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Written by Fong Carman, Pharmacist

What is Vaginal Candidiasis?

Vaginal Candidiasis  or it is more commonly known as “vaginal yeast infection”. It is a condition caused by a yeast called Candida. Normally, Candida lives inside the body such as the mouth, throat, gut and vagina and on skin without causing any problems. However,  the yeast cell can start to multiply and cause an infection if the environment inside the vagina changes in a way that encourages its growth.

Vaginal candidiasis are very common in women and it’s estimated that 75% of women will have at least one yeast infection in her lifetime.

Symptoms of Vaginal Candidiasis

Although most vaginal candidiasis is mild, some women can develop severe infections involving redness, swelling and cracks in the wall of the vagina.

Below are few symptoms such as:

  • Burning, redness and swelling of the vagina and the vulva
  • Pain during sexual intercourse
  • Pain or discomfort when urinating
  • A thick, white, odorless discharge, similar to cottage cheese
  • Watery vaginal discharge
  • Vagina rash

Remember to consult your doctor if you have any of these symptoms. These symptoms are similar to those of other types of vaginal infections and sexually transmitted infections (STIs), which are treated with different types of medicines. A doctor can tell you if you have vaginal candidiasis and how to treat it.

Who are at risk?

Women who are more likely to get vaginal candidiasis include those who:

  • Are pregnant
  • Use hormonal contraceptives (for example, birth control pills)
  • Have uncontrolled diabetes
  • Have a weakened immune system (for example, due to HIV infection or medicines that weaken the immune system, such as steroids and chemotherapy)
  • Are taking or have recently taken antibiotics

Preventions

Wearing cotton underwear might help reduce the chances of getting a yeast infection. Take antibiotics only when prescribed and exacly as your doctor tells you because taking antibiotics can lead to vaginal candidiasis as well. 

Try to AVOID:

  • Tight-fitting pantyhose
  • Douching, which removes some of the normal bacteria in the vagina that protect you from infection
  • Scented feminine products, including bubble bath, pads and tampons
  • Hot tubs and very hot baths
  • Unnecessary antibiotic use, such as for colds or other viral infections
  • Staying in wet clothes, such as swimsuits and workout attire, for long periods of time

Diagnosis and Testing

To diagnose a yeast infection, your doctor may:

  • Ask questions about your medical history. Might include collecting information about past vaginal infections or sexually transmitted infections.
  • Perform a pelvic exam. Your doctor examines your external genitals for signs of infection. Next, your doctor places an instrument (speculum) into your vagina to hold the vaginal walls open to examine the vagina and cervix — the lower, narrower part of your uterus.
  • Test vaginal secretions. Your doctor may send a sample of vaginal fluid for testing to determine the type of fungus causing the yeast infection.  Identifying the fungus can help your doctor prescribe more effective treatment for recurrent yeast infections.

Treatment

Vaginal candidiasis is usually treated with antifungal medicine. For most infections, the treatment is an antifungal medicine applied inside the vagina or a single dose of oral antifungal taken by mouth. 

1. Antifungal cream

The cream is applied to the genital area.

2. Antifungal pessary

A pessary is inserted up into the vagina.

3. Oral antifungal

During oral antifungal treatment, your doctor may require blood tests to check your kidney and liver function. Side effects may include stomach upset, headaches, and skin rash.

References

  1. Goncalves B, Ferreira C, Alves CT, Henriques M, Azeredo J, Silva S. Vulvovaginal candidiasis: Epidemiology, microbiology and risk factors. Critical reviews in microbiology 2016; 42:905-27.
  2. Sobel JD. Vulvovaginal candidosis. Lancet 2007;369:1961-71.
  3. Pappas PG, Kauffman CA, Andes DR, et al. Clinical Practice Guideline for the Management of Candidiasis: 2016 Update by the Infectious Diseases Society of America. Clinical infectious diseases : an official publication of the Infectious Diseases Society of America 2016;62: e1-50.
  4. AskMayoExpert. Vulvovaginitis. Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2018.
  5. Ferri FF. Vaginitis, fungal. In: Ferri’s Clinical Advisor 2019. Philadelphia, Pa.: Elsevier; 2019.
  6. Lobo RA, et al. Genital tract infections: Vulva, vagina, cervix, toxic shock syndrome, endometritis, and salpingitis. In: Comprehensive Gynecology. 7th ed. Philadelphia, Pa.: Elsevier; 2017.
  7. Cohen J, et al., eds. Vaginitis, vulvitis, cervicitis, and cutaneous vulval lesions. In: Infectious Diseases. 4th ed. Philadelphia, Pa.: Elsevier; 2017.
  8. Butler Tobah YS (expert opinion). Mayo Clinic, Rochester, Minn. Sept. 5, 2018.
  9. Blostein F, et al. Recurrent vulvovaginal candidiasis. Annals of Epidemiology. 2017;27:575.
  10. Bope ET, et al. Vulvovaginitis. In: Conn’s Current Therapy 2018. Philadelphia, Pa. Elsevier; 2018.
  11. Vaginal Yeast Infections. Office on Women’s Health. Retrieved from: https://www.womenshealth.gov/a-z-topics/vaginal-yeast-infections.
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