January 18, 2017

Vaginal Yeast Infection

Some of the top women’s health issues include cardiovascular diseases, sexual and reproductive health, mental health illnesses and bone density vulnerabilities. Even though men and women have similar risk factors females tend to be at a higher risk due to their anatomy and physiology. Infections and endocrine influence on a woman’s reproductive system is one such distinction between the sexes. The vagina is predominantly an internal structure which is warm and moist. This makes it more susceptible to opportunistic infections. Vaginal yeast is one of the many infections which can colonize the vagina.

Another name for vaginal yeast is Candidiasis. This is a fungal infection caused by yeasts that belong to the genus Candida. We have identified over 20 species of Candida yeasts that can cause infection in humans. Candida albicans is by far the most common species. It is important to note that Candida yeasts normally reside in the intestinal tract and can be found on mucous membranes and skin without causing infection. Whenever there is an excessive growth of colonies of this fungus then there are symptoms of infection if not treated very early may result in significant discomfort.

Symptoms of candidiasis vary depending on the area of the body that is infected:

  1. Oropharyngeal candidiasis occurs in the mouth or throat. It is commonly called thrush.
  2. Vaginal candidiasis occurs on the external and internal areas of the vulvo, vagina and cervix.
  3. Invasive candidiasis describes a systemic infection when candida enters the blood stream. This is an extremely serious condition which is life-threatening.

© Iryna Timonina | Dreamstime Stock PhotosVaginal Yeast Infection

The human body has a built-in mechanism to prevent overgrowth of organisms which are disease forming. The vagina produces a normal discharge which keeps the passage moist and “clean”. This body fluid has antimicrobial property. It is important to note that the amount and consistency of normal discharge varies during a woman’s menstrual cycle. During sexual excitation and sexual intercourse more vaginal discharge is produce to lubricate the vaginal vault.

Common symptoms include:

  • intense itching
  • swelling
  • irritation
  • urinary symptoms
  • vaginal discharge (thin, watery or thick and white)
  • an unpleasant smell (yeast-like)

The itchy tends to be worse at nights. Sexual intercourse at this time tends to be uncomfortable and even painful. There are women who may have no symptoms at all and the diagnosis is incidental on a pap smear report.

According to the Mayo Clinic, 3 out of 4 women will experience a yeast infection at one point in their lives. Once you get a yeast infection, you’re more likely to get another one.

Vaginal yeast infections can be spread by sexual contact, but in general they aren’t considered a sexually transmitted infection. Treatment for yeast infections is relatively simple, depending on their severity.

Other types of Vaginitis

Other organisms and conditions can cause the swelling, irritation and a vaginal discharge. Many clinicians refer to these infection or inflammation of the vagina as “vaginitis”. The most common kinds are:

  • Chlamydia
  • Gonorrhea
  • Reactions or allergies (non-infectious vaginitis)
  • Trichomoniasis
  • Viral vaginitis

It is possible to have more than one type of vaginitis but it is important to differentiate as each type has a specific course of treatment. Diagnosis can be confirmed by the microbiologist who cultures a sample of the discharge for specie identification.

What predisposes a woman to vaginal yeast infections?

The “good bacteria” called lactobacillus helps to keep candida in check in the GI tract, on the skin and in the vaginal vault. However, any condition which disturbs the growth of the lactobacillus will lead to an overgrowth of yeast, which causes the symptoms of vaginal yeast infections.

The imbalance that allows the overgrowth of yeast to happen can be due to:

  • Antibiotics over use or abuse lower the amount of lactobacillus, or good bacteria, in the vagina)
  • Pregnancy changes the balance (pH) of the vaginal fluids
  • uncontrolled diabetes predisposes to fungal infections
  • weak immune system decreases the body’s ability to respond to infections
  • poor diets, including high sugar intake predisposes to fungal overgrowth
  • hormonal imbalance associated with the menstrual cycle
  • stress depresses the body’s natural defense
  • lack of sleep also interferes with the optimal function of the immune response

What are the symptoms of a vaginal yeast infection?

Vaginal yeast infections have a common set of symptoms. Usually the length of time your yeast infection is left untreated has a direct impact on how severe your symptoms are. Frequent symptoms include:

  • itching
  • burning
  • large or small amounts of vaginal discharge, often whitish gray and thick (although there are also times the discharge can be watery)
  • pain during sex
  • soreness
  • rash

How are vaginal yeast infections diagnosed?

A history of the symptoms is sometimes enough to diagnose a vaginal yeast infection. The doctor will ask about the color, appearance and odor of the vaginal discharge. He or she will explore whether or not you have had prior yeast infections or a sexually transmitted infection.

The pelvic examination is then performed. Your doctor will examine the vagina and the surrounding area to see if there are external signs of infection. Using an instrument called a speculum and special lighting the doctor will also examine your vaginal vault and cervix. Depending on what your doctor discovers, they will take a vaginal sample to send to the lab for confirmation. Tests are usually ordered only for women that have yeast infections on a regular basis or for recurrent infections.

After a doctor’s visit for vaginal candida a woman should be able to determine the presence of a future yeast infection on your own based on the symptoms.

What is the best way to treat a vaginal yeast infection?

Most yeast infections are caused by a specific kind of yeast called Candida albicans. These yeast infections are easily treatable. If you’re having recurring yeast infections or problems getting rid of a yeast infection with conventional treatment, then a different version of Candida might be the culprit. A lab test can let your doctor know which type of Candida you have.

Each yeast infection is different, so your doctor will suggest a treatment that’s best for you. Treatments are generally determined based on an infection’s severity.

Yeast infections are classified as 1) Simple or 2) Severe/Complicated.

For simple yeast infections, your doctor will usually prescribe the following treatment(s):

  • A one- to three-day regimen of an antifungal cream, ointment, tablet, or suppository. Common antifungal medications are:
    • Butoconazole (Gynazole)
    • Miconazole (Lotrimin)
    • Monistat
    • Tereconazole (Terazol).
    • A single dose of oral medication, such as Fluconazole (Diflucan).

An important note: Women with simple yeast infections should follow up with their doctor to make sure the medicine worked. A follow-up will also be necessary if your symptoms return within two months.

Certain types of Candida will not respond to normal treatment and will require a more aggressive course of action. If you meet one of the following criteria, your doctor will more than likely treat your yeast infection as if it were a severe or complicated case. The severe or complicated candida infection is diagnosed when:-

  • You have severe redness, swelling, and itching that leads to sores or tears in your vaginal tissue.
  • You have had more than four yeast infections in a year.
  • Your infection is caused by Candida other than albicans.
  • You are pregnant.
  • You have uncontrolled diabetes or
  • a suppressed immune system either from medication or from being HIV-positive.

The treatment regime for severe or complicated yeast infections include:

  • 14-day intra-vaginal treatment with an anti-fungal cream, ointment, tablet, or suppository
  • A short course of 2-3 doses of fluconazole (Diflucan)
  • A long-term treatment of fluconazole (Diflucan) once weekly for 6 weeks,
  • Along with the above treatment the doctor may also prescribe a topical antifungal medication

It is important for your sexual partner to be treated with antifungal medication to interrupt the transmission of the fungal infection. Sex should be avoided during treatment but if this is not possible then a condom should be used when having sex

Differential diagnosis between Vaginal yeast infection and bacterial vaginosis

Two of the most common causes are related to organisms that live in your vagina. They can have very similar symptoms. Yeast infections are an overgrowth of the yeast that you normally have in your body. Bacterial vaginosis happens when the balance of bacteria is thrown off. With both conditions, you may notice white or grayish discharge.

How can you tell them apart? If there’s a fishy smell, bacterial vaginosis is a better guess. If your discharge looks like cottage cheese, a yeast infection may be to blame. That’s also more likely to cause itching and burning, though bacterial vaginosis might make you itchy, too.

It is possible to have both infection at the same time.

Natural remedies

You can treat mild vaginal yeast infections with natural home remedies if you would like to avoid taking prescription medication. These are some popular natural remedies:

  • tea tree oil
  • garlic or
  • boric acid vaginal suppositories
  • plain yogurt taken orally or inserted into the vagina


In many cases, you may know exactly what led to your yeast infection. For example, some women experience these infections every time they take antibiotics. By recognizing your own risk factors, you can prevent future infections.

Here are some common methods of prevention. Most are targeted at avoiding bacteria growth near the vagina:


  • wearing tight pants, pantyhose, tights, or leggings
  • using feminine deodorant or deodorant tampons or pads
  • sitting around in wet clothing, especially bathing suits
  • sitting in hot tubs or taking frequent hot tub baths
  • douching


  • eat a well-balanced diet
  • eat yogurt or take supplements with lactobacillus
  • wear natural fibers such as cotton, linen, or silk
  • wash underwear in hot water
  • replace old feminine products frequently

Preparing for the doctor’s visit

Do not hesitate to call your doctor when:

  • There is a significant change in your vaginal discharge i.e. it has an unpleasant odor, the color and consistency gives you reason for concern.
  • You are experiencing itching, burning, swelling, or soreness in or around your vagina.
  • There is burning when you urinate.
  • Sex is uncomfortable or painful.

There are subtle differences between the various types of vaginitis and so it is important for the patient to give as much information as possible about the symptoms she is experiencing. Tips for the patient include:

  • Making a note of which symptoms you have and when.
  • Pay attention to the color, texture, smell, and amount of discharge.
  • Doctors usually advise you not to wash the vaginal areas before the visit
  • Do not douche before your doctor’s visit. Some clinicians caution that the douche could send the infection further up the vagina and tubes. It will also the lab test falsely negative or equivocal
  • Some doctors will ask you to not have sex during the 24-48 hours before your appointment.
  • It’s better to see your doctor before you try over-the-counter medications as you can never be 100% sure about the diagnosis.

You treat non-infectious vaginitis by dealing with the probable cause.  what Note what new products you’re using that could be irritating your sensitive skin. For hormonal changes, your doctor may prescribe estrogen to ease symptoms.

Research Findings

  1. Genital yeast infections, JD Oriel, BM Partridge, MJ Denny, JC Coleman – Br Med J, 1972 – bmj.com

The researchers examine the relation between vaginal mycosis and oral     contraception as there has been some controversy over the subject. They also explored the importance of yeasts as actual or potential pathogens of the female genital tract especially in women who are taking oral contraceptives.

  1. Vaginal yeast infection, DI Tool jeffersonhospital.adam.com

Most women have a vaginal yeast infection at some time. Candida albicans is a common type of fungus. It is often found in small amounts in the vagina, mouth, digestive tract, and on the skin. Most of the time, it does not cause infection or symptoms.

  1. Vaginal Yeast Infection, I Gaoes – Sister Namibia, 2015 – search.proquest.com

Abstract Another home remedy is the use of garlic as it is a very well-known herb that kills yeast. The antifungal, antibacterial and natural antibiotic components present in garlic can be highly effective in treating any kind of yeast infection.

  1. Vaginal yeast infection, I Plans, P Care, P Numbers, DI Tool, G Rounds… – umm.edu

Most women have a vaginal yeast infection at some time. Candida albicans is a common type of fungus. It is often found in small amounts in the vagina, mouth, digestive tract, and on the skin. Most of the time, it does not cause infection or symptoms.

  1. Vaginal Yeast Infections, B Pay, G Cards – uwhealth.org

Yeast is a fungus that normally lives in the vagina in small numbers. A vaginal yeast infection means that too many yeast cells are growing in the vagina. These infections are very common. Although they can bother you a lot, they are not usually serious.

  1. Clinical and microscopic diagnosis of vaginal yeast infection : a prospective analysis,  J Abbott – Annals of emergency medicine, 1995 – Elsevier

Study objectives: To evaluate the accuracy of clinical findings and direct microscopy in the diagnosis of yeast vaginitis. Design: Prospective. Setting: Urban teaching hospital emergency department and walk-in clinic. Participants: 71

  1. Guidelines for treatment of candidiasis,  PG Pappas, JH Rex, JD Sobel… – Clinical Infectious …, 2004 – cid.oxfordjournals.org
  2. Genital yeast infections, AB Maclean – British medical journal, 1977 – ncbi.nlm.nih.gov

Dr RN Thin and others (9 July, p 93) to associate genital yeast infection in women. They found vaginal yeast infections among 183°/ of married and unmarried pregnant women. They also studied the significance of these yeasts during pregnancy.

  1. Practice guidelines for the treatment of candidiasis,  JH Rex, TJ Walsh, JD Sobel, SG Filler – Clinical infectious, 2000 – cid.oxfordjournals.org
  2. Hydrogen peroxide producing lactobacilli and acquisition  of vaginal infections, SE Hawes,   SL Hillier, J Benedetti… – Journal of Infectious …, 1996 – jid.oxfordjournals.org

During the follow- up period, 50 women acquired clinical evidence of BV, 25 developed symptomatic VVC requiring treatment, and 7 developed vaginal It is unknown whether douching directly leads to upper genital invasion by vaginal microorganism.

  1. Pathogenesis and treatment of recurrent vulvovaginal candidiasis, JD Sobel – Clinical Infectious Diseases, 1992 – cid.oxfordjournals.org

This study suggests that It is conceivable that treatment of male partners should be systemic rather than topical application. Anecdotal evidence indicates that anogenital and particularly oro- genital contact may transmit vaginal infections.

  1. Prevalence of recurrent vulvovaginal candidiasis in 5 European countries and the United States: results from an internal panel survey,  B Foxman,  R Muraglia, JP Dietz… – … of lower genital tract …, 2013 – journals.lww.com

Journal of Lower Genital Tract Disease Survey study [ 2 ]. Risk of RVVC may be overestimated, as women reported on average 3 vaginal yeast infections

  1. Current medical diagnosis & treatment 2010,  SJ McPhee, MA Papadakis, LM Tierney – 2010 – academia.edu

H. Trent Mackay Abnormal Premenopausal Bleeding Postmenopausal Vaginal Bleeding, Premenstrual Samuel A. Shelburne & Richard J. Hamill Candidiasis Histoplasmosis
Coccidioidomysosis or Overdose. The Symptomatic Patient Antidotes & Other Treatment Diagnosis

  1. Genital herpes simplex virus infections: clinical manifestations, course, and complications, L Corey, HG Adams, ZA Brown… – Annals of internal …, 1983 – Am Coll Physicians
  2. Definitions of invasive fungal disease from the European organization for research and treatment of cancer / invassive fungal infections cooperative group and … B De Pauw, TJ Walsh, JP Donnelly… – Clinical Infectious …, 2008 – cid.oxfordjournals.org

The group set out to re-examine the feasibility of using the definitions for treatment purposes, to manage cases. These infections can also manifest as wedge-shaped infiltrates and segmental or lobar infections. Patients with such lesions were defined as having probable hepato-splenic candidiasis.

  1. Sexually transmitted diseases treatment guidelines, 2010

Centers for Disease Control and Prevention – Annals of Emergency …, 2011 – Mosby

  1. Inadequate antimicrobial treatment of infections : a riskfactor for hospital mortality among crtically ill patients

MH Kollef, G Sherman, S Ward… – Chest …, 1999 – journal.publications.chestnet.orgFewer

  1. Vaginal yeast colonization in nonpregnant women : a longitudinal study

RH Beigi, LA Meyn, DM Moore, MA Krohn… – Obstetrics & …, 2004 – journals.lww.com

Others have investigated self-diagnosis and self-treatment with antifungal preparations using a questionnaire study assessing women’s ability to diagnose the correct genital infectious condition with sexually transmitted diseases, or non-infectious causes of vaginal complaints.

  1. Epidemiology and pathogenesis of recurrent vulvovaginal candidiasis, JD Sobel – American journal of obstetrics and gynecology, 1985 – Elsevier, JD Milne, DW Warnock; Effect of simultaneous oral and vaginal treatment on the rate of cure and relapse in vaginal candidosis. S Vellupillai, RN Thin; Treatment of vulvovaginal yeast infection
    with nystatin. How often is genital yeast infection sexually transmitted?
  2. Guidelines for prevention and treatment of opportunistic infections in HIV infected adults and adolescents, JE Kaplan, C Benson, KK Holmes, JT Brooks… – MMWR Recommendation, 2009 – francais.cdc.gov
  3. How often is genital yeast infection sexually transmitted?,  RN Thin, M Leighton, MJ Dixon – Br Med J, 1977 – bmj.com

Abstract We analysed data from a computer-based bank of clinical records of patients seen in a clinic for sexually transmitted diseases over a three-year period to investigate the association between genital yeast infections and sexually transmitted diseases (STDs).

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