Yeast infection

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Yeast infection is a term usually referring to a candidiasis infection.

Candidiasis.jpg

Candida albicans

There are over 20 species of Candida yeasts that can cause infection in humans, the most common of which is Candida albicans. Candida yeasts normally reside in the intestinal tract and can be found on mucous membranes and skin without causing infection; however, overgrowth of these organisms can cause symptoms to develop. Symptoms of candidiasis vary depending on the area of the body that is infected.

Thrush

Candidiasis that develops in the mouth or throat is called “thrush” or oropharyngeal candidiasis.

Vaginal yeast infection

Candidiasis in the vagina is commonly referred to as a “yeast infection.”

Invasive candidiasis

Invasive candidiasis occurs when Candida species enter the bloodstream and spread throughout the body.

Types of candidiasis

  • Candida infections of the mouth, throat, and esophagus
  • Vaginal Candidiasis
  • Invasive Candidiasis

Vaginal candidiasis

Symptoms of vaginal thrush

Symptoms you may experience if you develop vaginal thrush include: 

  • vaginal discomfort – itching or burning
  • a thick, white discharge with a ‘cottage cheese’ appearance and yeasty smell
  • redness or swelling of the vagina or vulva
  • stinging or burning while urinating or during sex
  • splits in the genital skin.

Diagnosis of vaginal thrush

To make a diagnosis of vaginal thrush, your GP will need to: 

  • take a detailed history of your symptoms 
  • examine your genitals
  • take a swab from the affected area.

Thrush is not sexually transmitted

Vaginal thrush is not a sexually transmissible infection (STI). It is caused by an overgrowth of the yeast Candida albicans  which is normally found on the genital area. This overgrowth may occur due to: 

  • antibiotic use
  • oral contraceptive use
  • diabetes
  • pregnancy
  • menstrual cycle changes
  • general illnesses like diabetes, iron deficiency and immune system disorders
  • associated vulval skin conditions, such as eczema.

Sometimes, the reason for candida overgrowth cannot be identified.

Treatment for vaginal thrush

Treatment aims to reduce the number of yeasts so they no longer cause symptoms. Options that are available from your local pharmacist without a script include: 

  • antifungal creams or vaginal pessaries (tablets) – these are put inside the vagina with a special applicator and are used from one to six days, depending on the instructions. Occasionally a second course of treatment is required. Repeated topical treatments (applied to the skin) may occasionally cause skin irritation
  • oral tablets – these are called fluconazole and are designed to be swallowed. This treatment is more expensive than other options and is not recommended for pregnant women or as a ‘first line’ treatment. If you are on other medications or are pregnant, consult with your doctor or pharmacist before taking fluconazole.

Sometimes symptoms only last for a short time (for example, the week before your period) and treatment is not necessary. 

Prevention of vaginal thrush

To help prevent vaginal thrush: 

  • Wipe your bottom from front to back after going to the toilet. This will prevent the spread of Candida albicansfrom the anus to the vagina.
  • Avoid using soap to wash the genital area. Soap substitutes can be used. Sorbolene (with or without glycerine) is probably the cheapest and is very effective. 
  • Avoid using antiseptics, douches or perfumed sprays in the genital area.
  • Avoid using perfumed toilet papers and menstrual products.
  • Avoid wearing tight-fitting pants and synthetic underwear.
  • Consider changing your clothes-washing detergent and don’t use fabric softeners.

Vaginal thrush and sex

You can still have sex when you have vaginal thrush. However, it can be uncomfortable and you may experience a burning sensation during or after sex. Use plenty of lubricant to protect your skin. 

Thrush is not an STI, but male partners can sometimes get redness and irritation after sex.

The treatment for thrush can weaken condoms, so apply the treatments after you have had sex if you are using condoms. 

Ruling out other vaginal conditions

A number of other vaginal conditions result in symptoms that are similar to those of thrush. See your doctor if you: 

  • are not sure if you have thrush
  • have had several episodes of thrush
  • have had recent unprotected sex with a new partner
  • have pain in your pelvic area or abnormal bleeding
  • treated yourself with a thrush treatment and your symptoms haven’t gone away.

Management of recurrent thrush

If you experience repeated episodes of thrush, it is recommended that you see your GP to confirm that it is thrush and that you don’t have an STI. Your GP can check for the presence of other skin conditions that may have similar symptoms and exclude other conditions that can cause thrush (such as diabetes). 

Any factor contributing to the overgrowth of Candida albicans should be identified and managed. If no contributing factors are found, a course of preventative treatment may be recommended. 

There is no evidence to support the treatment of male partners of women who experience thrush. Thrush outbreaks, while uncomfortable, do not cause any long-term health issues. There is also no clear evidence that dietary changes prevent thrush, but the research is limited.


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