What is a yeast infection – vaginal yeast infection?
Yeast infections in the genital area are caused by the fungus (Candida albicans). This fungus normally lives on our skin or in our intestines as a saprophyte and does not cause problems.
However, under certain changes in local conditions—as we will describe below—it can overgrow and cause a yeast infection, known as candidiasis. Candidiasis is not usually sexually transmitted, although in some cases it can be. Both the female and male genital organs can be affected by various types of fungi.
What are the main symptoms?
The most common symptoms in women (vaginal yeast infection) are:
- Pain, itching, irritation, and inflammation of the vulva and vagina
- Heavy vaginal discharge
- Swelling and redness of the vulva
- The inner surface of the vagina may be covered with white discharge
- The skin in the area may be sensitive and show small cracks or abrasions
Symptoms in men (penile yeast infection)
Men, unlike women, usually do not show significant symptoms. However, some possible symptoms include:
- Occasionally, both the glans and the foreskin may become red, inflamed, and painful. These symptoms often worsen after sexual intercourse.
- The tip of the penis may develop small sores or be covered with a white coating.
- Discharge from the penis may also be present.
What causes it, and what are the reasons?
Although yeast infections are more common in the summer — since the increased temperature combined with moisture in the vaginal area and the alkaline environment created by sweat promote fungal growth — this does not mean that we are not at risk in the winter.
During the summer, microbes may “hide” in sand, seawater, and swimming pools, but in winter, there are also several factors that can lead to a yeast infection.
Such as: tight pants and synthetic underwear.
Note also
In our time, genital yeast infections are becoming increasingly common. The reasons for their appearance include:
- Both the widespread and ever-increasing use of antibiotics and, in some women, the use of birth control pills.
- Other medications that can also affect the environment of the genital area — especially the female vagina — may promote the development of yeast infections.
What should you do to avoid vaginal yeast infections?
- Follow basic hygiene rules.
- Avoid contact with public/shared toilets.
- After bathing or washing the area, dry it very carefully.
- Choose underwear made of natural fibers (cotton, linen, silk). Synthetic underwear promotes the growth of pathogenic microorganisms.
- Avoid very tight pants.
- Do not use panty liners unless necessary.
- Take a shower after sexual intercourse.
How is the diagnosis made?
The diagnosis of a yeast infection is based primarily on the patient’s medical history, clinical presentation, and additional tests. The direct collection of samples from the vagina, vulva, or penis and their examination can confirm a fungal infection. For this reason, it is very useful to send samples promptly to a microbiology laboratory for cultures.
What is the appropriate treatment?
Vaginal yeast infections in women
Treatment in women is based on vaginal creams or suppositories with antifungal action, such as miconazole, terconazole, tioconazole or clotrimazole, or on a fluconazole tablet taken by mouth. For daily hygiene, lukewarm water or a mild, fragrance-free cleanser on the external area and thorough drying are enough. Antiseptic products and vaginal douches do not help. On the contrary, they disrupt the normal vaginal flora and may encourage recurrences.
In men – Penile yeast infection
In men, treatment is needed only when there are symptoms, such as redness or itching on the glans. Washing with plain water, drying well and applying an antifungal cream are enough. Treating a partner who has no symptoms does not reduce recurrences in the woman.
Some important points you should know
- In certain groups of patients, it may be necessary to administer oral antifungal medications, such as ketoconazole, fluconazole, or itraconazole.
- Birth control pills do not need to be stopped for a simple yeast infection. Only in selected women with frequent recurrences that seem to be linked in time to the pill can a change of product or contraceptive method be discussed with the doctor.
- When you take antibiotics, preventive vitamins are not needed: there is no evidence that they prevent yeast infections. Probiotics are safe, but the evidence on whether they reduce episodes remains limited. If you have had a yeast infection during a previous course of antibiotics, ask your doctor whether you need a preventive antifungal.
Vaginal yeast infections and fertility: Is there an impact?
Yeast infections do not directly affect a woman's fertility. Of course, the discomfort can make sex difficult or even prevent it. However, it should be stressed that similar symptoms can be caused by other types of infection, such as bacterial vaginitis, chlamydia, gonorrhea, etc. In these cases, the vaginal environment becomes hostile to sperm, and conception may be hindered.
Therefore, it is wise that diagnosis and treatment be accurate rather than empirical, in order to ensure the long-term health of the female reproductive system.
In short, you shouldn’t neglect your appointment with your gynecologist .
What a vaginal yeast infection looks like
On examination, a vaginal yeast infection has a characteristic appearance: white, thick discharge resembling curdled milk or cottage cheese, stuck to the vaginal walls, with redness and swelling of the labia. There are often small fissures from scratching. The odor is mild or absent, unlike bacterial vaginosis. Photos online can help, but they are not enough for a diagnosis, because a similar picture can be caused by vaginitis, herpes or dermatitis. If symptoms keep coming back or do not improve with treatment, an examination and a culture of vaginal fluid are needed.
Uncomplicated or complicated vaginal yeast infection: why it matters
Guidelines divide vaginal yeast infections into two categories. The category determines how long treatment will last and whether tests are needed.
Uncomplicated yeast infection
- sporadic episodes, fewer than three a year,
- mild or moderate symptoms,
- most likely caused by Candida albicans,
- in a woman without diabetes, immunosuppression or pregnancy.
It is treated with a short course, topical or oral, and usually does not require a culture.
Complicated yeast infection
- severe symptoms, with extensive redness, swelling and fissures,
- repeated episodes,
- a yeast species other than Candida albicans,
- pregnancy, uncontrolled diabetes or a weakened immune system.
Here, a culture that identifies the yeast species and a longer course of treatment, set by the doctor, are needed.
When the yeast is not Candida albicans
In a small percentage of women, mainly those with recurrences, the yeast responsible is a different species, most often Candida glabrata. These species:
- often cause milder symptoms, with burning more than itching,
- respond less well to the usual antifungal medications,
- can only be identified with a culture.
Their treatment is different and may include special vaginal preparations, always under medical guidance. That is why, if the yeast infection “will not go away” with standard medications, do not keep switching products: ask for a culture.
Recurrent yeast infection: the treatment plan
When episodes reach three to four a year, the approach changes. The goal is no longer just to clear the current episode, but to stop the recurrences.
- Confirmation: a culture at the time of symptoms, to confirm that it is a yeast infection and which species is involved.
- Looking for the cause: checking blood sugar, medications, hormonal factors and hygiene habits.
- Induction therapy: a more intensive course to clear the infection completely.
- Maintenance therapy: a low dose of antifungal, usually once a week, for about six months.
This regimen controls episodes in most women for as long as it lasts. After it is stopped, some women will have a recurrence again, so the plan is reassessed.
Vaginal suppository, cream or pill: how we choose yeast infection treatment
For an uncomplicated yeast infection, topical treatments and the oral pill are similarly effective. The choice depends on your situation and your preference.
- Vaginal suppositories or creams: they act locally, with minimal absorption into the body. They are the first choice during pregnancy. The cream also soothes the external skin of the vulva.
- Oral pill: more convenient, often a single dose. It is not given during pregnancy and interacts with certain medications, such as some anticoagulants and cholesterol drugs, so tell your doctor about anything else you are taking.
Practical tips for topical treatments
- Insert the suppository in the evening, before bed, so it stays in the vagina longer.
- The oily ingredients in creams can weaken the latex of condoms and diaphragms.
- A mild burning sensation in the first few days is common. If the irritation gets worse, stop and let your doctor know.
Vaginal yeast infections in diabetes, pregnancy and menopause
Diabetes mellitus
High sugar levels in body fluids “feed” yeast. Better diabetes control significantly reduces recurrences. Some newer diabetes medications, the gliflozins, increase glucose in the urine and are linked to more frequent genital yeast infections. If you recently started such a medication and are having episodes, tell your doctor and do not stop the treatment on your own.
Pregnancy
Higher estrogen levels favor yeast. Treatment is with topical preparations, usually for seven days, because short courses fail more often in pregnancy. If you also have gestational diabetes, good blood sugar control helps here too.
Menopause
After menopause yeast infections become less common, because low estrogen does not favor their growth. Itching and burning at this age are more often due to atrophy or a skin condition. The exception is women who take hormone therapy or have diabetes.
Myths about vaginal yeast infections
- “Yogurt in the vagina cures yeast infections.” There is no reliable evidence, and it may cause irritation or delay proper treatment.
- “Garlic or essential oils are a natural solution.” They can cause chemical burns and dermatitis on the sensitive mucosa.
- “You catch yeast infections from the pool.” Yeast already lives in our bodies. What triggers an episode is hours of moisture from a wet swimsuit, not the pool water.
- “Any itching with discharge is a yeast infection.” Many women who treat themselves turn out to have a different cause. A diagnosis at the office saves time.
Yeast infection after antibiotics: can it be prevented?
Many women know from experience that every course of antibiotics brings a yeast infection with it. If you are one of them, tell the doctor who prescribes the antibiotic. For women with this history, the gynecologist may suggest preventive antifungal treatment during or at the end of the antibiotic course.
Oral probiotics have not been proven reliable for prevention. They do no harm, but do not rely on them alone. And never stop a course of antibiotics early because you are afraid of a yeast infection.
Yeast infections in girls before puberty
Before the first period, the vagina has low estrogen and a neutral pH, an environment that does not favor yeast. That is why vaginal yeast infections are unusual in young girls. Exceptions are babies in diapers, children who recently took antibiotics and children with diabetes.
Itching and redness at this age are usually caused by irritation from soaps, bubble baths, tight clothing or poor wiping technique, and by pinworms. Do not use antifungal creams without an examination. The pediatrician or gynecologist will assess the cause.
For a personalized assessment of your case, book an appointment with Dr. Panagiotis Polyzos at his office in Athens or Volos.
Frequently Asked Questions
Are vaginal yeast infections contagious?
A yeast infection is not considered a sexually transmitted disease. A partner needs treatment only if he has symptoms, such as redness or itching.
How many days does it take to clear with treatment?
Symptoms usually subside within 2 to 3 days, and the infection clears within a week. Complete the treatment even if you feel better sooner.
Why do yeast infections keep coming back?
Common causes are repeated antibiotic use, uncontrolled diabetes, pregnancy, tight synthetic clothing and overuse of cleansing products. Four or more episodes a year require a culture and a longer course of treatment.
Are yeast infections dangerous during pregnancy?
They are very common and do not harm the fetus. They are treated with topical vaginal preparations. Oral pills are avoided unless your doctor recommends them.
How do I tell a yeast infection apart from other vaginitis?
Yeast causes white, thick discharge without a strong odor, along with intense itching. Grayish discharge with a fishy smell points to bacterial vaginosis. See the guide on vaginitis.
Can I continue treatment if my period starts?
The cream or the oral pill can be continued as usual. Vaginal suppositories can also be continued, although the flow may reduce the medication's contact with the vagina. Do not use tampons while on topical treatment.
Is sex allowed during treatment?
It is better to wait until the symptoms subside. Friction further irritates the inflamed mucosa, and creams can weaken latex condoms.
Do I need a culture every time I have a yeast infection?
Not for a sporadic, typical episode diagnosed by a doctor. A culture is needed when episodes recur, when treatment does not work or when the symptoms are unusual.
Can a vaginal yeast infection pass to the baby during delivery?
It can be passed on and cause oral thrush in the newborn, which is usually mild and easily treated. Treating symptomatic episodes during pregnancy reduces this likelihood.
