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• Vaginal Infections and Pelvic Inflammatory Disease
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• The vagina may be infected by a yeast called Candida, usually Candida albicans, resulting in a yeast infection called candidiasis. Being pregnant or overweight 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 reproductive 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, overweight 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 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. ButoconazoleSome Trade Names
GYNAZOLE-1
, clotrimazoleSome Trade Names
LOTRIMIN AF MYCELEX
, miconazoleSome Trade Names
MONISTAT
, and tioconazoleSome Trade Names
VAGISTAT-1
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 fluconazoleSome Trade Names
DIFULCAN
and itraconazoleSome Trade Names
SPORANOX
) taken by mouth require a prescription. A single dose of fluconazoleSome Trade Names
DIFULCAN
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 ButoconazoleSome Trade Names GYNAZOLE-1 Applied as a cream once a day for 3 days Also available as a sustained-release cream that is applied once ClotrimazoleSome Trade Names LOTRIMIN AF MYCELEX 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) MiconazoleSome Trade Names MONISTAT 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 TioconazoleSome Trade Names VAGISTAT-1 Applied as an ointment only once Drugs taken by mouth, available by prescription FluconazoleSome Trade Names DIFULCAN One tablet taken only once ItraconazoleSome Trade Names SPORANOX Available as a capsule, once or twice a day for up to 6 months

Last full review/revision September 2008 by David E. Soper, MD