Definition
A vaginal yeast infection is caused by the fungus
Candida albicans. Although yeast is common in the vagina, it can cause problems when it grows excessively. This excess growth causes the uncomfortable symptoms of a yeast infection.
Causes
Yeast grows in conditions that are less acidic. Vaginal fluids are most often mildly acidic, but this fact can change. For example, acid levels can decrease during menstrual flow. Good bacteria also helps keep yeast levels in check. Conditions that decrease levels of good bacteria will also increase the chance of a yeast infection.
Risk Factors
Factors that can increase the chance of a yeast infection include situations
that can cause hormonal changes, such as the use of birth control pills; pregnancy; menopause;
steroid use; broad-spectrum antibiotics; diabetes,
especially when blood sugar is not well-controlled; a compromised immune
system, such as with human immunodeficiency virus infection;
perfumed feminine hygiene sprays, deodorant tampons, or bubble bath; tight jeans,
synthetic underwear, or a wet swimsuit; and douching.
Symptoms
Symptoms of yeast infection include vaginal itching, ranging from mild to severe; a clumpy, vaginal discharge that may look like cottage cheese; vaginal soreness, irritation, or burning; rash or redness on the skin outside the vagina; painful urination; and painful sexual intercourse.
Screening and Diagnosis
A doctor will perform a pelvic exam. Vaginal discharge, if any, will be tested.
One should consult a doctor at the first onset of symptoms. Other infections have
symptoms that are like those of a yeast infection. These other infections include
bacterial
vaginosis and trichomoniasis.
If a woman has had a yeast infection, she may be able to recognize the signs of a new infection. In this case, over-the-counter medications are safe to use.
Treatment and Therapy
Treatment for vaginal yeast infection includes the use of medications. Various
antifungal drugs are available as intravaginal creams, tablets, or suppositories.
These drugs include Monistat (miconazole nitrate), Gyne-Lotrimin (clotrimazole
vaginal), Fem-stat (butoconazole vaginal), Terazol (terconazole vaginal), and
Mycelex (clotrimazole vaginal). The treatments come in one-day, three-day, and
seven-day packs. Some of these are over-the-counter, and others (such as Terazol)
may require a prescription. A doctor also can prescribe fluconazole (Diflucan), an
oral medication. It is a single-dose treatment. If pregnant, one should consult a
doctor before any treatment.
Prevention and Outcomes
To help reduce the chance of getting a yeast infection, one should take the
following steps: Dry outside the vaginal area thoroughly after a shower, bath, or
swim; remove a wet bathing suit or damp workout clothes as soon as possible; wear
cotton underwear; avoid tight clothing; avoid douching unless instructed to do so
by a health care provider (douching decreases vaginal acidity); avoid bubble
baths, perfumed feminine hygiene sprays, and scented soap; and avoid frequent or
prolonged use of antibiotics, if possible. Persons with diabetes should
control their blood sugar levels.
Bibliography
Berek, Jonathan S., ed. Berek and Novak’s Gynecology. 14th ed. Philadelphia: Lippincott Williams & Wilkins, 2007.
EBSCO Publishing. DynaMed: Candida Vulvovaginitis. Available through http://www.ebscohost.com/ dynamed.
National Institute of Allergy and Infectious Diseases. “Vaginal Yeast Infection.” Available at http://www.niaid.nih.gov/topics/vaginalyeast.
National Institutes of Health, Medline Plus. “Yeast Infections.” Available at http://www.nlm.nih.gov/medlineplus/yeastinfections.html.
Richardson, Malcolm D., and Elizabeth M. Johnson. Pocket Guide to Fungal Infection. 2d ed. Malden, Mass.: Blackwell, 2006.
Stewart, Elizabeth Gunther, and Paula Spencer. The V Book: A Doctor’s Guide to Complete Vulvovaginal Health. New York: Bantam Books, 2002.
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