Vaginal Yeast Infection
Vaginal yeast infection or vulvovaginal candidiasis is a common
cause of vaginal irritation. Doctors estimate that approximately 75
percent of all women will experience at least one symptomatic yeast
infection during their lifetimes. Yeast are always present in the
vagina in small numbers, and symptoms only appear with overgrowth.
Several factors are associated with increased symptomatic infection
in women, including pregnancy, uncontrolled diabetes mellitus, and
the use of oral contraceptives or antibiotics. Other factors that may
increase the incidence of yeast infection include using douches,
perfumed feminine hygiene sprays, and topical antimicrobial agents,
and wearing tight, poorly ventilated clothing and underwear. Whether
or not yeast can be transmitted sexually is unknown. Because almost
all women have the organism in the vagina, it has been difficult for
researchers to study this aspect of the natural history.
Symptoms. The most frequent symptoms of yeast infection in women
are itching, burning, and irritation of the vagina. Painful urination
and/or intercourse are common. Vaginal discharge is not always
present and may be minimal. The thick, whitish-gray discharge is
typically described as cottage-cheese-like in nature, although it can
vary from watery to thick in consistency. Most male partners of women
with yeast infection do not experience any symptoms of the infection.
A transient rash and burning sensation of the penis, however, have
been reported after intercourse if condoms were not used. These
symptoms are usually self-limiting.
Diagnosis. Because few specific signs and symptoms are usually
present, this condition cannot be diagnosed by the patient's history
and physical examination. The doctor usually diagnoses yeast
infection through microscopic examination of vaginal secretions for
evidence of yeast forms.
Scientists funded by the National Institute of Allergy and
Infectious Diseases (NIAID) have developed a rapid simple test for
yeast infection, which will soon be available for use in doctors'
offices. If such a test were available for home screening, it would
help them to appropriately use yeast medication.
Treatment. Various antifungal vaginal medications are available to
treat yeast infection. Women can buy some antifungal creams, tablets,
or suppositories (butoconazole, miconazole, clotrimazole, and
tioconazole) over the counter for use in the vagina. But because BV,
trichomoniasis, and yeast infection are difficult to distinguish on
the basis of symptoms alone, a woman with vaginal symptoms should see
her physician for an accurate diagnosis before using these products.
Other products available over the counter contain antihistamines
or topical anesthetics that only mask the symptoms and do not treat
the underlying problem. Women who have chronic or recurring yeast
infections may need to be treated with vaginal creams for extended
periods of time. Recently, effective oral medications have become
available. Women should work with their physicians to determine
possible underlying causes of their chronic yeast infections.
HIV-infected women may have severe yeast infections that are often
unresponsive to treatment.
Note: All information is based upon materials published by the National
Institute of Allergy and Infectious Diseases (NIAD).