HealthTricks

Symptoms

The symptoms of vaginal yeast infection include:

- Vaginal itching that is often severe.
- Vaginal discharge that is usually white, thick, clumpy, and odorless.
- Red, irritated skin around the opening to the vagina (labia).
- Pain while urinating when urine touches irritated skin.
- Pain in the vagina during sexual intercourse.

Symptoms of a vaginal yeast infection are more likely to occur during the week before a menstrual period.

There are other conditions with similar symptoms, such as bacterial vaginosis or a sexually transmitted disease. Itching and redness of the vulva can also be caused by a reaction to vaginal products such as soap, bath oils, spermicidal jelly, or douches. If you are unfamiliar with your symptoms, see your doctor for an accurate diagnosis.

Treatment Overview

You have a number of treatment options for a vaginal yeast infection, including nonprescription vaginal medicine, prescription oral or vaginal medicine, or nonprescription vaginal boric acid capsules.

Only use nonprescription vaginal yeast infection treatment without a doctor’s diagnosis and advice if you:

- Are not pregnant.
- Are sure your symptoms are caused by a vaginal yeast infection. (In one study, only 1 out of 3 women who had self-diagnosed a simple vaginal yeast infection actually had one.2) If you have never been diagnosed with a vaginal yeast infection, see your doctor.
- Have not been exposed to a sexually transmitted disease (STD), which would require a medical examination.
- Are not having multiple, recurrent infections.
The risk of self-treatment is that your symptoms may be caused by another vaginal infection, such as a sexually transmitted disease, that requires different treatment. If you may have been exposed to an STD, it is best to discuss your symptoms with your doctor before using a nonprescription medicine. Your doctor may recommend testing for STDs if you have risk factors for these diseases.

Yeast infection during pregnancy

Vaginal yeast infections are common during pregnancy, likely caused by elevated estrogen levels. If you are pregnant, don’t assume you have a yeast infection until it is diagnosed, and don’t use nonprescription medicines without discussing your symptoms with your doctor.

Vaginal medicine is used to treat a vaginal yeast infection during pregnancy. If you are pregnant, do not use antifungal medication pills that you take by mouth. Also, do not use vaginal boric acid treatment.

Acute vaginal yeast infection

For the occasional yeast infection, you can use a nonprescription vaginal medicine without seeing your doctor first. Only use these medicines if you are certain that your symptoms are caused by a yeast infection. If you prefer, you can use a single-dose prescription oral tablet, a prescription vaginal tablet, or boric acid capsules. Vaginal treatments are applied at bedtime. Medicines are used for 1 to 7 days, depending on the type. All treatments cure vaginal yeast infection 80% to 90% of the time.3, 4

If you have HIV infection, your vaginal yeast infection treatment options are the same as those for women without HIV.4 But your treatment may take longer or need to be repeated.

Recurrent yeast infection

For a vaginal yeast infection that recurs within 2 months of treatment, or four times in 1 year (recurrent vaginal yeast infection), see your doctor. Further testing or a different treatment may be needed. If you have been using a nonprescription medicine for your vaginal symptoms, be sure to tell your doctor. This information could affect what treatment is recommended.

Recurrent vaginal yeast infection can be treated with prescription oral medicine (one or two doses), nonprescription vaginal medicine (7 to 14 days), or vaginal boric acid capsules (14 days), followed by less frequent suppressive or maintenance therapy over 6 months to 1 year to prevent reinfection.5, 3 About 30% to 40% of women develop another yeast infection after stopping maintenance therapy.5

Although both men and women can get yeast infections, most doctors do not treat sex partners. A vaginal yeast infection is not a sexually transmitted disease (STD). After having unprotected sex with a man who has a yeast infection, you may have more than the normal amount of yeast in your vagina. But if after having sex you develop a yeast infection that causes symptoms, it is most likely because other factors are also involved.

What To Think About

It is important to complete the entire recommended treatment to cure a yeast infection.

Studies have shown that vaginal infections caused by types of yeast other than Candida albicans may be more difficult to cure with standard antifungal medicine. For treatment-resistant infections, a culture of vaginal discharge is done to identify the type of yeast causing the infection.

Boric acid is usually effective for treating Candida albicans (C. albicans) infection, as well as non–C. albicans yeast infections that don’t respond to antifungal medicine.5, 3

Women who take the anticoagulant medicine warfarin (such as Coumadin) and use a nonprescription vaginal yeast-fighting medicine, such as Monistat, may have increased bruising and abnormal bleeding. If you take warfarin, talk with your doctor before using a yeast-fighting medicine.

Sexual pain problems tend to go on for a lot longer than necessary because they are so commonly misdiagnosed as vaginal infections. And some experts say the situation is made worse by a more general trend toward overdiagnosing yeast infections.

Doctors frequently diagnose yeast infections without using a microscope, but an infection that looks like yeast with the naked eye could be desquamative vaginitis (a severe and rare form of vaginitis) or trichomoniasis. And doctors aren’t the only ones to blame. “Seventy percent of women who treat themselves for yeast infections don’t have them,” says Marjorie Green, MD, director of the Mount Auburn Female Sexual Medicine Center in Cambridge, Mass., and a clinical instructor at Harvard Medical School.

Another theory holds that a major cause of vulvodynia is excessive and improper use of anti-yeast medications.

If you have sexual pain, it’s important to consult your primary care physician or gynecologist first; if that doesn’t get you anywhere after a few visits, ask for a referral to a sexual medicine specialist. Or find one yourself by contacting the National Vulvodynia Association or a university hospital in your area.

Sexual health problems can be difficult to diagnose—even for the experts. “If it was easy, I wouldn’t need to spend an hour and 15 minutes [with new patients],” says Andrew Goldstein, MD, an associate professor at George Washington University. “This stuff is hard!”