The Facts About Yeast Infections

A yeast infection is a fungal infection that causes irritation and intense itchiness of the tissues at the vaginal opening, as well as producing atypical discharges. The condition is very common, with up to three out of four women likely to be affected at some point in their life, most often during pregnancy or when having intercourse with a new partner.

Anytime people have an issue in their genital area, they may be embarrassed to talk about it, and therefore may not always seek medical help. Fortunately, there are over-the-counter (OTC) medicines that effectively treat these infections without a trip to the doctor.

The science of yeast infections

The fungus Candida is responsible for most vaginal yeast infections. Simply put, a fungal overgrowth causes the signs and symptoms of a yeast infection.

Overgrowth of yeast can result from:

• Antibiotic use, which causes an imbalance in the natural vaginal flora
• Pregnancy
• Uncontrolled diabetes
• An impaired immune system
• Oral contraceptives or hormone therapy

Candida albicans is the most common type of fungus to cause yeast infections, although, rarely, they also can be caused by other types of Candida: When this happens, they can be more difficult to treat and generally need more aggressive therapies, prescribed by a medical professional.

Yeast infections directly affect the vulva, which is the outer part of the female genitalia. The vulva includes the opening of the vagina, the labia majora (outer lips), the labia minora (inner lips) and the clitoris. A healthy vagina has a small number of yeast cells and many bacteria, the most common of which, Lactobacillus acidophilus, helps keep other organisms, like yeast, under control. When something happens to change the balance of these organisms, too much yeast can grow and cause symptoms.

Causes of vaginal yeast infections

Even though yeast infections are common, the stigma around genital health keeps many people in the dark when it comes to causes and treatments. More than half of young women say they don't know how to deal with a yeast infection, and two out of three women don't know it can be cured with an OTC treatment.

Planned Parenthood identifies the six most common causes of yeast infections:

1. Normal changes in hormone levels (like those that occur during your menstrual cycle or from taking birth control pills)
2. Antibiotics, cortisone and other drugs
3. Pregnancy
4. Diabetes
5. A weak immune system
6. A natural reaction to another person's genital chemistry

But let's be clear, a yeast infection is not a sexually transmitted infection (STI) or disease (STD): It isn't contagious, and it can't spread to another person during sex. Contrary to popular belief, using a laptop does not cause a yeast infection, but if you have something hot on your lap and it causes you to perspire, you may well be creating the damp environment ideal for the overgrowth of yeast.

Symptoms and treatment

Yeast infection symptoms can range from mild to moderate, such as:

• Itching and irritation in the vagina and vulva
• A burning sensation, especially during intercourse or while urinating
• Redness and swelling of the vulva
• Vaginal pain and soreness
• Vaginal rash
• Thick, white, odorless vaginal discharge with a cottage-cheese-like appearance
• Watery vaginal discharge

For mild to moderate symptoms and infrequent episodes, all the above symptoms can be treated with over-the-counter treatments, such as:

Vaginal tablets and suppositories: The most commonly used treatment—a leading brand name is Monistat—comes in one-, three- and seven-day formulations. The one-day product is a high-dose, one-time-use product. Some women who are sensitive to the ingredients in the one-day formulation may prefer the regular-strength three-day option. The seven-day option is recommended for pregnant women and those with diabetes.

Both the tablets and the suppositories must be placed into your vagina and then allowed to dissolve. They often come packaged with a plastic "inserter" that helps you get the medication to the right place.

One benefit of tablets and suppositories is that they are less messy than a vaginal cream and less likely to ooze out during the day. Another benefit is that you use the doses for fewer days, and get symptom relief sooner. It is preferred you use any insertions at night, to prevent leakage and loss of medication.

Vaginal creams: Creams should be inserted inside the vagina to kill off the yeast causing the infection. Monistat is one of the most popular brands. These products usually come with an applicator that measures the right dose.

Vaginal creams can be messy and might leak out during the day, so you may want to use them before you go to bed.

Note that some of these products may come as a cream that you put on the opening of the vagina and surrounding tissue, and not actually inside the vagina. This type of cream may ease itching and treat skin tissues but does not treat the yeast infection itself. Make sure you do some research and, better still, ask for recommendations from your friends and family.

When using suppositories or creams, follow the package directions exactly, and complete the whole treatment, even if your symptoms seem to resolve after a shorter period of time.

Talk to your pharmacist before taking an antifungal medication, especially if you are already taking other prescribed medications. Be sure to see your doctor if the symptoms don't clear up once the over-the-counter treatment is concluded.

Home remedies for vaginal yeast infections

Olivia P. Myrick, M.D., a clinical assistant professor with the Department of Obstetrics and Gynecology at New York University Langone, has endorsed two scientifically vetted home remedies for infections: probiotics and boric acid.

Probiotics, specifically lactobacillus, supply the vagina with healthy bacteria. This may help treat yeast infections and improve vaginal health by restoring the balance of bacteria in the vagina.

You can easily integrate probiotics into your diet by eating more lactobacillus-rich foods such as kombucha, sauerkraut and miso. Probiotic supplements that contain at least 1 billion colony-forming units (CFUs) may also be helpful for improving vaginal health.

Probiotic supplements such as acidophilus tablets, taken twice daily, can increase healthy bacteria in the vagina. Women who have recurrent yeast or vaginal infections should speak to their primary care physician about taking tablets daily as they may help prevent future infections.

Boric acid is a powdery substance with antifungal and antiviral properties, and is especially effective at treating Candida albicans. To treat yeast infections, place about 600 mg of boric acid into suppository capsules—these are cone-shaped pills that dissolve in your body—that can then be inserted into the vagina. Standard treatment requires using a pill once a day before bed for seven days straight.

You should be aware that there may be some side effects of using boric acid. Some people have complained of vaginal burning, watery discharge and vaginal reddening. Pregnant women should not take boric acid suppositories, as the substance is toxic to a fetus.

Some people believe garlic can be used to treat yeast infections by inserting it into the vagina. This is not so. And just to be completely straightforward, inserting any foreign object in the vagina may cause further complications or even worsen an infection. There is no scientific proof that any use of garlic can cure a yeast infection.

Preventing vaginal yeast infections

Most women self-diagnose their yeast infections by vaginal itching and odorless white discharge. The good news is that there is much you can do to prevent these infections from occurring in the first place:

• Wear breathable underwear, preferably cotton. It doesn't hold onto heat or moisture and keeps you dry.
• Keep things loose. Avoid tight jeans, skirts, underwear, leggings, tights, etc., whenever possible.
• Don't douche. Feminine hygiene products, including those found in douches, can disrupt the balance of bacteria in your vagina by removing the good bacteria you need to fight infections.
• Skip scented products. Opt instead for fragrance-free bubble baths, soaps, sprays, tampons and pads. Think nondeodorant. This advice also applies to hygiene products and soaps.
• Avoid hot tubs.
• Change out of wet clothes. Don't sit in a wet bathing suit after you go swimming or damp workout gear after the gym.
• Wipe from front to back after using the toilet.
• Frequently change tampons, pads and panty liners.
• Manage your diabetes.
• Use antibiotics only when you have to.

Planned Parenthood advises not to have vaginal or oral sex until you've finished treatment and the infection has gone away.

Yeast infections are easily treatable. Find out which medications work best for you and always have them on hand, so you can start taking them as soon as you detect an infection. Make an appointment to see your doctor if the first round of over-the-counter medications doesn't work or if your infections start to occur frequently as there could be a mixed infection—that is, it's more than just yeast that's the problem—or perhaps the infection is caused by a species of yeast that is resistant to OTC antifungal medicines.