Vaginal Yeast Infection

What is a yeast infection?

Yeast infections - often referred to as thrush - are a common vaginal infection that occurs primarily in women of reproductive age. It is caused by an imbalance in the microbiome of the vagina that allows the yeast (usually Candida albicans) to grow and cause an infection. This produces symptoms of itching, pain and whitish discharge. It is often treated with anti-fungal medications as well as a cream to soothe the symptoms.

Yeast infections are commonly caused by the Candida albicans fungus (50-60% of infections). Candida is normally found on the skin, but does not usually cause a problem, because it is kept under control by the bacteria and other substances that are naturally found on the skin. If something upsets this natural balance, i.e. taking antibiotics, the Candida fungi can grow too rapidly and lead to an infection.

Factors that can cause this imbalance are:

• Antibiotics
• Diabetes
• Hot and humid environments
• Tight-fitting clothing
• Obesity
• Diabetes
• Strenuous activity
• Compromised immune system
• Steroids
• Sexual contact
• Poor hygiene practices
• Douching
• Use of perfumed soaps

As mentioned previously, most yeast infections are caused by Candida albicans, which accounts for 50-60% of all yeast infections. However, other types of Candida can also lead to similar infections.

If you have a vaginal yeast infection, you may experience some of the following symptoms:

• Itching - especially around the entrance to the vagina and vulva
• Pain
• Burning
• Swelling
• Pain during sex
• Stinging sensation when urinating
• Thick white discharge
• Cracked skin

If you have had a yeast infection before, you will probably know when it returns, because the symptoms are very recognizable.

To diagnose a yeast infection, you will be asked about your symptoms. If it is still not clear if you have thrush a doctor may do a visual assessment of your vagina and a swab may be taken to check for other conditions such as STIs.

Various conditions can predispose you to vaginal yeast infections. These factors include:

• Diabetes: Poorly controlled diabetes can result in spikes in your blood sugar. Having higher blood sugar can create an environment in which the Candida fungus can flourish.
• Obesity: People with obesity often have deeper skin folds than people of a healthy weight. These skin folds can be harder to keep clean, but also can become moist as sweat is less able to evaporate from the skin. Warm, damp environments are the ideal circumstances for Candida to grow. In addition, people with obesity often also have diabetes, which further increases your risk of yeast infection.
• Pregnancy: During pregnancy, your hormones will fluctuate. These hormone changes can alter the acidity of the vagina, making an environment that is more suited to the Candida fungus.
• Compromised immune system: If you have a compromised immune system, your body is less able to fight infection, therefore you are more likely to get a yeast infection.
• Birth control pills: Oral contraceptive pills alter your hormone balance. This can have an effect upon the acidity of the environment. Changes in the acidity can make the vagina more hospitable to the Candida fungus.
• Chronic steroid use: Long-term use of steroids can weaken your immune system, making you more susceptible to all infections, including yeast infections.
• Antibiotics: Antibiotics can kill some of the bacteria that help to keep the Candida fungus under control.

Other factors that may contribute to a yeast infection are:

• Hot & humid climates: You are likely to sweat more in hot & humid environments and the sweat is more likely to cling to your skin. This can create an environment suited to the growth of the Candida fungus.
• Tight-fitting clothing: Loose clothing allows your skin to breathe, reducing a build of sweat and keeping your skin cooler. Candida thrives in warm moist environments, such as those created by tight-fitting clothing.
• Strenuous exercise: As you exercise, sweat accumulates on your skin. This can result in moist, warm areas forming which are the ideal environment for Candida fungus to grow. It is a good idea to shower, thoroughly dry yourself and change your clothes after exercise.
• Sexual contact: Sexual contact results in heat and moisture and increases your risk of getting a yeast infection. Sometimes your partner can experience symptoms if you have an active infection.
• Douching: Douching upsets the natural microbiome of the vagina, that helps to keep the Candida fungus in check.
• Poor hygiene: Candida thrives in warm, moist conditions. It is important that you wash the external labia/vulva regularly, ensure that you always dry yourself thoroughly and wear a fresh pair of underwear every day. This will help to prevent an overgrowth of Candida.
• Perfumed soaps: Perfumed soap products can kill bacteria in and around the vagina and alter the pH. Many of these bacteria are good for you and help to keep the Candida fungus under control.

If you have a yeast infection, a combination of treatments is often most effective: one treatment to soothe the symptoms, and another to treat the underlying infection.

Most women will be prescribed one of the following to treat the fungal infection:

• Clotrimazole suppositories
• Oral Fluconazole tablets
• Topical Clotrimazole cream to be applied to the affected area (usually vagina or vulva).  

Applying cold packs to the affected area can be an easy way to soothe your symptoms. You may sometimes be prescribed topical steroid creams to reduce inflammation or numbing agents to reduce painful symptoms.

It usually takes several days for symptoms to resolve and sometimes topical creams can make the symptoms worse before they improve.