Bacterial Vaginosis: Symptoms, Causes, and Treatment
Vaginal Yeast Infections
The vagina normally contains a healthy balance of bacteria and yeast. The hormone estrogen helps bacteria called lactobacilli to grow. These bacteria kill harmful organisms in the vagina and keep you healthy. But when something happens to tip that balance, a fungus called candida can grow out of control and cause a yeast infection, also known as vaginal candidiasis.
They're itchy and uncomfortable, and no one really likes to talk about them. But vaginal yeast infections are very common. It's estimated that 75% of women will have at least one yeast infection in their lifetime.
Though yeast infections can happen to anyone at any time, certain things make them more likely. Most infections can be cleared up quickly and easily.
Yeast infection vs. Bacterial vaginosis
Yeast infections and bacterial vaginosis (BV) are both vaginal infections called vaginitis. While the conditions may have similar symptoms, they happen for different reasons and need different treatments. You can use an over-the-counter treatment for a yeast infection but will probably need prescription medicine for BV.
You can treat some vaginal infections with over-the-counter medicine, but others require a prescription. Your doctor can help you figure out which condition you have and the right treatment. (Photo Credit: DigitalVision/Getty Images)
Itchiness and discomfort are the main symptoms of a yeast infection, but there are others:
If you think you have a yeast infection, see your doctor before treating yourself. The symptoms of yeast infections are similar to other, more serious conditions, including sexually transmitted infections and bacterial vaginosis (bacterial overgrowth in the vagina). An accurate diagnosis is important so you can get the best treatment.
There are many reasons you could get a yeast infection, including:
Are yeast infections contagious?
You can get a yeast infection both through sex and without sexual contact, but it's not a sexually transmitted infection (STI).
Diagnosing a yeast infection involves your doctor or nurse examining your vulva and vagina. They'll also get a sample of discharge by swabbing your vagina, then send the sample to a lab to be examined.
The most common way to treat yeast infections is with over-the-counter antifungal creams, ointments, or suppositories (with clotrimazole or miconazole). Treatment can take 1 to 7 days. Your doctor may also prescribe an oral antifungal medication, such as fluconazole (Diflucan) or ibrexafungerp (Brexafemme).
If you're pregnant, it's safe to use creams or suppositories, but avoid oral medications.
It's important for you to know that some yeast infection medications weaken condoms or diaphragms. That makes it easier for you to get pregnant or contract a sexually transmitted disease. Be sure to read instructions and warnings before using.
Recurrent yeast infections
If you have diabetes or a weakened immune system, you may get yeast infections over and over again. It's a condition called recurrent vulvovaginal candidiasis (RVVC). If you get yeast infections at least four times a year, your doctor may recommend that you take a weekly fluconazole pill for 6 months to fight them. Oteseconazole (Vivjoa) has been approved for those with recurring problems with infections who do not want to have children (or have more children).
Some studies have shown that eating probiotic yogurt or taking Lactobacillus acidophilus supplements may slow the growth of yeast in the vagina, lowering the risk of infections. More research is needed before a clear connection can be made. Other ways of avoiding a yeast infection include:
Vaginal yeast infections are common, with symptoms including itchiness, redness, swelling, pain during urination or sex, and a thick, white discharge. Treatments range from over-the-counter antifungal creams or oral medications to prescription options. Infections that continue to come back may require long-term treatment. Probiotics like yogurt or supplements containing Lactobacillus acidophilus might help prevent yeast overgrowth, but more research is needed to confirm how well they work.
Oh, Great: You Can Get Eczema On Your Vulva
Lots of things can irritate your nether regions, however, so sometimes it can be tough to know what you're dealing with. Though a derm or ob-gyn can make the final call (and help you find the right treatment), here are three other common culprits to consider:
Yeast infections
This happens when there's a disruption of your normal, healthy microorganisms, and an overgrowth of certain kinds of yeast, in your vagina. Alongside itchiness, you'll probably have white, chunky, odorless discharge and sometimes feel a burning sensation while peeing or having sex. While Dr. Kenkare says this *likely* means your issues aren't eczema-related, a yeast infection can sometimes trigger a flare-up of eczema symptoms or increase discomfort if you're in the throes of one. But in both cases, "it is not contagious, nor is it a sign of bad hygiene," Dr. Smith says.
Contact dermatitis
Atopic dermatitis is a chronic condition, meaning it might recur repeatedly. So if this is a one-off scratching situation and you haven't been diagnosed with eczema in the past, you might have contact dermatitis, which happens when your skin reacts to something specific, like a new type of laundry detergent or a "cleansing" wipe loaded with fragrances. In this case, identifying what's bothering you and getting rid of it should solve the urge to scratch, Chris G. Adigun, MD, FAAD, a board-certified dermatologist at Dermatology & Laser Center of Chapel Hill in NC, tells SELF.
STIs
While gonorrhea and chlamydia can both cause itchiness around the genitals, they may result in an unusual discharge, sometimes with an odor that eczema wouldn't cause. You might also experience other problems, like pain during sex, abdominal aches, or a fever. (Although STIs often cause no symptoms at all.) If you've been sexually active, particularly with new or multiple partners, and your vulva suddenly feels inflamed, it's probably a good idea to get tested for STIs just to be 100% sure you aren't dealing with something that requires antibiotics, Dr. Kenkare advises.
Fortunately, there are treatments for eczema flare-ups, and the best way to get relief on your vulva isn't too far off from how you'd deal with itchiness on other body parts, Dr. Adigun says.
If your symptoms are mild—you get tiny, slightly itchy patches every few months or so—Dr. Kenkare says you can manage irritation with some gentle skin care. Her rec: Apply topical petroleum jelly wherever you're having issues. "People might not realize that an area in the body that can get to be humid and swampy would also require moisturization, but it really does," Dr. Kenkare says.
Look for products labeled as sensitive or fragrance-free and have the National Eczema Association seal on the bottle. Try not to pat on just any cream or lotion—some contain menthol, for example, which can exacerbate itchiness. The same goes for harsh, perfumy soaps. Also, steer clear of anything that claims to "freshen" things up, like sprays, douches, and powders. (Here are a few tips to safely clean your vagina in general.) Use a fragrance-free laundry detergent made for sensitive skin, Dr. Adigun says. It can also help to wear 100% cotton underwear, as synthetic fibers may make things worse.
Yeast Infection Treatments
A vaginal yeast infection (also called vaginal candidiasis) happens when too many candida yeast cells grow in the vagina. These cells are always there, but factors such as pregnancy, taking antibiotics, having too much stress, or wearing a wet swimsuit for too long can cause an overgrowth of bad bacteria and yeast, making them outgrow the good ones.
Yeast infections typically cause symptoms such as itching, redness, and swelling of the vagina and vulva; vaginal pain or a burning sensation; a vaginal rash; and/or a thick, odorless, white, cottage cheese-like discharge.
There are many over-the-counter (OTC) yeast infection treatments. If those don't work for you, or your yeast infections keep returning, talk to your doctor to see if you need a longer course of treatment.
Yeast infections are very common, affecting about 75% of women and people assigned female at birth (AFAB) at some point in their lives. The duration, symptoms, and frequency of these infections vary widely from person to person. That's why there are several vaginal yeast infection medications on the market.
There are two main types of yeast infection treatments:
Short course. These antifungal medications range from a one-time pill (fluconazole) that you take orally to 3- to 7-day courses of antifungal creams, tablets, and suppositories. You can buy some of these over the counter, but others have to be prescribed by your doctor.
Long course. If you have very severe symptoms, or yeast infections that keep returning, your doctor may recommend long-course treatment. This may be an antifungal vaginal medication that you use for 2 weeks or two to three doses of a pill that you take by mouth. Your doctor may also recommend boric acid tablets that you insert in your vagina (these pills can be fatal if taken by mouth, so talk to your doctor before using).
You can get antifungal vaginal creams from your doctor or buy them without a prescription at most large drugstores and supermarkets. Some creams you can apply inside the vagina; these usually come with an applicator that helps you measure the right dose. Others are suppositories or tablets you place in your vagina where they dissolve.
Many yeast infection treatments come in 1-day, 3-day, and 7-day strengths. OTC vaginal creams and other antifungal products have the same ingredients to fight a yeast infection as the medication your doctor might prescribe but in less-concentrated doses.
Some creams also cover different strains of yeast. You'll need a prescription for these:
In general, the more concentrated the drug, the shorter the time you have to take it. A vaginal cream that has the number 7 after its name, for instance, would usually be used for 7 days. If the same product name had a number 3 behind it, it would be a more concentrated version of the vaginal cream and you'd only need it for 3 days.
Your doctor may also prescribe a steroid cream for a few days to ease more serious inflammation, redness, and soreness at the opening of the vagina and the surrounding tissue, called the vulva.
OTC yeast infection creams
First, read all package directions carefully. Vaginal creams can be messy and may leak out during the day, so you might want to use them only at bedtime.
When you use a vaginal cream that's oil-based, you may need to use birth control that's not a condom or diaphragm or skip sex while you're using the cream. That's because the oil in the cream could damage the latex in a condom or diaphragm.
Yeast infection suppositories
Medications in vaginal creams (such as clotrimazole and miconazole) may also be available as vaginal tablets or suppositories. You put these into your vagina and let them dissolve. Some brands call them "ovules" because they're oval-shaped. These products often come packaged with a plastic inserter that helps you get the medication to the right place.
One benefit of a suppository is that it's less messy than a vaginal cream and less likely to leak during the day. Another benefit of tablets or suppositories is that you use the doses for fewer days, so you get relief from your symptoms sooner.
Safety tips for OTC yeast infection treatment
Before you use any of these products, you need to know for sure that you have a yeast infection, not something else. See your doctor if you're not sure because using the wrong medicine can make an infection harder to diagnose.
Always follow the package directions exactly. Pay special attention to how often to use the product and how much to use. You need to get those two things right because the dose targets the growth cycle of the yeast.
Complete the entire course of medication, even if your symptoms go away early.
Antifungal medications can change the way some drugs work. Talk to your doctor or pharmacist before taking an antifungal if you are taking other medications.
No matter which yeast infection treatment you try, see your doctor if your symptoms don't clear up after you finish it.
If you have a severe infection, your doctor might prescribe an oral medication. Ibrexafungerp (Brexafemme) is taken twice a day for 1 day and targets the specific fungal cells behind the infection. Fluconazole (Diflucan) is a pill that kills fungus and yeast throughout your body. You would take fluconazole for a week -- every third day (days 1, 4, and 7) -- initially, for three doses total. Then, your doctor might have you take it weekly for 6 months to make sure the yeast infection doesn't come back. Side effects for either include stomach upset, diarrhea, or headaches.
You shouldn't take either of these oral medications to treat yeast infections if you're pregnant.
Another antifungal medicine, oteseconazole (Vivjoa) has been approved for people who have repeated infections and who are not able to get pregnant due to being postmenopausal or permanently infertile. Infertility might be because you've had your uterus or your ovaries and fallopian tubes removed, or you've had your tubes tied (tubal ligation).
Never take any medication or use a nonprescription vaginal cream while you're pregnant unless you've spoken to your doctor about it first.
If you think you may have a yeast infection you should talk to your doctor. Everyone's symptoms are different and yeast infection symptoms can be confused with other vaginal conditions, including skin allergies, sexually transmitted diseases (such as trichomoniasis), bacterial vaginosis, and hormonal changes.
You may have heard of several home remedies to treat yeast infections. One study showed that coconut oil may effectively kill candida, but it wasn't tested in people. Other at-home treatments that you may find include garlic, essential oils, and vinegar, but none are proven to cure the condition.
You may not always be able to prevent a yeast infection. But if you've had one before and you want to avoid them in the future, some of these tips may help:
Most yeast infections clear up within about a week. But the time it hangs around will depend on how severe it is and if you get the right treatment.
Will a yeast infection go away on its own?
If you have a very mild yeast infection, it may go away on its own. But you'll need medication to treat most moderate and severe yeast infections.
Frequent yeast infections
If you have four or more vaginal yeast infections in a year, it could be a condition called recurrent vulvovaginal candidiasis. It's not common, but if you have it, you may need to take an antifungal medication prescribed by your doctor for up to 6 months.
Frequent, repeated yeast infections can also be a sign of a resistant strain or more serious condition, including untreated diabetes. You are also more likely to have recurrent yeast infections when you have hormonal changes, (such as during pregnancy) or when your immune system is weakened because you have HIV or have had an organ transplant.
If you have frequent yeast infections, talk to your doctor who may do some testing to find out why.
Reach out to your doctor or pharmacist if you have any questions about your prescription and how to take your medicine. Let your doctor know if your symptoms don't disappear after you finish taking all your medicine as prescribed. You should also call your doctor if you have any new symptoms because they might be related to other conditions.
Yeast infections can be uncomfortable to have, but antifungal medications can help treat them in as little as one day. Symptoms of a yeast infection can be the same as those of other conditions including skin allergies and sexually transmitted diseases. If you think you have a yeast infection or have ones that keep coming back, talk to your doctor to figure out the best treatment for you.
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