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Vaginal Yeast Infection (Candidiasis)

by David E. Soper, MD

The vagina is infected by a yeast called Candida, usually Candida albicans, resulting in a yeast infection called candidiasis.

  • Being pregnant or having diabetes or a weakened immune system increases the risk of yeast infections.

  • The vagina and vulva itch, and women often have a thick, white discharge resembling cottage cheese.

  • Antifungal drugs—creams, vaginal suppositories, tablets, or capsules—are effective.

Causes

In women of child-bearing age, yeast infections due to Candida albicans are particularly common. This yeast normally resides on the skin or in the intestine. From these areas, it can spread to the vagina. Yeast infections are not transmitted sexually. They are common among pregnant women and women who have diabetes. Yeast infections are more likely to occur just before menstrual periods. Yeast infections are also more likely to develop if the immune system is weakened—suppressed by drugs (such as corticosteroids or chemotherapy drugs) or impaired by a disorder (such as AIDS).

Antibiotics taken by mouth tend to kill the bacteria that normally reside in the vagina and that prevent yeast from growing. Thus, using antibiotics increases the risk of developing a yeast infection.

After menopause, yeast infections are uncommon except in women who take hormone therapy.

Symptoms

The vagina and vulva may itch or burn, particularly during sexual intercourse. The genital area may become red and swollen. Women may have a white discharge, often thick and resembling cottage cheese. Symptoms may worsen the week before a menstrual period begins.

Did You Know...

  • Yeast infections are not sexually transmitted.

  • Taking antibiotics increases the risk of yeast infections.

Prevention

Women who are at high risk of a yeast infection may need to take an antifungal drug by mouth to help prevent yeast infections. Such women include those with the following:

  • A weakened immune system

  • Diabetes

  • A need to take antibiotics for a long time

  • Repeated yeast infections

Treatment

Yeast infections are treated with antifungal drugs. They may be applied as a cream to the affected area, inserted into the vagina as a suppository, or taken by mouth. Butoconazole, clotrimazole, miconazole, and tioconazole are available without a prescription. Oils in these creams and ointments weaken latex-based condoms (but not diaphragms), so women cannot rely on condoms for birth control.

Antifungal drugs (such as fluconazole and itraconazole) taken by mouth require a prescription. A single dose of fluconazole is as effective as the creams and ointments. However, if infections recur often, women may need to take several doses.

Drugs Used to Treat Vaginal Yeast Infections

Drug

Dosage

Creams or gels, available without a prescription

Butoconazole

Applied as a cream once a day for 3 days

Also available as a sustained-release cream that is applied once

Clotrimazole

Applied as a cream once a day for 7 to 14 days

Also available as a vaginal tablet inserted once a day for 7 days or for 3 days or inserted only once, depending on the dose (number of milligrams per tablet)

Miconazole

Applied as a cream once a day for 7 days

Also available as a vaginal suppository inserted once a day for 7 days or for 3 days, depending on the dose

Tioconazole

Applied as an ointment only once

Drugs taken by mouth, available by prescription

Fluconazole

One tablet taken only once

Resources In This Article

Drugs Mentioned In This Article

  • Generic Name
    Select Brand Names
  • MYCELEX
  • SPORANOX
  • VAGISTAT-1
  • FEMSTAT 3
  • MONISTAT 3
  • DIFLUCAN