Vaginal Yeast Infection: Symptoms, Causes & Treatment

What Is a Vaginal Yeast Infection?

A vaginal yeast infection (vulvovaginal candidiasis) is a fungal infection caused by an overgrowth of Candida yeast, most commonly Candida albicans, in the vagina and vulva. It causes itching, burning, and a thick white discharge but is not dangerous and can be easily treated with antifungal medications.

Vaginal yeast infections are one of the most common gynecological conditions, affecting an estimated 75% of women at least once during their reproductive years. Approximately 40-45% of women will experience two or more episodes, and 5-8% suffer from recurrent vulvovaginal candidiasis, defined as four or more infections within a 12-month period. While yeast infections can occur at any age after puberty, they are most common during the reproductive years when estrogen levels are highest.

The infection occurs when the natural balance of microorganisms in the vagina is disrupted, allowing Candida yeast—which normally exists in small amounts in the vaginal environment—to multiply excessively. This overgrowth triggers an inflammatory response in the vaginal tissue and vulva, producing the characteristic symptoms of itching, burning, and discharge. Understanding this condition is essential because it helps women distinguish yeast infections from other vaginal conditions that may require different treatment approaches.

Despite being uncomfortable and sometimes distressing, vaginal yeast infections are not considered serious medical conditions. They do not cause long-term damage to the reproductive system and are highly treatable. However, proper diagnosis is important because other conditions—such as bacterial vaginosis, trichomoniasis, or contact dermatitis—can produce similar symptoms and require different treatments. Self-treatment is appropriate for women who have previously been diagnosed with a yeast infection and recognize their symptoms, but first-time sufferers or those with unusual symptoms should seek medical evaluation.

The role of Candida in vaginal health

Candida albicans is the species responsible for 85-90% of vaginal yeast infections. Other Candida species, including C. glabrata, C. tropicalis, C. parapsilosis, and C. krusei, account for the remaining cases. These non-albicans species are becoming increasingly common, particularly in women with recurrent infections or those who have used multiple courses of antifungal treatment. Non-albicans Candida may be more resistant to standard treatments and may require different therapeutic approaches.

In a healthy vaginal environment, Candida coexists with beneficial bacteria, particularly Lactobacillus species, which produce lactic acid and hydrogen peroxide to maintain an acidic pH (typically 4.0-4.5). This acidic environment inhibits the overgrowth of potentially harmful organisms, including Candida. When this delicate balance is disrupted—through factors such as antibiotic use, hormonal changes, or immune system alterations—Candida can transition from a harmless commensal organism to an invasive pathogen, triggering symptoms.

What Are the Symptoms of a Vaginal Yeast Infection?

The most common symptoms of vaginal yeast infection are intense vaginal and vulvar itching, a thick white "cottage cheese-like" discharge with no odor, burning sensations (especially during urination or intercourse), vulvar redness and swelling, and small cracks or fissures in the skin.

Vaginal yeast infection symptoms range from mild discomfort to severe irritation that significantly impacts daily activities and quality of life. The hallmark symptom is intense itching of the vagina and vulva (the external genital area), which may be constant or intermittent. Many women describe this itching as the most bothersome aspect of the infection, sometimes causing difficulty sleeping or concentrating on daily tasks. The itching typically worsens at night and may be exacerbated by warmth, moisture, or friction from clothing.

The vaginal discharge associated with yeast infections is characteristically thick, white, and clumpy—often compared to cottage cheese or curdled milk. Unlike bacterial vaginosis or trichomoniasis, the discharge from a yeast infection typically has no odor or only a mild, bread-like yeast smell. The amount of discharge varies; some women experience copious discharge while others notice only minimal changes. In some cases, the discharge may be thin and watery rather than thick, which can make diagnosis more challenging without clinical testing.

Vulvar symptoms

The vulva often shows visible signs of infection, including redness (erythema), swelling (edema), and sometimes a whitish coating. The skin may become dry, cracked, or develop small tears (fissures), particularly around the vaginal opening. These skin changes can make the area tender to touch and painful during activities such as walking, exercising, or sitting. In severe cases, the irritation can extend to the inner thighs and perineal area.

A burning sensation is another common symptom, which may be constant or triggered by specific activities. Many women experience dysuria (painful urination), not because of urinary tract infection, but because urine contacts the irritated vulvar skin. Similarly, dyspareunia (painful intercourse) is common during active infections due to inflammation of the vaginal tissue and vulvar skin. The vaginal walls may feel sore and swollen, making penetration uncomfortable or painful.

What Causes Vaginal Yeast Infections?

Vaginal yeast infections are caused by an overgrowth of Candida yeast, usually triggered by factors that disrupt the normal vaginal flora. Common causes include antibiotic use, hormonal changes (pregnancy, menstrual cycle, birth control), weakened immune system, diabetes, and lifestyle factors like tight clothing or douching.

Understanding the causes of vaginal yeast infections helps explain why some women are more susceptible than others and provides guidance for prevention. The fundamental cause is an imbalance in the vaginal microbiome that allows Candida yeast to proliferate beyond normal levels. However, numerous factors can trigger this imbalance, and many women experience infections without any identifiable cause.

Antibiotic use

Antibiotics are one of the most common triggers for vaginal yeast infections. While antibiotics effectively kill disease-causing bacteria, they also destroy beneficial Lactobacillus bacteria in the vagina. Without these protective bacteria, the vaginal pH rises and Candida can overgrow. Studies suggest that 25-35% of women develop yeast infections during or shortly after antibiotic treatment. The risk is higher with broad-spectrum antibiotics and longer courses of treatment.

Hormonal factors

Hormonal fluctuations significantly influence vaginal yeast infection risk. Estrogen promotes glycogen storage in vaginal cells, providing a food source for Candida. This explains why yeast infections are more common during pregnancy (2-3 times higher risk), the luteal phase of the menstrual cycle, and with use of high-estrogen oral contraceptives.

Immune system and diabetes

The immune system plays a crucial role in controlling Candida overgrowth. Conditions that weaken immune function—including HIV/AIDS, immunosuppressive medications, chemotherapy, and chronic stress—increase yeast infection susceptibility. Women with diabetes, especially those with poorly controlled blood sugar levels, have a significantly higher risk because elevated glucose promotes Candida growth.

What Can I Do to Treat a Yeast Infection at Home?

Mild vaginal yeast infections can often be treated at home with over-the-counter antifungal medications (creams, suppositories, or tablets) containing clotrimazole, miconazole, or tioconazole. Treatment durations range from 1-7 days, with most women experiencing symptom relief within 2-3 days.

Self-treatment with over-the-counter (OTC) antifungal medications is appropriate for women who have previously been diagnosed with a vaginal yeast infection and recognize their current symptoms. These medications are highly effective for uncomplicated infections, with cure rates of 80-90%. However, if this is your first yeast infection, if you're unsure of your diagnosis, or if you have certain risk factors, it's best to see a healthcare provider for proper evaluation before treating yourself.

Treatment tips for best results

• Complete the full course: Even if symptoms improve quickly, use all of the medication as directed to prevent recurrence
• Apply at bedtime: Nighttime application allows the medication to stay in place longer and reduces leakage
• Use a panty liner: Medication may leak out; a liner protects clothing and bedding
• Avoid sexual intercourse: Wait until treatment is complete and symptoms have resolved
• Don't use tampons: They may absorb the medication; use pads instead during your period

When Should You See a Doctor for a Yeast Infection?

See a healthcare provider if: this is your first yeast infection, OTC treatment doesn't work within 3-7 days, you have 4 or more infections per year, you're pregnant, you have diabetes or are immunocompromised, or you experience fever, pelvic pain, or unusual discharge.

While most vaginal yeast infections can be safely treated at home, certain situations warrant professional medical evaluation. Seeing a healthcare provider ensures proper diagnosis, as several other conditions can mimic yeast infection symptoms. A provider can also prescribe stronger treatments when needed and evaluate for underlying conditions that may be contributing to recurrent infections.

Specific situations requiring medical care

• First-time infections: If you've never had a diagnosed yeast infection, see a provider to confirm the diagnosis
• Treatment failure: If your symptoms don't improve within 2-3 days of starting OTC treatment, or if they haven't resolved completely after 7 days
• Recurrent infections: If you experience four or more yeast infections within a year
• Pregnancy: Treatment requires special consideration; consult your prenatal care provider
• Diabetes or immunocompromise: May have more severe or complicated infections

How Are Vaginal Yeast Infections Treated?

Vaginal yeast infections are treated with antifungal medications, available as OTC topical treatments (creams, suppositories) or prescription oral fluconazole. Uncomplicated infections typically respond to 1-7 day courses, while complicated or recurrent infections may require extended treatment protocols.

Treatment for vaginal yeast infections aims to eliminate the Candida overgrowth and relieve symptoms. Most women with uncomplicated infections achieve cure rates of 80-95% with appropriate treatment.

Prescription medications

Oral fluconazole (Diflucan) is a prescription option offering single-dose convenience. For uncomplicated infections, a single 150mg dose provides cure rates comparable to topical treatments. However, fluconazole can interact with other medications and is contraindicated during pregnancy.

Treatment for complicated infections

• Severe infections: May require 7-14 days of topical therapy or two doses of oral fluconazole (given 72 hours apart)
• Non-albicans species: May need 7-14 days of a non-fluconazole azole or boric acid suppositories (600mg daily for 14 days)
• Recurrent infections: Initial intensive treatment followed by maintenance therapy (fluconazole 150mg weekly for 6 months)

How Can You Prevent Vaginal Yeast Infections?

While not all yeast infections can be prevented, you can reduce your risk by: avoiding unnecessary antibiotics, wearing breathable cotton underwear, changing out of wet clothes promptly, avoiding douching and scented products, and maintaining good blood sugar control if diabetic.

Hygiene and lifestyle practices

• Wash the external genital area with warm water only: Soap can irritate delicate tissues and alter vaginal pH
• Never douche: Vaginal douching disrupts the natural bacterial balance
• Wipe front to back: Prevents transfer of intestinal bacteria and yeast
• Choose cotton underwear: Cotton is breathable and absorbs moisture
• Avoid tight clothing: Creates a warm, moist environment favorable for yeast
• Change out of wet clothes promptly: Don't stay in wet bathing suits or sweaty workout clothes

What Is the Difference Between Yeast Infection and Bacterial Vaginosis?

Yeast infections and bacterial vaginosis (BV) have different causes and symptoms. Yeast infections cause thick, white, odorless discharge with intense itching, while BV produces thin, grayish discharge with a fishy odor and minimal itching. BV requires antibiotics; yeast infections need antifungals.

Frequently Asked Questions