AT A GLANCE: Preventing yeast infections matters because small steps can help lower the risk of discomfort, recurring symptoms and delayed care when symptoms point to another condition. Here are five things you will learn about yeast infections from Melisa M. Edler, MD, an ob-gyn in Milford, Delaware with Bayhealth, in this article:
- Yeast infections are common and happen when there is an overgrowth of yeast, often from the Candida species.
- Symptoms of a yeast infection can include itching, burning, irritation, thick white discharge, redness, swelling, pain during sex or burning when urinating.
- Pregnancy, antibiotics, diabetes with elevated blood sugar and conditions that lower immunity can increase the risk of yeast infections.
- Keeping the vaginal area dry, changing out of sweaty clothes, wearing breathable clothing and avoiding scented products can help lower your risk of a yeast infection.
- Yeast infection symptoms can overlap with other conditions, so it is best to talk with a physician before relying on over-the-counter treatment.
Yeast infections are common, uncomfortable and often frustrating—especially when they are recurring. While many people associate them with itching or irritation, yeast infections can also raise bigger questions about everyday habits, antibiotic use, diabetes, hormones and when it is time to talk with a physician.
The good news? Yeast infections can be prevented, and it starts with understanding what can disrupt the body’s natural balance. From choosing breathable clothing to avoiding unnecessary products that irritate the vagina, small steps can help lower the chance of infection and help patients know when symptoms may point to something else.
The AMA’s What Doctors Want Patients to Know™ series gives physicians a platform to share what they want patients to understand about today’s healthcare headlines and how to take charge of their health through preventive care.
In this installment, Melisa M. Edler, MD, an ob-gyn in Milford, Delaware with Bayhealth, took time to discuss what patients should know about preventing yeast infections.
Bayhealth is part of the AMA Health System Member Program, which provides enterprise solutions to equip leadership, physicians and care teams with resources to help drive the future of medicine.
A yeast infection is inflammation of the vagina
“A yeast infection is inflammation or infection of the vagina. We call this vaginitis,” said Dr. Edler. “In terms of a yeast infection, that’s where it’s a vaginitis caused by a type of fungal infection, specifically it’s something within the Candida species.”
Yeast infections are “a very common reason for gynecological visits—it is the second most common in the vaginitis category,” she said, noting that “almost half of women will experience at least one yeast infection in their lifetime.”
Itching or burning are symptoms of a yeast infection
Common symptoms of a yeast infection can include itching, burning or irritation in or around the vagina. Some people may also notice thick, white discharge that can look like cottage cheese, along with redness or swelling around the vulva and vagina.
Other symptoms can include small cuts or tiny cracks in the skin of the vulva, burning when urinating and pain during sex. Because these symptoms can also be signs of other conditions that affect the vagina, it is important to talk with a physician or other health professional for an exam and accurate diagnosis.
Women of reproductive age are at high risk
Yeast infections are more common “in women of reproductive age. By that I mean before puberty, a yeast infection is not typically an issue,” Dr. Edler said. “In most postmenopausal women, it’s also a non-issue because estrogen is known to be a driving factor for increasing the risk of yeast infections.
“The reason for this is because when there’s estrogen present, it is a host of producing a lactic acid product or it causes colonization of the vagina by something we call Lactobacillus,” she added. “A lot of women don’t like to think about this, but you do actually have organisms in your vagina, even if you have no symptoms.”
“These are different types of bacteria and as well as yeast, that can help ward off infectious agents. With the estrogen, it helps maintain this colony in there,” Dr. Edler said. “Then with a yeast infection, you have overgrowth of yeast that are causing symptoms.”
Reasons for a yeast infection
Different health conditions can increase your risk for a yeast infection, such as “if someone has diabetes and they don’t have good blood sugar control,” Dr. Edler said. “I always tell my patients that yeast love sugar, so elevated blood sugars are basically increasing the chances of overproduction of yeast within the vagina.”
“Also, if someone has a health condition that lowers their immunity—for example, HIV—it can increase their risk of a yeast infection,” she said.
Pregnancy can increase risk of yeast infections
“Pregnancy actually can increase the risk of yeast infections because you have a higher amount of estrogen while you’re pregnant,” Dr. Edler said, explaining that she has “some patients who only have a problem with yeast infections when they’re pregnant and it happens frequently throughout their pregnancy.”
“Of course, every pregnant woman can have different issues during their pregnancy, but some women can have more than one yeast infection during a pregnancy,” she said.
Thrush is caused by the same fungus
“It depends on the location of the infection, what it’s called. For example, thrush is typically in the mouth and that is more common in younger children,” Dr. Edler explained.
Thrush is caused by Candida yeast, which is naturally present on the body but multiplies out of control. It typically appears as a red, inflamed rash accompanied by a white or yellow discharge, soreness or tiny cracks in the skin.
Jock itch and a yeast infection are not the same
A yeast infection and jock itch both cause itchy rashes in the groin. However, jock itch and a yeast infection are distinct conditions. Jock itch is typically a dermatophyte (mold) infection while a yeast infection is caused by Candida.
Symptoms of jock itch include a spreading, ring-shaped or half-moon reddish rash that is dry, scaly or crusty at the edges. Jock itch is typically confined to the groin, inner thighs and buttocks. Both jock itch and a yeast infection thrive in warm, moist areas and can require different treatments.
Yeast infections can also occur on the outer part of the vagina
“For the most part, when you’re talking about yeast infections, it’s when someone is having vaginal discharge or irritation within the vagina,” Dr. Edler said. However, “sometimes I will see a yeast infection where it’s only on the outer part of the vagina, what we call the vulva, which includes the labia majora and the minora.”
“Since when I am performing an exam, I’m looking at the whole pelvis, sometimes I’ll notice a yeast infection in some women within the crease of the groin,” she explained. “They also might have it underneath in between the abdomen and the top of the mons pubis, depending on how the skin folds over.”
Some antibiotics can cause yeast infections
“This is more common with broad spectrum antibiotics or antibiotics that are known to treat multiple types of infection,” Dr. Edler said. Certain antibiotics “can potentially affect some of the normal bacteria that’s in the vagina and then that gives yeast the propensity to increase, leading to a yeast infection.”
“It’s always a good idea that if you are given a prescription for an antibiotic, if you know that has happened to you before, you should bring it up to your doctor,” she said, “because many times they can talk to you about treatment that you can do at the same time, whether it is an over-the-counter treatment for yeast infection or something oral.”
Yeast infections can last a few days
“Typically, a yeast infection can last a few days,” said Dr. Edler, noting that “once someone has a yeast infection, they have to get treated in order for it to go away.
“But usually once they begin treatment, they start to feel better within a couple of days,” she added, emphasizing that “once you’re given medicine, finish the whole treatment even if you feel better.”
A yeast infection is not an STD
It is important to understand that a yeast infection “is not considered a sexually transmitted infection,” said Dr. Edler. “A common question I do get from patients is if they are sexually active, they will ask if their partner needs to be treated for yeast infections too.
“Even if they are sexually active, their partner does not require a treatment because that hasn’t been shown to prevent the reinfection rate,” she added. “Another thing that I sometimes find in practice is that if someone is getting a pap smear or an STD screening, some STD screening tests do include yeast even though it’s not considered a sexually transmitted infection.”
With those tests, “sometimes it will show that someone has a positive result for yeast, but they don’t actually need treatment if they’re not having any symptoms,” Dr. Edler explained.
Avoid intercourse if you have a yeast infection
While a yeast infection is not an STD, said Dr. Edler, “it’s recommended that while you have a yeast infection, avoid intercourse because it can cause worsening irritation.”
It is also important to avoid intercourse because “some of the yeast infection treatment medications can weaken the material in condoms,” she said.
There is no link between diet and yeast infections
“There’s been a lot of research and talk about trying different foods to see if that can help lower the risk of yeast infections,” said Dr. Edler. “A lot of those studies have not shown a link between diet and developing a vaginal yeast infection.”
“Some studies have shown higher dairy consumption in women who have symptomatic vaginal yeast infections,” she said. “But it could be because those women are eating more yogurt to try to prevent a yeast infection.”
Keep the area dry to prevent yeast infections
One key prevent strategy is “trying to keep the area dry. What I mean by that is after you shower or bathe, make sure you are drying off the skin surrounding the vagina,” Dr. Edler said. “If you are in a rush and you shower and then you get dressed, that area is still moist, and yeast infections love warm, dark, moist places.
“In addition to that, if someone is working out or they’re outside in hot weather and they’re sweating, if they don’t change out of that outfit as soon as they’re able to, that is also increasing the risk for a yeast infection,” she explained. “It is the same for working out. Someone who works out in the gym, they do quite a gruesome workout and then after that they go run errands without changing out of their clothes. That can increase the risk for a yeast infection.”
You don’t need to use soap in the vagina
“In terms of bathing, you do not have to use soap in the vagina,” Dr. Edler said. This is “because we always say the vagina cleans itself.”
“Using soap in that area can cause irritation,” she said, adding that it is also important to “wear clothing that can breathe, so we recommend all cotton underwear.”
Wear loose clothing
Another good prevention measure is to wear “loose clothing,” Dr. Edler said. “That doesn’t mean that someone has to throw out their clothing because some people can wear anything they want and they never have a problem with the yeast infection.”
“Some women have to follow all of this to a T because otherwise they’re going to have more frequent infections,” she said.
Avoid using scented products on the vagina
“Also, avoid any kind of perfumes or anything scented in the area of the vagina,” Dr. Edler said. “This includes using a lubricant during sex.”
Instead, “use unscented lubricants and I also recommend water-based lubricants as well,” she said. “If you are using certain products down in the vaginal area that are reusable such as menstrual cups or spermicide applicators, those need to be cleaned after every use.”
Douching is not good for the vagina
“Do not use douching products for the vagina. Just don’t. You’re just asking for trouble,” Dr. Edler said. “What douching does is it is marketed as something that can help treat infections or help with vaginal irritation, but it typically causes more harm than good.”
That is “because it can wipe out any of the bacteria within the vagina that normally colonize it to help ward off pathogens,” she explained. “Then it either increases your risk of other infections and it can also increase the risk of a yeast infection because it would lead to overgrowth.”
Be careful when choosing over-the-counter medicine
“Many women, if they start to have symptoms of what they think is a yeast infection, will purchase treatment over the counter instead of seeking medical care,” Dr. Edler said. “But it is important to contact your doctor because symptoms of a yeast infection can overlap other types of infections. For example, it can overlap with bacterial vaginosis, a urinary tract infection or STDs.”
“The problem is, if you buy something over the counter but it’s not really a yeast infection, you could be delaying your treatment,” she said. For example, “if it’s something that we call pelvic inflammatory disease, then those can get very serious if you are delaying treatment.”
“While it is best to contact your doctor to be evaluated for a yeast infection, if someone does use one of the over-the-counter remedies such as Monistat, it comes in different lengths,” Dr. Edler said. “I commonly get asked which one to use. I recommend patients use the longer courses, such as the seven-day course, because that is less concentrated than the one or the three-day courses to help prevent further irritation.”
A yeast infection may occur even if you do everything right
“With any medical field, prevention is key,” Dr. Edler emphasized. But “sometimes you can do everything right and still get a yeast infection. “
“Patients sometimes will come in with signs of an infection and say they feel gross or like they did something wrong and that they are dirty and caused this. I never want anyone to feel that way,” she said. “Sometimes when you do everything right, you can still come up with an infection and you should feel that you can come to us so we can help you out even if it’s intimidating to talk about.”
