Signs and Symptoms of Vaginal Yeast Infections
Vaginal yeast infections present with a characteristic constellation of symptoms including vaginal itching, irritation, vaginal soreness, external dysuria (burning on urination), and dyspareunia (painful intercourse), often accompanied by a white, thick, curd-like vaginal discharge. 1
Primary Symptoms
Subjective complaints:
- Pruritus (itching) - the most prominent symptom 1, 2
- Vaginal irritation and soreness 1
- Burning sensation with urination (external dysuria) 1, 2
- Painful intercourse (dyspareunia) 1, 2
- Vaginal discharge changes - though not always present 1
Physical Examination Findings
Observable signs on examination:
- Vulvar edema (swelling) 1
- Erythema (redness) of the vulva and vagina 1, 3, 2
- Excoriation (scratch marks from itching) 1
- Fissures (small cracks in the skin) 1
- White, thick, curd-like vaginal discharge that resembles cottage cheese 1, 3, 2
- Rash or redness on the external genital skin (vulva) 2
Diagnostic Characteristics
Laboratory and clinical features:
- Normal vaginal pH (4.0-4.5) - this distinguishes yeast infections from bacterial vaginosis and trichomoniasis 1
- Presence of yeast or hyphae on microscopy using potassium hydroxide (KOH) wet mount preparation 1
- The white adherent vaginal discharge is associated with burning and itching 1
Clinical Context and Variations
In HIV-infected or immunosuppressed patients:
- Episodes may be more severe and more frequently recurrent 1
- The syndrome can be mild to moderate in severity and sporadic (similar to immunocompetent hosts) 1
Important clinical pitfall: These symptoms and signs are nonspecific and can result from various infectious and noninfectious etiologies including bacterial vaginosis, trichomoniasis, and other conditions 1. Before proceeding with antifungal therapy, diagnosis should be confirmed by wet-mount preparation with saline and 10% KOH to demonstrate yeast or hyphae 1.
What Vaginal Yeast Infections Do NOT Cause
Critical exclusions - if present, consider alternative diagnoses:
- Fever or chills 2
- Lower abdominal, back, or shoulder pain 2
- Foul-smelling vaginal discharge 2
- Missed menstrual period 2
These symptoms may indicate sexually transmitted diseases (STDs), pelvic inflammatory disease, or tubal pregnancy and require immediate medical evaluation 2.