The cause of infection is unknown in at least half of cases. It may be that a genetic susceptibility causes a response to yeast that lays the groundwork for the next infection. This may be the main cause in women with recurrent infections.
A thick white discharge, unaccompanied by other symptoms, is rarely a sign of infections.
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How Is a Yeast Infection Diagnosed?
During an examination of the vaginal area, the clinician will look for signs of infection. Using a swab, he or she may collect a sample of cells from the vagina. The cells will be examined through a microscope to look for yeast and rule out other possible causes of infection. In some cases, cultures will be sent to a laboratory, which is very effective in diagnosing the infection and identifying the specific type of yeast so the best treatment can be determined.
Many women may self-diagnose itching and irritation as a yeast infection. This is not recommended because other conditions have the same or similar symptoms, including trichomoniasis ("trich"), bacterial vaginosis, genital herpes, and many benign vulvar skin conditions.
How Is a Yeast Infection Treated
Treatments for yeast infections include:
- Oral medication: fluconazole by prescription
- Vaginal medication: various creams or suppositories, by prescription or over the counter
Symptoms that do not go away after treatment with over-the-counter medications need to be evaluated further.
Comfort measures during treatment include:
- Sitz baths—warm or lukewarm water with 4-5 tablespoons of baking soda can soothe vulvar itching and burning
- Cool gel pack or compresses to the vulvar area, helpful at night to sleep
- A+D® ointment, petroleum jelly, or Crisco®—apply a small amount to protect the irritated vulvar skin
What about sex during treatment?
Sex during treatment is OK as long as it is comfortable. Sometimes sex will cause irritation or burning, so it may be necessary to delay sexual activity until after treatment. It is important to remember that medications used in the vagina may weaken latex condoms, causing breakage.
Recurring or Complicated Yeast Infections
Some women have symptoms that persist or recur after treatment. It is important to verify that an infection is truly present, and to find out what type of yeast is causing it. Some recurrent infections may be caused by a different type of Candida (for example, Candida glabrata) that does not respond to common yeast medications, or the infection may be complicated and require treatment for a longer period of time. Women who have frequent yeast infections may also require longer treatment to suppress the growth of yeast and prevent symptoms.
Common Misconceptions About Yeast Infections
Do sexual partners need treatment?
It is not necessary to treat sexual partners because there is no evidence that treating a partner is helpful. Oral sex may, however, be a contributing factor.
Will eating yogurt or applying it to the vagina will prevent or treat yeast infections?
Yogurt containing live yeast cultures will not treat or prevent yeast infections, whether eaten or applied to the vagina.
Is all vaginal itching a yeast infection?
Other infections and conditions may cause itching. Any persistent itching that does not respond to treatment needs to be evaluated.