Vaginal yeast infections
Vaginal mycoses, or vaginal yeast infection (also called candidal vulvovaginitis, vaginal thrush, or candidiasis) is extremely common. Mycoses is found in about 20% of vaginal secretions tested in laboratories. The pain and discomfort caused by this condition often requires immediate medical attention.
A vaginal yeast infection causes irritation, discharge, and intense itchiness of the vagina and the vulva. It is not considered a sexually transmitted disease (STD): you can get it even if you are not sexually active. However, sexual intercourse may be a trigger for this infection. Therefore, if you do have a yeast infection, both you and your partner can consult your doctors to order to avoid recurring discomfort.
The good news is that vaginal yeast infection, although unpleasant, is generally not a severe or dangerous condition. It is caused by one of several strains of naturally occurring yeast, most commonly Candida albicans—a microorganism found in the digestive tracts of up to 60% of adult humans. Candida albicans normally lives in the gut but is also found in other parts of the body: the mouth, pharynx, and oesophagus, on the skin, and in the vagina. In small amounts, yeasts of the genus Candida are beneficial to the body but can become pathogenic if growth is overstimulated.
Symptoms of vaginal yeast infection
Symptoms can range from mild to moderate, and include:
- itching and irritation in the vagina and vulva
- swelling around the vagina
- odour-free, thick, creamy white discharge
- burning sensation during urination and/or sexual intercourse
- pain during sexual intercourse
- bright red, swollen vulva
The main symptom of yeast infection is itching but by itself itching can be caused by various dermatological conditions, such as psoriasis or eczema.
A vaginal yeast infection is not considered an STD (sexually transmitted disease). Although it can be activated during unprotected sex, it is not sexually transmitted—if you have a yeast infection you will not necessarily infect your partner (and vice-versa). In rare cases the infection can be transmitted during sex but, unless your partner has symptoms, there is no need to assume they also have a yeast infection. If symptoms appear, consult your doctor.
Men can also get yeast infections. Early symptoms of a penile yeast infection often include an itching or burning sensation, a red rash, and white, shiny patches on the penis. The skin of the phallus may feel unusually moist, and a thick, white substance may be found under the foreskin or within other folds of skin. In most cases, topical antifungal ointments and creams are enough to clear up a yeast infection.
Causes
The vaginal flora or vaginal microbiome is made up of bacteria that colonise the vagina. Normally, when the microbiome is in balance, bacteria protect the vagina from infections thanks to their acidity. However, excess vaginal acidity or some other imbalance can promote an excessive growth of yeast that results in infection.
For two-thirds of women who experience it, vaginal yeast infection is caused by a disruption of the natural balance of the vaginal flora. For the remaining third, contamination is external—through sexual contact or contact with an infected object.
Risk factors
When do the usually harmless microorganisms that inhabit our bodies become a problem?
Many different factors can play a role. The cause may simply be stress or lack of sleep, but there are pre-existing conditions, such as diabetes and some endocrine diseases, that can also result in yeast infection.
The hormonal changes that occur around the time of your period or those that are caused by pregnancy can make you more susceptible to yeast infection. If you are pregnant, be sure to consult your midwife or gynaecologist for a suitable treatment.
Other factors include vaginal acidity, increased sugar content in vaginal secretions, or bowel contamination; tight clothing or garments made of artificial, non-breathable material; and chemical disruption caused by anti-bacterial soaps or chlorine in swimming pools.
Another common contributing factor is taking antibiotics! We take them to rid ourselves of harmful, disease-causing bacteria, but they can also damage “good” bacteria, which can result in an imbalance not only in the vaginal microbiome but also in the urinary tract—another common site for fungal infections.
What to do if you have a yeast infection?
If you think you have a yeast infection, first consult your doctor. Each treatment is prescribed individually taking into consideration the severity of the symptoms.
The type and dosage of a leftover medication may not be the right treatment for your condition and taking antibiotics when not strictly necessary increases your risk of yeast infection.
Yeast infections and your period
Having both a yeast infection and your period at the same time can feel like a double burden. Sadly, this is something many women experience. Yeast infections are more likely to occur in the days just before a woman starts her period. Hormone fluctuations are the most likely reason for this as they can cause an imbalance in the vaginal microbiome.
A disbalance in the vaginal bacteria is common in adolescence as hormone levels are not yet stable. Hormonal changes due to pregnancy can also bring on a yeast infection.
If you do notice a whitish-yellowish discharge in the week preceding your period, it is not necessarily a yeast infection. Vaginal discharge changes depending on the stage of the menstrual cycle and ‘normal’ varies from woman to woman. Remember, a yeast infection is typically accompanied by other characteristic symptoms, such as redness, burning, and itching.
That said, early diagnosis and treatment can help clear up your yeast infection before your period starts. If symptoms persist even after your period is over, seek advice from your doctor or gynaecologist!
Treatments
The symptoms of vaginal yeast infection can often be relieved within a few days once treatment has begun. For more severe cases, it can take up to 2 weeks.
There are two main treatments for vaginal yeast infection:
Systemic treatment or antifungal medication (capsules or pills) taken orally.
An anti-fungal drug passes through the blood stream and reaches the mucous membranes, where it destroys the fungi. This treatment is only available with a prescription from your doctor or gynaecologist.
Your doctor or gynaecologist may take a vaginal swab for laboratory tests to determine which microorganism is responsible for the inflammation. By specifying the cause of the infection, it is possible to choose the most effective therapy.
Local treatment or vaginal suppositories inserted into the vagina using a plastic applicator.
There are both single dose and short-term (3-day) treatments. Both are effective. The suppository is usually inserted in the evenings (including during menstruation) to avoid messy discharge during the day. Your doctor or pharmacist may also recommend a cream or lotion to be applied to the skin and external mucous membranes.
In most cases, suppositories are available in pharmacies without a prescription. However, make sure you really have a vaginal yeast infection before using them. Self-medication without medical advice is not recommended, especially if this is the first time you have a yeast infection or if you are pregnant! Consult your doctor to determine the cause for any irritation or redness you may be experiencing.
How to avoid recurring yeast infections
Genital yeast infections affect millions of women worldwide; they can cause problems in sexual relations, reduce quality of life, and represent a significant cost to the household budget.
For the time being, there is no general treatment to protecting women against recurring vaginal yeast infection, but here are some tips to limit the risk:
Hygiene—Do not use perfumed soaps or special sprays for your intimate hygiene routine; and do not wash your intimate parts more than twice a day.
Do not use an intra-vaginal douche, do not disinfect your vagina, do not use anti-bacterial soap. None of this is necessary! Your vagina is self-cleaning; using additional cleaning agents is likely to harm your natural vaginal microflora. Natural vaginal discharge keeps your vagina clean.
Clothing—Avoid wearing skinny jeans and other tight-fitting clothes. If possible, choose cotton underwear, washable at 60° C—this temperature will kill any fungus found on your garments.
After swimming in chlorinated water, rinse yourself with running water and change out of your wet swimsuit.
Sex—Avoid irritating tender vaginal tissues. If necessary, use a lubricant to prevent friction damage to the vaginal wall during sexual intercourse.
Diet—Avoid sweets, as sugar is the perfect base for fungi to grow. Women with elevated blood sugar or uncontrolled diabetes are far more likely to suffer from yeast infections. If you have been diagnosed with either condition, talk to your doctor about how to best cope with it.
Consider including probiotics in your diet. These are health-supporting bacteria that keep yeast levels in balance. Look for lactobacillus, the type of bacteria that lives in healthy gut and vaginal flora. Lactobacillus bacteria can be found in yogurt and kefir with live active cultures on the shelves of your grocery store.
Some women use yoghurt (with lactobacillus) vaginally as a home remedy for yeast infection, but this is not recommended: even unsweetened yogurt contains natural sugars that can fuel yeast growth and end up making things worse.
The takeaway
Yeast infections can be annoying, but they are common occurrences, and with prompt treatment the symptoms can be drastically reduced within a few days. If you notice symptoms of an infection, consult your doctor in order to find the best treatment plan for you.
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