Yeast infection

Yeast infection is a term usually referring to a candidiasis infection.

Candida albicans

There are over 20 species of Candida yeasts that can cause infection in humans, the most common of which is Candida albicans. Candida yeasts normally reside in the intestinal tract and can be found on mucous membranes and skin without causing infection; however, overgrowth of these organisms can cause symptoms to develop. Symptoms of candidiasis vary depending on the area of the body that is infected.

Thrush

Candidiasis that develops in the mouth or throat is called “thrush” or oropharyngeal candidiasis.

Vaginal yeast infection

Candidiasis in the vagina is commonly referred to as a “yeast infection.”

Invasive candidiasis

Invasive candidiasis occurs when Candida species enter the bloodstream and spread throughout the body.

Types of candidiasis

• Candida infections of the mouth, throat, and esophagus
• Vaginal Candidiasis
• Invasive Candidiasis

Symptoms of vaginal thrush

Symptoms you may experience if you develop vaginal thrush include: 

• vaginal discomfort – itching or burning
• a thick, white discharge with a ‘cottage cheese’ appearance and yeasty smell
• redness or swelling of the vagina or vulva
• stinging or burning while urinating or during sex
• splits in the genital skin.

Diagnosis of vaginal thrush

To make a diagnosis of vaginal thrush, your GP will need to: 

• take a detailed history of your symptoms 
• examine your genitals
• take a swab from the affected area.

Thrush is not sexually transmitted

Vaginal thrush is not a sexually transmissible infection (STI). It is caused by an overgrowth of the yeast Candida albicans  which is normally found on the genital area. This overgrowth may occur due to: 

• antibiotic use
• oral contraceptive use
• diabetes
• pregnancy
• menstrual cycle changes
• general illnesses like diabetes, iron deficiency and immune system disorders
• associated vulval skin conditions, such as eczema.

Sometimes, the reason for candida overgrowth cannot be identified.

Treatment for vaginal thrush

Treatment aims to reduce the number of yeasts so they no longer cause symptoms. Options that are available from your local pharmacist without a script include: 

• antifungal creams or vaginal pessaries (tablets) – these are put inside the vagina with a special applicator and are used from one to six days, depending on the instructions. Occasionally a second course of treatment is required. Repeated topical treatments (applied to the skin) may occasionally cause skin irritation

• oral tablets – these are called fluconazole and are designed to be swallowed. This treatment is more expensive than other options and is not recommended for pregnant women or as a ‘first line’ treatment. If you are on other medications or are pregnant, consult with your doctor or pharmacist before taking fluconazole.

Sometimes symptoms only last for a short time (for example, the week before your period) and treatment is not necessary. 

Prevention of vaginal thrush

To help prevent vaginal thrush: 

• Wipe your bottom from front to back after going to the toilet. This will prevent the spread of Candida albicansfrom the anus to the vagina.
• Avoid using soap to wash the genital area. Soap substitutes can be used. Sorbolene (with or without glycerine) is probably the cheapest and is very effective. 
• Avoid using antiseptics, douches or perfumed sprays in the genital area.
• Avoid using perfumed toilet papers and menstrual products.
• Avoid wearing tight-fitting pants and synthetic underwear.
• Consider changing your clothes-washing detergent and don’t use fabric softeners.

Vaginal thrush and sex

You can still have sex when you have vaginal thrush. However, it can be uncomfortable and you may experience a burning sensation during or after sex. Use plenty of lubricant to protect your skin. 

Thrush is not an STI, but male partners can sometimes get redness and irritation after sex.

The treatment for thrush can weaken condoms, so apply the treatments after you have had sex if you are using condoms. 

Ruling out other vaginal conditions

A number of other vaginal conditions result in symptoms that are similar to those of thrush. See your doctor if you: 

• are not sure if you have thrush
• have had several episodes of thrush
• have had recent unprotected sex with a new partner
• have pain in your pelvic area or abnormal bleeding
• treated yourself with a thrush treatment and your symptoms haven’t gone away.

Management of recurrent thrush

If you experience repeated episodes of thrush, it is recommended that you see your GP to confirm that it is thrush and that you don’t have an STI. Your GP can check for the presence of other skin conditions that may have similar symptoms and exclude other conditions that can cause thrush (such as diabetes). 

Any factor contributing to the overgrowth of Candida albicans should be identified and managed. If no contributing factors are found, a course of preventative treatment may be recommended. 

There is no evidence to support the treatment of male partners of women who experience thrush. Thrush outbreaks, while uncomfortable, do not cause any long-term health issues. There is also no clear evidence that dietary changes prevent thrush, but the research is limited.

Frequently asked questions

Most women will get a vaginal yeast infection at some point in their life. Symptoms of vaginal yeast infections include burning, itching, and thick, white discharge.

Candidiasis is an infection caused by a yeast (a type of fungus) called Candida. Candida normally lives inside the body (in places such as the mouth, throat, gut, and vagina) and on skin without causing any problems. Sometimes Candida can multiply and cause an infection if the environment inside the vagina changes in a way that encourages its growth. Candidiasis in the vagina is commonly called a “vaginal yeast infection.” Other names for this infection are “vaginal candidiasis,” “vulvovaginal candidiasis,” or “candidal vaginitis.”

 Symptoms of vaginal yeast infections

The symptoms of vaginal candidiasis include:^1,2

• Vaginal itching or soreness
• Pain during sexual intercourse
• Pain or discomfort when urinating
• Abnormal vaginal discharge

Although most vaginal candidiasis is mild, some women can develop severe infections involving redness, swelling, and cracks in the wall of the vagina.

FAQs

Who gets vaginal candidiasis?

Vaginal candidiasis is common, though more research is needed to understand how many women are affected. Women who are more likely to get vaginal candidiasis include those who:

• Are pregnant
• Use hormonal contraceptives (for example, birth control pills)
• Have diabetes
• Have a weakened immune system (for example, due to HIV infection or medicines that weaken the immune system, such as steroids and chemotherapy)
• Are taking or have recently taken antibiotics

 How can I prevent vaginal candidiasis?

Wearing cotton underwear might help reduce the chances of getting a yeast infection. Because taking antibiotics can lead to vaginal candidiasis, take these medicines only when prescribed and exactly as your healthcare provider tells you.

 Sources

Candida normally lives inside the body (in places such as the mouth, throat, gut, and vagina) and on skin without causing any problems. Scientists estimate that about 20% of women normally have Candida in the vagina without having any symptoms. Sometimes, Candida can multiply and cause an infection if the environment inside the vagina changes in a way that encourages its growth. This can happen because of hormones, medicines, or changes in the immune system.

Can I get a yeast infection from having sex?

Yes. A yeast infection is not considered an STI, because you can get a yeast infection without having sex. But you can get a yeast infection from your sexual partner. Condoms may help prevent getting or passing yeast infections through vaginal, oral, or anal sex.

Is it safe to use over-the-counter medicines for yeast infections?

Yes, but always talk with your doctor or nurse before treating yourself for a vaginal yeast infection. This is because:

• You may be trying to treat an infection that is not a yeast infection. Studies show that two out of three women who buy yeast infection medicine don't really have a yeast infection. Instead, they may have an STI or bacterial vaginosis (BV). STIs and BV require different treatments than yeast infections and, if left untreated, can cause serious health problems.
• Using treatment when you do not actually have a yeast infection can cause your body to become resistant to the yeast infection medicine. This can make actual yeast infections harder to treat in the future.
• Some yeast infection medicine may weaken condoms and diaphragms, increasing your chance of getting pregnant or an STI when you have sex. Talk to your doctor or nurse about what is best for you, and always read and follow the directions on the medicine carefully.

How do I treat a yeast infection if I'm pregnant?

During pregnancy, it's safe to treat a yeast infection with vaginal creams or suppositories that contain miconazole or clotrimazole.

Do not take the oral fluconazole tablet to treat a yeast infection during pregnancy. It may cause birth defects.

Can I get a yeast infection from breastfeeding?

Yes. Yeast infections can happen on your nipples or in your breast (commonly called "thrush") from breastfeeding. Yeast thrive on milk and moisture. A yeast infection you get while breastfeeding is different from a vaginal yeast infection. However, it is caused by an overgrowth of the same fungus.

Symptoms of thrush during breastfeeding include:

• Sore nipples that last more than a few days, especially after several weeks of pain-free breastfeeding
• Flaky, shiny, itchy, or cracked nipples
• Deep pink and blistered nipples
• Achy breast
• Shooting pain in the breast during or after feedings

If you have any of these signs or symptoms or think your baby might have thrush in his or her mouth, call your doctor. Learn more about thrush in our Breastfeeding section.

If I have a yeast infection, does my sexual partner need to be treated?

Maybe. Yeast infections are not STIs. But it is possible to pass yeast infections to your partner during vaginal, oral, or anal sex.

• If your partner is a man, the risk of infection is low. About 15% of men get an itchy rash on the penis if they have unprotected sex with a woman who has a yeast infection. If this happens to your partner, he should see a doctor. Men who haven't been circumcised and men with diabetes are at higher risk.
• If your partner is a woman, she may be at risk. She should be tested and treated if she has any symptoms.

How can I prevent a yeast infection?

You can take steps to lower your risk of getting yeast infections:

• Do not douche. Douching removes some of the normal bacteria in the vagina that protects you from infection.
• Do not use scented feminine products, including bubble bath, sprays, pads, and tampons.
• Change tampons, pads, and panty liners often.
• Do not wear tight underwear, pantyhose, pants, or jeans. These can increase body heat and moisture in your genital area.
• Wear underwear with a cotton crotch. Cotton underwear helps keep you dry and doesn't hold in warmth and moisture.
• Change out of wet swimsuits and workout clothes as soon as you can.
• After using the bathroom, always wipe from front to back.
• Avoid hot tubs and very hot baths.
• If you have diabetes, be sure your blood sugar is under control.

Does yogurt prevent or treat yeast infections?

Maybe. Studies suggest that eating eight ounces of yogurt with "live cultures" daily or taking Lactobacillus acidophilus capsules can help prevent infection.

But, more research still needs to be done to say for sure if yogurt with Lactobacillus or other probiotics can prevent or treat vaginal yeast infections. If you think you have a yeast infection, see your doctor or nurse to make sure before taking any over-the-counter medicine.

What should I do if I get repeat yeast infections?

If you get four or more yeast infections in a year, talk to your doctor or nurse.

About 5% of women get four or more vaginal yeast infections in one year. This is called recurrent vulvovaginal candidiasis (RVVC). RVVC is more common in women with diabetes or weak immune systems, such as with HIV, but it can also happen in otherwise healthy women.

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