The Itch ‘Down There’: Vaginal Yeast Infections

This may be a very private question, but it’s one that most women, perhaps you, can relate to: Are you experiencing a horrible, itching, burning sensation “down there,” in the most private spot possible? 

If so, a vaginal yeast infection could be the cause. 

If you haven’t had one yet, you most likely will at some point in your life. According to the U.S. Office on Women’s Health, 75 percent of women in the U.S. will develop a yeast infection. Half of those will experience two or more. The Centers for Disease Control and Prevention report that it is the second most common type of vaginal infection, after bacterial vaginal infections.

Yeast infections are usually fairly simple to treat. The key to conquering them is to know the symptoms, the causes and when to seek medical help. 

Here are answers to six questions to help you get a better understanding:

According to the U.S. Office on Women’s Health, 75 percent of women in the U.S. will develop a yeast infection.

1. What Causes Yeast Infections?

A vaginal yeast infection is caused by the fungus Candida albicans. The fungus is often found in small amounts in the vagina, as well as in the digestive tract, the mouth and on the skin, without causing problems.

“The vagina has its own little ecosystem, with good microorganisms and bad microorganisms,” explains Stacy Hudepohl, MSN, CNM, certified nurse midwife at the Center for Women’s Health and Wellness in Mason, Ohio. “Sometimes you can get an overgrowth of some of the microorganisms, and that can lead to either a yeast infection or other vaginal infections throughout a woman's lifetime.”

2. How Do You Know You Have One?

According to Hudepohl, the most noticeable symptom is itching (both in the vagina and externally along the vulva), along with a thick, white discharge. 

“Sometimes, that itching can be just overwhelming,” she says. “It can be very, very uncomfortable.”

In some cases, you could also experience:

• Burning, redness and irritation of the vaginal area
• Swelling of the labia (lips) outside of the vagina
• Pain upon urination as the urine passes over sore tissues
• Pain during sex 

3. Should You See a Medical Professional?

Absolutely. “It's very, very important to discuss with your provider any discharge or symptoms that you're having, to make sure that we're treating the correct condition,” says Hudepohl. 

Your doctor will conduct a pelvic exam to look for swelling and discharge. He may also use a cotton swab to take a sample of the discharge from your vagina. A lab technician will look at the sample under a microscope to see whether there is an overgrowth of the Candida fungus.

4. What Are the Risk Factors?

Candida and other microorganisms that live in the vagina usually stay in balance with each other. But sometimes this balance can be thrown off, and fungi like Candida can multiply. The following can lead to a vaginal yeast infection:

• Pregnancy
• Hormonal contraceptives (like birth control pills)
• Diabetes, especially if your blood sugar is not under control
• A weakened immune system (for example, from HIV infection, steroids and/or chemotherapy)
• Antibiotics, which can kill the normal bacteria in your vagina, giving the yeast an opportunity to grow
• Obesity
• Douches and vaginal sprays 
• Tight underwear made of a material like nylon or Lycra that traps moisture and heat 

5. How Do You Prevent Yeast Infections?

Here are ways to avoid yeast infections:

• Take antibiotics only as directed by your health care provider.
• Never douche. Douching removes some of the normal bacteria in the vagina that protects you from infection.
• Don’t take bubble baths.
• Change tampons, pads and panty liners often, and avoid scented ones.
• Do not wear tight underwear, pantyhose, pants or jeans. These can increase body heat and moisture in your genital area.
• Wear cotton underwear, or at least, underwear with a cotton crotch. Cotton helps keep you dry and doesn't hold in warmth and moisture, which the fungus needs to thrive.
• Change out of wet swimsuits and tight workout clothes as soon as you can.
• After using the bathroom, always wipe from front to back.
• Avoid hot tubs and very hot baths.
• If you have diabetes, keep your blood sugar under control.

Eating foods that contain acidophilus bacteria (like yogurt with live cultures or kombucha tea) may also help prevent yeast infections, Hudepohl says. 

6. Do You Need to See a Doctor, Or Can You Self Treat?

Always talk with your health care provider before treating yourself for a yeast infection. Here’s why:

• Your infection may not be caused by yeast. The symptoms for sexually transmitted infections (STI) and bacterial vaginitis can mimic yeast infections, but require different treatments. If not treated correctly, these conditions can cause serious health complications.
• Frequent yeast infections could be a sign of something more serious going on in your body, like uncontrolled diabetes.
• You can develop a resistance to antifungal medication if you don’t actually have a yeast infection. This can make actual yeast infections harder to treat in the future.
• Some antifungal medicines can weaken condoms and diaphragms, increasing your chance of getting pregnant or an STI when you have sex. 

Once your provider has confirmed that the infection is caused by yeast, she’ll either write you a prescription or recommend an over-the-counter medication.

Antifungal medicines come in the form of creams, tablets, ointments or suppositories that you insert into your vagina. Your treatment may be given in one dose or daily for several days, depending on the brand. Make sure you follow the directions precisely and use up all the doses as prescribed.

If you get more than four vaginal yeast infections a year, or if your infection doesn't go away after using over-the-counter treatment, you may need to take regular doses of antifungal medicine for up to six months. Check with your health care provider.

“I think women just need to be aware of their bodies, and be aware that not all infections and treatments are the same,” Hudepohl explains. “And that's why talking to their provider about what is happening with their symptoms is most important.” 

Source: Stacy Hudepohl, MSN, CNM, certified nurse midwife, Center for Women’s Health and Wellness; Office of Women’s Health, U.S. Department of Health and Human Services; Centers for Disease Control; The Center for Young Women’s Health, Boston Children’s