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Yeast Infections

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Most yeast infections are caused by a fungus called candida. Some people normally have yeast in their mouth and intestines. Many healthy women also have yeast in their vaginal secretions without having any symptoms of infection, such as itching or burning.

Causes
An overgrowth of yeast can be caused by:

antibiotics, since they may also kill the lactobacilli, a type of bacteria that keeps yeast in check
hormonal changes, especially those due to pregnancy
a weakened immune system
medications that suppress the immune system
diabetes

The use of the following can increase the risk of developing a yeast infection:

warmth and moisture, which create a favorable environment for yeast growth
douching or washing the genital area with soap or shower gel, which can wash away healthy bacteria
using deodorants or scented products in the genital area, including scented tampons and pads

It is uncommon for males to develop yeast infections and infection from sex occurs rarely.

Symptoms

itching, irritation, or burning of the vulva (the inner and outer lips surrounding the vaginal opening)
swelling, cracked skin, or tears on the vulva
whitish vaginal discharge (often thick/curd-like)
painful intercourse
burning during urination

Treatment
Before attempting to treat a yeast infection at home, get a diagnosis to be sure. A recent study showed that 2/3 of the women that bought over-the-counter medication to treat yeast did not actually have yeast infections. Many other types of vaginal and vulvar irritation can cause similar symptoms.

Anti-fungal medications can be used to treat yeast infections. Medications are available as vaginal creams, suppositories, or oral pills.

Many effective vaginal creams and suppositories are available over-the-counter at most pharmacies. Some treatments include:

miconazole
clotrimazole
tioconazole

These medications are available in one-, three-, or seven-day formulas. Although a one-day formula seems most convenient, some women find that the drug’s higher concentration causes burning and irritation.

The oral antifungal medication, fluconazole (Diflucan), is prescribed in one or two doses. While convenient to use, fluconazole requires a prescription from a clinician, may be more expensive, and is usually no more effective than a vaginal cream or suppository. Do not use fluconazole if pregnant or if pregnancy is suspected.

Boric acid capsules can be used to treat yeast infections and may be more effective than prescription drugs for recurrent or resistant infections. Boric acid is inexpensive and does not require a prescription. If raw or broken skin is present around the vulva, boric acid may increase discomfort. In this case, a vaginal cream may be preferred. Ingredients and detailed instructions are available at Community Pharmacy.

An ointment containing zinc oxide (such as Desitin) may provide temporary relief from itching and irritation when applied to the external genitalia. It will not cure a yeast infection.

Intercourse is permitted during treatment of a yeast infection but may be uncomfortable. It is important to remember that vaginal yeast medications may also cause latex condoms to fail. Intercourse should be avoided until treatment is completed if condoms are used for contraception and/or STI prevention.

Oral sex should not be performed on someone with a yeast infection as it can cause thrush, an overgrowth of yeast in the mouth.

Prevention

Bathe with plenty of water and avoid soap in the genital area.
To minimize the moist environment that yeast favors:
- Wear underwear or pantyhose with a cotton crotch and loose-fitting pants.
- Do not wear underwear to bed.
- Change out of sweaty exercise clothing or wet bathing suits as soon as possible.
Wipe from front to back after bowel movements to avoid spreading bacteria.
Avoid feminine hygiene sprays, scented tampons or pads, colored or perfumed toilet paper, or tear-off fabric softeners.
Eating yogurt with live cultures or taking acidophilus tablets may decrease the amount of yeast in the bowel but has not been proven to prevent vaginal yeast infections.
Boric acid capsules can be used at the first sign of a yeast infection—one capsule inserted into the vagina every night for two or three nights may change the environment enough to stop the growth of yeast. If yeast infections typically develop prior to menstruation, this strategy can be used at that time.

When to contact a clinician
If yeast infection symptoms persist or keep coming back, evaluation by a clinician is recommended.

[HU454 : updated 12/08]

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