A yeast infection is a condition caused by the fungus Candida albicans. It is also called candidiasis. The yeast may infect the vagina, mouth, or other moist areas on the skin.

How does Yeast infection occur?

Yeast organisms are normally present in the rectal and vaginal areas. Yeast causes trouble only when there are too many of them. Sometimes the yeast grows (multiplies) quickly and causes an infection.

There are several situations in which the yeast may multiply. Sometimes, if you are taking antibiotics, it can kill the bacteria that normally keep yeast levels down. Conditions that cause hormonal changes, such as menopause, pregnancy, or taking birth control pills, may also cause the yeast to grow. Yeast infections are often associated with diabetes, especially when the blood sugar level is too high. Recurring or stubborn cases may sometimes be an early sign of diabetes. In some cases, yeast infections that don’t go away are an early sign of HIV infection. Drugs that reduce the body’s defenses, such as drugs used to treat AIDS, also allow the yeast to grow and spread.

A yeast infection is usually is not spread by sexual intercourse.

What are Yeast infection symptoms?

In women, symptoms may include:

•  a discharge from the vagina that is thick and white and looks like paste or cottage cheese
•  itching
•  redness of the outer part of the vagina (the vulva)
•  a burning feeling when you urinate.

Some women have no symptoms.

In men, the yeast can cause swelling and redness on the penis and foreskin. Yeast infections of the penis are more common when the penis is uncircumcised.

If the mouth is infected, the lining of the mouth is often red and sore. Sometimes the yeast causes white spots and patches on the tongue and cheek lining. This is called “thrush.” The yeast can cause creamy-yellow, raised sores on the mouth.

On the skin a yeast infection produces an itchy red rash. Often the rash is a red patch with small red bumps around it.

How is Yeast infection diagnosed?

Your health care provider will ask about your symptoms and examine you. Your provider may collect samples of cells from places you are having symptoms, such as the mouth or vagina. A few cells scraped from a skin rash may also show yeast when viewed under a microscope.

How is Yeast infection treated?

Medicines are available as suppositories, creams, and tablets to be taken by mouth. Some medicines you can buy without a prescription, such as miconazole nitrate (Monistat-7) and clotrimazole (Gyne-Lotrimin, Mycelex-7, and FemCare). You should see your health care provider before you use any of these nonprescription products, especially if:

•  you have never had a yeast infection
•  there is any doubt that yeast is the cause of your symptoms
•  you are sexually active.

Suppository tablets

Your provider may recommend a suppository. A suppository is a tablet that is pushed up into the vagina each evening just before you go to bed. You will do this for 3 or 7 nights, depending on the type of suppository. Your body temperature will melt the suppository, so you may want to wear a sanitary pad to protect your clothing. Continue using the suppositories even if your menstrual period occurs during this time.

Vaginal cream

Sometimes it is necessary to use vaginal cream instead of or in addition to vaginal suppositories. For example, it may be necessary if the outside part of your vagina is red, swollen, and itchy. The vaginal cream may be applied 2 times a day for 4 to 7 days, depending on how bad your symptoms are.

Other medicines

If you have tried one of the nonprescription medicines and it has not worked for you, your provider may prescribe a medicine such as an antifungal medicine taken by mouth.

Treatment for yeast infections will not help or cure sexually transmitted infections such as chlamydia, gonorrhea, or trichomonas.

How long will Yeast infection effects last?

With proper treatment, the infection usually clears up in a few days to a week.

How can I take care of myself?

If you have a vaginal yeast infection, follow these guidelines:

1.  Follow the full treatment prescribed by your health care provider.
2.  Avoid sexual intercourse until the infection is gone.
3.  After urinating, wipe gently to avoid irritation.
4.  Use unscented soaps.
5.  Avoid using douches and other chemicals, such as bubble bath or hygiene spray, in the vaginal area unless recommended by your health care provider.
6.  Take a shower instead of a bath. Pat the genital area dry.
7.  Wear cotton underwear to allow ventilation and to keep the area drier.
8.  Lose weight if you are obese (20% over normal weight).
9.  If you are diabetic, maintain a normal blood sugar.

If you have been diagnosed previously with a yeast infection, try using a nonprescription medicine the next time you have a yeast infection. If your symptoms do not improve, then you should see your health care provider.

When should I call my health care provider?

See your health care provider promptly if you have repeated yeast infections within a 2-month period or a yeast infection that persists despite treatment. Let your provider help you be certain that yeast infection is the problem and, if it is, to determine why it’s not responding to treatment.

What can be done to prevent a yeast infection?

To prevent yeast infection follow these guidelines:

1.  Keep moist areas of the body cool and dry.
2.  Avoid wearing a wet bathing suit or damp clothing for long periods of time.
3.  Avoid frequent douching.
4.  Avoid bubble baths (scented or unscented).
5.  Avoid wearing underwear made from nylon or other nonventilating materials.
6.  Avoid wearing tight pantyhose or tight pants.
7.  Add yogurt to your diet.
8.  Avoid frequent or prolonged use of oral antibiotics if possible.

Candida, which is a type of yeast or fungus, is normally found in the human body. When things are in balance it usually causes no problems. But, when the internal environment is offset, this yeast can proliferate. Symptoms include:

• thick, white, odorless vaginal discharge (often described as resembling cottage cheese).
• vaginal itching and burning.
• pain or discomfort with urination or sexual intercourse.
• vulvar redness or irritation.

About 80 percent of yeast infections are caused by a specific species of Candida, called Candida albicans. The remaining twenty percent of yeast infections are caused by other types of Candida. These infections may require treatment with special medications that are different from the usual treatment. While yeast infections are not considered sexually transmitted diseases (STDs), they can still be transmitted between partners. Try to avoid intercourse until you have completed treatment and the symptoms have subsided.

Antifungal medication
Since yeast is a fungus, treatment involves an anti-fungal medication. Several vaginal creams or suppositories are available over the counter. Sometimes an oral medication is prescribed by a physician, if the condition is more severe or not responding to initial treatment. Treatment just for the irritation and itching will not cure the infection. If using an oral medication, you may also need a topical vaginal cream to soothe the discomfort until the infection has been properly treated. If using vaginal creams or suppositories, don’t use a tampon. They can absorb the medication. Use sanitary pads instead.

While nonprescription, over-the-counter medications for yeast infections are readily available, be sure that you do indeed have a yeast infection before using them. As described below, other vaginal infections can have symptoms similar to those associated with yeast infections. If these infections are not treated properly, they can have serious consequences. If this is your first infection, be sure to have your doctor check the discharge under a microscope to make an accurate diagnosis. Symptoms such as pain or burning with urination could indicate a urinary tract infection, which would require prescription antibiotics. If you have recurrent yeast infections, do not continue to self-medicate: Go to your healthcare provider.
Self-diagnosis of a yeast infection may not be as obvious as one would think. A 1997 study at Temple University Medical School reported in the July issue of Obstetrics and Gynecology, found that only 28 percent of female participants presenting with recurrent yeast infections had candidiasis. Eleven percent actually had bacterial vaginosis (BV, see below), a more serious condition. This study also reported that 15 percent of these women had irritant dermatitis , a skin reaction from coming in contact with an irritating product or substance. This condition was exacerbated by using over-the-counter medications for a problem they did not have.

In a 1996 Israeli study, reported in the November/December issue of Archives of Family Medicine, researchers found that some women reporting a history of yeast infections and BV had instead contracted trichomoniasis, chlamydia, or herpes simplex.

Predisposing factors
Yeast feeds on glucose, which is the body’s form of sugar, so anything that increases the blood sugar or alters the hormonal balance that regulates blood sugar can encourage yeast to grow out of control. These conditions include:

• diabetes
• pregnancy, especially in the third trimester
• birth control pills
• steroids
• antibiotics
• immunocompromised states, such as with HIV infection

Prevention
To decrease your risk of a yeast infection, make the environment less favorable for its growth. Here are some tips:

• If you are diabetic, keep your blood sugar as close to normal as possible.
• Keep the genital area clean, cool, and dry.
• Avoid tight-fitting clothing that retains heat and traps moisture.
• Use white cotton underpants to allow for better air circulation and to decrease the risk of a dye-related irritation.
• Dry off well after a shower or swimming, using a cool hand-held hair dryer if needed.
• Change as soon as possible out of wet clothes, including bathing suits.
• After urinating, wipe from front to back: yeast can exist in the intestinal tract and be swept into the vagina, along with E. coli and other bacteria, when wiping from back to front.
• Avoid douching and using other irritants such as perfumed bath products and colored/scented toilet paper.