendered at the earliest to prevent complications.