Vaginal yeast infection

The vagina is a part of the female reproductive system. This is the muscular tube that connects the cervix (the lowest section of the uterus, or womb) to the vulva (the tissues where the vagina opens to the outside of the body). 

A vaginal yeast infection (vaginal candidiasis) is caused by an overgrowth of yeast called Candida. Yeast is a type of fungus. Candida normally lives in small amounts in the vagina and other parts of the body, such as the skin, mouth, and digestive tract. When it grows excessively, however, Candida can throw off the vagina’s natural balance of germs (known as the vaginal flora) and cause an infection.  

A yeast infection is also a type of vaginitis, which refers to irritation or inflammation of the vagina. (A vaginal infection caused by bacteria, called bacterial vaginosis, is another common type of vaginitis). A yeast infection is not considered a sexually transmitted infection (STI), though some infections may be spread through sexual contact.  

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There are two main types of vaginal yeast infections:   

• Uncomplicated yeast infections are caused by Candida albicans fungi and are usually mild. Most yeast infections are uncomplicated.   
• Complicated yeast infections refer to more severe infections that occur frequently, develop during pregnancy, are caused by a species of Candida other than Candida albicans, or are associated with other medical conditions, such as diabetes.   

Around 5 percent of people with vaginal yeast infections experience recurrent vulvovaginal candidiasis (RVVC), or four or more yeast infections within one year.  

Other types of yeast infections   

A vaginal yeast infection is a common type of infection caused by Candida yeast. But this yeast can grow excessively and cause infections elsewhere in the body. Other types of yeast infections include:  

• Candidiasis in the throat or mouth (thrush)  
• Candidiasis at the corners of the mouth (angular cheilitis, or perlèche)  
• Candidiasis in the esophagus   
• Candidiasis of the skin (cutaneous candidiasis)  
• Candidiasis in nail folds or cuticles (nail candidiasis, or candidal paronychia)  
• Candidiasis of the penis (penile candidiasis)  

Invasive candidiasis is a more serious infection that occurs when yeast infects the brain, kidneys, or bloodstream. It typically occurs in people who are sick and hospitalized. People who are generally healthy aren’t at risk for invasive candidiasis.  

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Symptoms of a vaginal yeast infection are typically mild and involve one or more of the following:   

• Itchiness, burning, swelling, or discoloration in the vagina, vulva, or labia (the “lips” around the vulva)  
• Vaginal discharge that may be thick and white and resemble cottage cheese  
• Watery vaginal discharge  
• A rash around the vagina and vulva  
• Pain or burning during urination  
• Pain during sexual intercourse  
• Small cracks or cuts on the skin of the vulva, which may be discolored and inflamed    

Some yeast infections may not cause any noticeable symptoms. 

Signs of a complicated yeast infection 

You may have a complicated vaginal yeast infection if you’re experiencing severe symptoms, or if you have symptoms and:  

• Are pregnant  
• Have a weakened immune system (the network of tissues and cells that protect you from infections)  
• Have uncontrolled diabetes  
• Frequently get yeast infections (four or more in a year)  

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A vaginal yeast infection is unlikely to go away on its own. Consider visiting a healthcare provider (HCP) if you experience possible symptoms of a yeast infection. This HCP could be a primary care provider, gynecologist (a medical doctor who specializes in the female reproductive system), or an HCP at an urgent care center.   

It’s especially important to visit an HCP if:  

• Your symptoms worsen, or you begin to develop other symptoms  
• Your symptoms don’t improve with over-the-counter (OTC) yeast infection treatments  
• This is the first time you’ve experienced yeast infection symptoms  
• You recently had unprotected sex or think you may have been exposed to an STI (yeast infections and STIs often have similar symptoms)  

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A community of microorganisms—including Candida and “good” Lactobacillus bacteria—live in the vagina and work to keep each other in balance. A vaginal yeast infection occurs when Candida grows out of control and throws off this balance. An overgrowth of Candida albicans is to blame for most yeast infections. Infections caused by other species of Candida are typically more difficult to treat.  

Although uncommon, someone with a vaginal or penile yeast infection may spread candidiasis to their partner during sex.  

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Various factors can increase a person’s risk of a vaginal yeast infection, including:  

• Changing estrogen levels: Being pregnant, having obesity, or taking certain types of hormonal birth control raises levels of a hormone called estrogen in the body. This can disrupt vaginal flora and cause a yeast infection.  
• Certain medical conditions: Having uncontrolled diabetes or a weakened immune system from conditions such as HIV or cancer increases the risk of infections, including yeast infections.  
• Certain medications: The balance of microorganisms in the vagina can be affected by certain drugs and medications, including antibiotics, hormone therapy, steroids, and chemotherapy.  
• Hygiene practices: Behaviors like using scented soaps and personal products on the genital area, wearing tight, non-breathable underwear or clothes, and waiting too long to change out of sweaty or wet clothes raise the risk of infection by creating a moist environment where yeast can thrive.   
• Age: Yeast infections are most likely to occur between puberty and menopause, which usually takes place in a person’s early 50s.  

Frequent stress and mental health issues can also increase a person’s risk of developing a yeast infection by negatively affecting the immune system. One 2020 study, published in the Journal of the Turkish-German Gynecological Association, found anxiety, depression, and stress to be risk factors for RVVC.  

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Your HCP may be able to diagnose a vaginal yeast infection after:  

• Asking you questions about your symptoms and what medications or supplements you may be taking  
• Discussing your medical history  
• Performing a pelvic exam 

During a pelvic exam, an HCP checks for swelling, discoloration, and other irregularities around the vagina and vulva. An HCP may use an instrument called a speculum to hold open the vagina and examine the vaginal walls and cervix.  

Your HCP may also want to collect a sample of vaginal fluid for testing under a microscope. This is known as a wet mount test. Your HCP will collect the sample during a pelvic exam using a cotton swab. 

A wet mount test can determine if a fungal infection is causing your symptoms, and if so, what species of Candida is present. This can help guide treatment decisions. Testing is also used to rule out other possible causes of symptoms, such as bacterial vaginosis, an STI, or a urinary tract infection (UTI).  

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If you’re diagnosed with a vaginal yeast infection, asking your HCP questions can help you better understand the condition and make informed treatment choices. Some basic questions you may have for your HCP about yeast infections include:  

• What do you think caused the yeast infection?  
• What type of yeast infection do I have?  
• What are my yeast infection treatment options?  
• What should I do if my yeast infection symptoms don’t improve? Or if they return after treatment?  
• How can I manage a yeast infection with other conditions I have?  
• Am I at risk for yeast infection complications?  
• How can I prevent yeast infections in the future?  

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Vaginal yeast infections are treated with antifungal medication. What form of antifungal medication—and how long you need to use it—will depend on the severity of the infection and your symptoms.  

Many yeast infections are mild and can be treated with a short course of an antifungal medicine, such as:  

• Miconazole  
• Tioconazole 
• Clotrimazole  
• Butoconazole  

These antifungal medicines fight yeast overgrowth and can be obtained with or without a prescription. They’re available as a cream that’s applied to the vagina using an applicator, or as a vaginal suppository (a small capsule that’s placed inside the vagina). Temporary itching and burning are possible side effects. If you’re pregnant, your HCP may recommend using clotrimazole or miconazole.  

Alternatively, your HCP may prescribe a single pill of fluconazole (Diflucan) to clear a yeast infection. Multiple doses of this oral medication may be recommended if your symptoms are more severe or return. Fluconazole is not safe for use in pregnant people.   

Other treatment options for complicated yeast infections include:  

• Oteseconazole: Oteseconazole is a prescription oral medication that’s approved for people who aren’t pregnant and have frequent yeast infections that don’t respond to other treatments. 
• Ibrexafungerp: Like oteseconazole, ibrexafungerp is a prescription oral medication that addresses difficult-to-treat yeast infections and helps prevent them from returning. It should not be used in pregnant people.   
• Boric acid therapy: Boric acid therapy involves placing a capsule of boric acid in the vagina. Boric acid is a naturally occurring chemical that can treat some yeast infections that don’t respond to other medicines. Boric acid cannot be taken by mouth. Pregnant people should not use boric acid therapy.    
• Long-course vaginal therapy: A longer course of treatment may be appropriate for people who have frequent yeast infections or RVVC. This involves using an antifungal medicine daily for up to 14 days, then periodically as determined by your HCP.  

Use all antifungal treatments exactly as prescribed by your HCP. If you use an OTC medicine, carefully follow the package directions. Let your HCP know right away if you experience severe or unexpected side effects from any medicine. Avoid having sex until the infection is gone and your HCP says it’s safe to do so.   

Can you treat a yeast infection on your own?  

Many antifungal treatments for vaginal yeast infections are available over the counter, which means you can get them without a prescription. But it’s best to visit your HCP to make sure you have a yeast infection before using medicine for it. If you have another type of infection, such as bacterial vaginosis or an STI, antifungal medication won’t be effective and may actually cause harm.    

Using antifungal treatment without a fungal infection may cause your body to become resistant to this type of medicine. So, if you get a yeast infection in the future, it could be more difficult to treat. Some antifungal creams and suppositories may also weaken birth control methods like diaphragms and condoms and increase your risk of an unplanned pregnancy or STI.  

How can I manage yeast infection symptoms during treatment?  

As antifungal medicine works to treat the infection, taking a few self-care measures can help ease symptoms or prevent them from getting worse. For example:  

• Wear loose bottoms and underwear made with a breathable fabric, such as cotton.  
• Keep your genital area dry and clean.  
• Rinse your genital area with water when bathing and avoid soap.  
• Try sitting in a warm (not hot) bath for a few minutes to soothe pain and burning. 
• Avoid sex until the infection is gone. If you do have sex, be sure to use a condom.  
• Quickly change out of wet or sweaty bathing suits or workout gear.  

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Vaginal yeast infections rarely cause serious health complications. When complications occur, they’re usually linked to scratching open inflamed, itchy skin around the genital area. This can aggravate symptoms and cause a skin infection. The infection may also spread to the urethral opening (where urine exits the body) and affect other nearby tissues. Having a weakened immune system increases the risk of these complications.  

A pregnant person who has a yeast infection can also spread the infection to her baby during childbirth. This can cause rash or inflammation in the membranes that line the baby’s mouth. Having a yeast infection during pregnancy also increases the risk of miscarriage or premature birth (delivery before the 37th week of pregnancy).  

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If you have a vagina, you’ll likely have a vaginal yeast infection at least once in your life. But there are several steps you can take to help prevent yeast infections and promote vaginal health. For example:  

• Wear breathable, cotton underwear that doesn’t fit too tightly around the crotch. If you wear pantyhose, choose an option with a cotton crotch.  
• Quickly change into clean, dry clothes after swimming or sweating.   
• Avoid vaginal douching, which destroys beneficial bacteria that can help prevent infections.   
• Don’t use scented personal products such as bubble bath soaps, tampons, pads, feminine sprays, lubricants, and deodorants.  
• Regularly change out tampons, pads, and panty liners during your menstrual period, if you have one. 
• After using the bathroom, wipe from front to back (from the vagina towards the anus) in one swipe.   
• Avoid using hot tubs or taking very hot baths.  
• Don’t take antibiotic medication unless an HCP prescribes it. 
• If you have diabetes, work to control your blood sugar levels.   

Does eating yogurt prevent yeast infections?  

There’s no conclusive evidence that eating yogurt can prevent a vaginal yeast infection. But some science suggests it may help. Yogurt that contains probiotics—or beneficial bacteria—can promote a healthy balance of yeast in the body. Specifically, a type of bacteria called Lactobacillus acidophilus may support healthy vaginal flora. 

Keep in mind that simply eating yogurt is not an effective way to prevent yeast infections. It’s more important to keep the genital area clean and dry and to avoid using scented personal products. Additionally, yogurt cannot treat a yeast infection. Do not attempt to insert yogurt into the vagina to ease symptoms. Sugars found in yogurt (including unsweetened yogurt) can make a yeast infection worse.  

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The outlook for someone with a yeast infection is typically positive. Appropriate treatment cures up to 90 percent of yeast infections in two weeks or less. Many infections resolve in just a few days.    

Recurring yeast infections may require ongoing treatment. A yeast infection that continues to come back without explanation could be a sign of an immunosuppressive condition such as diabetes or HIV.   

Adhering to your HCP’s treatment guidance is key to successful yeast infection treatment. Be sure to use all medicine as prescribed by your HCP, even if your symptoms clear in a day or two. Stopping treatment too soon can allow the infection to return.   

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Vaginal yeast infections are common and uncomfortable. But most yeast infections resolve with antifungal treatment in just a few days. You can lower your risk of yeast infections by maintaining good hygiene, wearing breathable underwear, and avoiding scented personal products. If you frequently develop yeast infections, your HCP can suggest a treatment plan for your needs.  

Speak with your HCP to learn additional information about yeast infection risk factors, treatment, prevention, and more. 

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• 8 essential health screenings for women  
• What causes yeast infections—and how to avoid them   
• 10 simple tips for a healthy vagina