From the Guidelines
Vaginal candidiasis, also known as yeast infection, is a common fungal infection caused by Candida albicans.
Cause and Risk Factors
Vaginal candidiasis is caused by an overgrowth of Candida albicans, which can occur due to factors such as antibiotic use, pregnancy, diabetes, hormonal changes, and impaired immune function 1. Other risk factors include tight-fitting clothing, use of scented soaps or bubble baths, and sexual intercourse.
Preventive Measures
To prevent vaginal candidiasis, it is recommended to practice good hygiene, wear loose-fitting clothing, avoid scented soaps or bubble baths, and change out of wet swimsuits or workout clothes promptly. Additionally, managing diabetes, avoiding excessive antibiotic use, and maintaining a healthy diet can help reduce the risk of infection.
Signs and Symptoms
Common signs and symptoms of vaginal candidiasis include itching, burning, or soreness in the vaginal area, redness and swelling of the vulva, a thick, white, cottage cheese-like discharge, and pain during urination or intercourse 1.
Treatment
For mild to moderate cases, treatment with an over-the-counter (OTC) antifungal medication such as clotrimazole (Gyne-Lotrimin) or miconazole (Monistat) is recommended 1. These medications are available in cream, tablet, or suppository form and are typically used for 3-7 days. For more severe cases or recurrent infections, a prescription medication such as fluconazole (Diflucan) may be necessary, with a typical dose of 150 mg as a single oral dose 1. It is essential to complete the full treatment course and follow up with a healthcare provider if symptoms persist or worsen. Some key treatment regimens include:
- Clotrimazole 1% cream: 5 g intravaginally daily for 7–14 days
- Clotrimazole 2% cream: 5 g intravaginally daily for 3 days
- Miconazole 2% cream: 5 g intravaginally daily for 7 days
- Fluconazole 150 mg: single oral dose 1
From the FDA Drug Label
If you get vaginal yeast infections often (such as once a month or 3 in 6 months), you should talk to a doctor. Listed below are some of the causes of repeated yeast infections: • hormonal changes occurring a few days before the monthly period • use of antibiotics • use of some birth control pills • pregnancy • diabetes (“sugar” or “high blood sugar”) • clothing – wearing tight layers or moist clothing in the genital area • weakened immune system – some drugs (such as chemotherapy or steroids) and medical conditions can weaken the body’s normal ability to fight infection. To lower your chances of getting another yeast infection: • Try to keep the genital area cool and dry Yeast grow well in warm, moist areas. The following suggestions may be helpful: (1) Wear cotton underwear and loose-fitting clothes. (2) Change out of damp clothes or a wet bathing suit as soon as possible. (3) If you use minipads when you are not having a menstrual period, change the minipads often. • Talk with your doctor about any drugs you are now taking You are more likely to get a vaginal yeast infection if you are taking certain drugs such as antibiotics, steroids, or birth control pills. Do not stop taking these drugs without first asking your doctor. A doctor may need to see you to make sure that you do not have other medical conditions such as diabetes or a weakened immune system. Vaginal yeast infections are usually not spread by having intercourse (sex) However, if your partner has a rash, itching or discomfort in his genital area, he should contact a doctor to find out the cause of his symptoms and tell the doctor that you are treating your vaginal yeast infection with this product.
The cause of vulvovaginal candidiasis (Vaginal Yeast Infection) includes:
- Hormonal changes
- Use of antibiotics
- Use of some birth control pills
- Pregnancy
- Diabetes
- Wearing tight or moist clothing
- Weakened immune system
Risk factors for vulvovaginal candidiasis include:
- Taking certain drugs such as antibiotics, steroids, or birth control pills
- Having a weakened immune system
- Having diabetes
Preventive measures for vulvovaginal candidiasis include:
- Keeping the genital area cool and dry
- Wearing cotton underwear and loose-fitting clothes
- Changing out of damp clothes or a wet bathing suit as soon as possible
- Talking with your doctor about any drugs you are now taking
Signs and symptoms of vulvovaginal candidiasis are not explicitly listed in the provided text, but it is mentioned that symptoms such as itching and irritation may occur.
Treatment of vulvovaginal candidiasis includes using a vaginal insert and cream, such as miconazole, and following the instructions provided by the doctor or pharmacist. It is also important to talk with your doctor about any drugs you are now taking and to follow the preventive measures listed above. 2
It is also worth noting that fluconazole, an oral antifungal medication, can be used to treat vaginal candidiasis, with a therapeutic cure rate of 55% in one study. 3
From the Research
Cause of Vulvovaginal Candidiasis
- Vulvovaginal candidiasis (VVC) is a frequently occurring infection of the lower female genital tract, mostly affecting immuno-competent women at childbearing age 4.
- Candida albicans is the most prevalent pathogenic yeast, apart from other non-albicans species, related to this fungal infection 4, 5.
- The development of VVC is usually attributed to the disturbance of the balance between Candida vaginal colonization and host environment by physiological or nonphysiological changes 6.
Risk Factors
- Host-related factors include pregnancy, hormone replacement, uncontrolled diabetes, immunosuppression, antibiotics, glucocorticoids use, and genetic predispositions 6.
- Behavioral risk factors include use of oral contraceptives, intrauterine device, spermicides and condoms, and some habits of hygiene, clothing, and sexual practices 6.
- Hormonal changes, especially estrogen, play a critical role in increasing susceptibility to VVC from menarche to menopause 5.
Preventive Measures
- Probiotics, which focus on vaginal microbiome balance, appear as viable preventative strategies for VVC 5.
- Maintaining good hygiene and avoiding certain habits of clothing and sexual practices may help prevent VVC 6.
Signs and Symptoms
- Physical symptoms of VVC include genital discomfort, decreased sexual pleasure, and psychological suffering 5.
- VVC can cause physical and psychological problems, affecting up to 75% of women and causing morbidity and lowering quality of life 5.
Treatment
- Antifungal medicines are widely used for the therapy of VVC, but have resulted in resistance issues, demanding a rethinking of therapeutic techniques 5, 7.
- Current care is based on antifungals, but problems continue, necessitating the investigation of new drugs, such as oteseconazole and ibrexafungerp, which show promise and have the potential to change RVVC therapy 5.
- Treatment options for women with azole-resistant refractory VVC are extremely limited, and new therapeutic options and strategies are urgently needed to meet this challenge of azole drug resistance 7.