What is vaginal candidiasis?
Vaginal candidiasis is an infection of the vagina involving overgrowth of a yeast, or fungus, known as Candida. This yeast is normally present in the mouth, gut and vagina, as are a number of other organisms. If the balance of microorganisms is disrupted, as can occur with taking broad spectrum antibiotics, hormonal fluctuations, and other conditions, an overgrowth of yeast can occur. Vaginal candidiasis, often referred to as a "yeast infection," is a common problem, affecting nearly 75% of adult women in their lifetime (Source: CDC).
Itching and a thick, white discharge are the most common symptoms of vaginal candidiasis. It can also make sexual intercourse and urination painful. The external tissue around the vagina, the vulva, may become red and swollen.
Vaginal candidiasis can be treated with a variety of antifungal agents, some of which are available over-the-counter. Although the only way to unambiguously diagnose vaginal candidiasis is to see the yeast under the microscope, many women treat themselves based on their symptoms. Studies suggest that, of all the purchases of over-the-counter yeast treatments, as many as two-thirds are used by women who do not have vaginal candidiasis (Source: CDC).
Appropriate treatment usually results in a resolution of the symptoms. If symptoms remain or recur, it may signify that another condition is present or that the yeast has become resistant to the treatment that was used.
Vaginal candidiasis is rarely associated with a medical emergency; however, symptoms similar to those that occur with vaginal candidiasis can be present with other, more serious conditions. Seek immediate medical care (call 911) for high fever (higher than 101 degrees Fahrenheit), severe pelvic or abdominal pain, persistent nausea and vomiting, or bleeding while pregnant.
If you have symptoms of vaginal candidiasis, but have never had it before, or if you have a fever or have persistent or recurrent symptoms despite treatment, seek prompt medical care.Women who have symptoms of vaginal candidiasis and are pregnant or are worried about sexually transmitted infections should also seek prompt medical care.
What are the symptoms of vaginal candidiasis?
Women who have vaginal candidiasis may experience itching and a thick, white discharge. They may notice redness and swelling around the vagina and may experience pain with urination or intercourse. The intensity of symptoms can vary from person to person.
Common symptoms of vaginal candidiasis
Common symptoms of vaginal candidiasis include:
Itchy feeling in the vagina and the tissue around it (vulva)
Pain during sexual intercourse
Pain or burning with urination
Redness and swelling of the vulva
Thick, white vaginal discharge that has a texture similar to cottage cheese
Serious symptoms that might indicate a life-threatening condition
Vaginal candidiasis is rarely an emergency medical condition by itself. In people who have weakened immune systems, it is possible for the infection to spread into the bloodstream and cause invasive candidiasis, a potentially life-threatening condition. Also, other types of vaginal or pelvic infections may be mistaken for vaginal candidiasis. Seek immediate medical care (call 911) if you, or someone you are with, have any of these life-threatening symptoms including:
Bleeding while pregnant
High fever (higher than 101 degrees Fahrenheit)
Severe abdominal or pelvic pain
Uncontrolled nausea and vomiting
What causes vaginal candidiasis?
Vaginal candidiasis is most commonly caused by Candida albicans, a type of yeast, or fungus, that is normally present in the mouth, gut and vagina. It can occasionally be caused by other species of Candida.
Our bodies are normally colonized with a variety of organisms, including different bacteria and yeast. These organisms exist in a balance, but if something like a broad-spectrum antibiotic, which can kill several types of bacteria, disrupts this balance, overgrowth of the other organisms can occur, leading to problems such as vaginal candidiasis. The hormonal changes in pregnancy and excess levels of sugars, as can be present in diabetes, can also contribute to this imbalance.
Generally, vaginal candidiasis is not considered contagious; however, it can occasionally spread to a sexual partner.
What are the risk factors for vaginal candidiasis?
A number of factors increase the risk of developing vaginal candidiasis. Not all people with risk factors will get vaginal candidiasis. Risk factors for vaginal candidiasis include:
Broad-spectrum antibiotic use
Compromised immune system due to such conditions as HIV/AIDS, taking corticosteroids, organ transplant medications, or cancer and cancer treatment
Diabetes (chronic disease that affects your body’s ability to use sugar for energy)
Exposure to vaginal douches and chemical irritants
Oral contraceptive use
Reducing your risk of vaginal candidiasis
You may be able to lower your risk of vaginal candidiasis by:
Avoiding products that can irritate the vaginal tissues, such as feminine hygiene sprays, perfumes, powders and soaps
Eating yogurt with live cultures or taking Lactobacillus acidophilus tablets if you need to take antibiotics
Keeping your blood sugars under control if you have diabetes
How is vaginal candidiasis treated?
Vaginal candidiasis is treated with antifungal medications. Several are available in the form of creams, suppositories and tablets that can be placed directly in the vagina. Some are available over-the-counter, while others require a prescription.
Antifungals available for intravaginal treatment of vaginal candidiasis include:
- Butoconazole (Femstat, Gynazole-1)
- Clotrimazole (Gyne-Lotrimin, Mycelex)
- Miconazole (Monistat)
- Terconazole (Terazol)
- Tioconazole (Vagistat-1)
An oral antifungal drug, fluconazole (Diflucan), can also be used to treat vaginal candidiasis.
What you can do to improve your vaginal candidiasis
In addition to following your health care provider’s instructions and taking all medications as prescribed, you can help control your symptoms by:
Avoiding douching, which can rinse out vaginal treatments and disrupt the balance of organisms in the vagina
Avoiding irritants, such as feminine hygiene sprays, perfumes, powders and soaps
Keeping your genital area dry and clean
Sitting in a warm bath to relieve your symptoms
Using pads instead of tampons
Wearing loose-fitting, airy clothes to allow air circulation and reduce irritation
What are the potential complications of vaginal candidiasis?
In some people, especially people with conditions that suppress the immune system, complications of untreated vaginal candidiasis can be serious, even life threatening in some cases. You can help minimize your risk of serious complications by following the treatment plan you and your health care professional design specifically for you. Complications of vaginal candidiasis include:
Adverse effects of treatment
Invasive candidiasis (serious infection in which Candida has spread into the bloodstream)
Secondary infections (infections that develop after vaginal candidiasis, often due to scratching)