What is a Vaginal Yeast Infection?
Yeast infections are caused by the proliferation of normally growing fungi which occur in small concentrations in the vagina. This overgrowth inflames the vagina and creates discharge, odor, irritation, and/or itching. Normally growing bacteria in the body typically keep yeast fungi in check. If the natural balance of microorganisms is altered, the yeast may multiply and become the dominant organism in the vagina. This phenomenon is so common that most women experience a yeast infection at least once during their lives. Disturbance of the normal vaginal environment natural may occur with any of the following:
- Use of antibiotics
- A weakened immune system (for example due to HIV/AIDS, steroid usage, pregnancy, cancer chemotherapy or other drugs that serve to weaken the immune system)
- Use of douches or feminine hygiene sprays
- Tight or noncotton underwear
- Hormonal changes
- Use of birth control pills
- Use of hormone therapy
What Causes Vaginal Yeast Infection?
- Vaginal yeast infections are caused by a fungus.
- The most common fungus which women acquire is called Candida albicans.
- This condition is also called candidiasis, genital candidiasis, or vulvovaginal candidiasis (VVC).
- In stubborn cases, there may be a resistant yeast organism or a mixed infection with Candida as one of the organisms.
- Yeast infection can spread to other parts of the body, including skin, mucous membranes, heart valves, the esophagus, and other areas.
- Rarely, yeast infection can cause life-threatening systemic infections, typically in people with weakened immune defenses. For more, please read the Vaginal Yeast Infection article.
What Are the Risks for Vaginal Yeast Infections?
- Many women often mistakenly think they have a yeast infection and treat themselves, when they actually have a similar vaginal infection that will not respond to self-treatment with over-the-counter yeast-fighting medications.
- A study by the American Social Health Association found that most women self-treated vaginal infections before calling a healthcare provider.
- Most often, they mistook a bacterial infection (bacterial vaginosis) for a yeast infection.
- Other problems that can cause similar symptoms might be just a local mechanical irritation (from sex or tampons), an allergic reaction, or a chemical irritation secondary to the usage of soap, perfumes, deodorants, or powders.
What Is the Treatment for Vaginal Yeast Infection?
- Women should see a healthcare provider the first time vaginal yeast infection symptoms occur or if they are unsure as to whether they have a yeast infection. If certain, the condition can be treated with over-the-counter medications.
- However, if symptoms do not respond to one course of over-the-counter medications, yeast infection may not be the problem.
- Pregnant women or those with weakened immune systems should contact a doctor before beginning any over-the-counter self-treatment.
- Women who experience recurrent vaginal yeast infections, or yeast infections that do not clear up with treatment, should immediately contact a healthcare provider for professional diagnosis and management.
- If a woman has more than four episodes of vulvovaginal candidiasis (VVC) in a year, she is deemed to have recurrent vulvovaginal candidiasis.
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Antifungal Drugs to Treat Yeast Infection
- Oral agents: Fluconazole (Diflucan), ketoconazole (Nizoral), itraconazole (Sporanox)
- Vaginal agents: Butoconazole (Femstat), clotrimazole (Mycelex, Gyne-Lotrimin, FemCare), miconazole (Monistat-7, Femizol-M), nystatin (Mycostatin), terconazole (Terazol), tioconazole (Vagistat-1)
- How antifungal drugs work: Antifungal drugs inhibit the ability of fungus to multiply and form new cell membranes.
- Who should not use these medications: Individuals with allergy to any ingredients contained within these products should not take them.
- Use: The choice of oral or vaginal dosage forms depends on the severity of the yeast infection, whether infection is recurrent, and the individual’s personal history (for example, immune system status, pregnancy, diabetes). Some drug regimens may include a combination treatment of an oral agent followed by vaginal application of a cream or vaginal suppository. Severe or recurrent infections may require maintenance treatment regimen prescribed by a doctor. Maintenance treatments are taken periodically (for example, once per week).
- Oral agents: These prescription drugs are available as tablets or capsules. Various treatment regimens are used. Patients with mild infections may require only a single dose or daily doses for a short duration.
- Vaginal agents: Some vaginal preparations are available without a prescription. Vaginal dosage forms include vaginal suppositories, creams, or tablets that come with special applicators for proper administration.
- Drug or food interactions: Clinically important drug interactions may occur with orally administered ketoconazole, fluconazole, or itraconazole. Patients should check with their doctor or pharmacist if they are currently taking other medications. Antacids or other drugs that decrease stomach acidity (for example, Pepcid, Tagamet, Zantac) may decrease the effectiveness of oral antifungal drugs. Common side effects with oral treatment include dizziness, fever, mild itching, nausea, bad taste, and diarrhea.
- Side effects: The most common side effect experienced with vaginally applied treatments is vaginal burning and itching. Less common side effects of vaginally applied treatments include contact dermatitis, irritation, inflammation, and pain with urination or intercourse. Creams and suppositories may contain oil which may compromise the effect of condoms by weakening the latex.