Vaginal yeast infections are one of the most common women’s health issues - so common, in fact, that they affect approximately 75% of women at some point in their lives. However, yeast infection symptoms can be identical to symptoms of other more serious conditions, such as dermatitis (skin irritation), certain sexually transmitted infections (STIs) and bacterial vaginosis.

Because of those similarities, it’s important to understand vaginal yeast infection causes, symptoms, testing and treatment options so that the infection can be identified and managed effectively. In this blog post, we’ll address some frequently asked questions about vaginal yeast infections, causes and symptoms, along with treatment options and preventative measures to help women stay healthy and comfortable.

What is a vaginal yeast infection?

A vaginal yeast infection, also known as vaginal thrush, vaginal candidiasis or vulvovaginal candidiasis, is a fungal infection of the vagina caused by an overgrowth of Candida albicans yeast. Candida yeast is a type of fungus that exists naturally in small amounts within your vagina, mouth, and digestive tract. It normally lives in harmony with bacteria and other organisms without causing any harm, a microbial balance which is often referred to as “vaginal flora.” However, when there is an imbalance in the body, the yeast can multiply and lead to an infection.

What causes vaginal yeast infections?

Vaginal yeast infections can be a result of habits, health conditions and more. Some common causes of vaginal yeast infections include:

• Antibiotic use: Antibiotics are normally prescribed to destroy “bad” bacteria that are causing an infection, but they can also destroy “good” bacteria that help maintain the balance of yeast in the vagina. This leads to an overgrowth of Candida, and explains why so many women often develop vaginal yeast infections after taking antibiotics for infections such as urinary tract infections (UTIs).
  
• Hormonal changes: Fluctuations in hormone levels due to pregnancy, oral contraceptives (birth control pills), or hormone replacement therapy can disrupt the balance of yeast in the vagina.
  
• Menopause: Yeast infections can occur more frequently in menopausal women, as hormonal changes can interfere with bacterial and fungal levels within the vagina and cause thinning of the vaginal tissue.
  
• Compromised immune systems: Individuals with weakened immune systems, such as those with HIV or undergoing chemotherapy, are at a higher risk of developing yeast infections.
  
• Diabetes: Women with poorly controlled diabetes are more susceptible to yeast infections due to elevated blood sugar levels, which can encourage yeast growth.
  
• Douching or feminine hygiene products: Douching and feminine hygiene sprays are a major cause of vaginal infections, as they can throw off your vagina’s natural balance and lead to an overgrowth of bacteria. Don’t be fooled by claims that the products are cleansing - vaginas are actually self-cleaning and do not require fragrant sprays or soaps to stay hygienic!
  
• Menstruation: The hormonal changes brought on by your period can result in bacterial balance disruption and lead to a yeast infection. Yeast infections can also occur if you are not changing sanitary napkins or tampons often enough.
  

• Damp or tight clothing: Wearing tight-fitting or wet clothing, such as wet swimsuits, pantyhose or tight leggings, can create a warm and moist environment that promotes yeast growth. Cotton underwear are a great way to avoid this occurrence, as cotton fabric is breathable and absorbs moisture.
  
  

  What are the symptoms of a vaginal yeast infection?

  
  

  Vaginal yeast infections are typically characterized by the following symptoms:
  

• Itchiness and irritation in the vaginal area
  
• Redness and swelling of the vulva
  
• Vaginal pain and soreness
  
• A burning sensation, especially during urination or sexual intercourse
  
• Thick, white, and odorless vaginal discharge, often described as resembling cottage cheese
  
  ## What are my treatment options for vaginal yeast infections?
  Over-the-counter (OTC) or prescription medications are generally considered to be the most effective and fastest way to get rid of yeast infections. The majority of vaginal yeast infection medications belong to a category of antifungals known as azoles, which work by stopping the growth of yeast. These treatments come in the form of vaginal creams or vaginal suppositories which are inserted into the vagina to fight off the yeast infection, or as oral antifungal pills which are taken by mouth. They can take anywhere from 1 to 7 days to treat your symptoms and infection depending on the form and dosage.

Examples of OTC vaginal yeast infection medications include:

• Miconazole (Monistat): Miconazole, commonly known by the brand name Monistat, is an OTC antifungal that is sold over-the-counter at most pharmacies and is available as Monistat 1, 3, & 7. The numbers correlate with the dosage, so Monistat 1 is a single-dose, highly-concentrated option, while Monistat 7 is taken over the span of a week and is the least concentrated option. Monistat is able to treat most yeast infections and claims to offer symptom relief within 1 hour. It comes as a cream or suppository which is inserted into the vagina to kill the yeast that are causing your infection. If you are pregnant, talk to your doctor before using yeast infection medicine. Only topical 7-day therapies (such as Monistat-7) are recommended for treating yeast infections during pregnancy.
  
• Clotrimazole (generic Gyne-Lotrimin): Vaginal clotrimazole, also known under the brand names Trivagizole or Gyne-Lotrimin, is an OTC cream which inserted into the vagina. It can be applied to the skin around the outside of the vagina and is available over-the-counter and via prescription. Clotrimazole usually begins to relieve symptoms within 3 days, and should improve your infection within 7 days. There are also stronger clotrimazole products available via prescription.
  
• Tioconazole (Vagistat-1): Tioconazole is an OTC vaginal yeast infection medication that treats the infection by stopping the growth of Candida within the vagina. It comes as an single-dose applicator that is inserted into the vagina so that the medication can be dispensed. The medication can also be applied to the vulva to relieve itching or burning. Patients typically see symptom improvement after the 1-day treatment, but it can take up to 7 days after using the 1-day dose before symptoms go away completely.
  

If over-the-counter medication is not helping to alleviate your vaginal yeast infection symptoms, you may want to consider prescription medication. Prescription vaginal yeast infection medications include:

• Terconazole: Terconazole is an antifungal medication that is prescribed as a cream and suppository to insert into the vagina. Terconazole should take effect within 5 to 10 hours after being inserted into the vagina, and symptoms should improve within 1 or 2 days after starting the medication.
  
• Clotrimazole: Vaginal clotrimazole is available both in OTC and prescription form and comes in the form of a tablet or medicated cream which are inserted into the vagina with an applicator. The prescription form of clotrimazole is more concentrated and typically begins to relieve symptoms within 3 days, and should improve your infection within 7 days.
  
• Fluconazole (generic Diflucan): Your healthcare provider may prescribe a one-time, single oral dose of fluconazole (Diflucan) to treat your yeast infection. Oral vaginal yeast infection medications like fluconazole should not be taken if you are pregnant, as it can harm the fetus. Symptom improvement is usually seen within 1 to 3 days.
  
• Ibrexafungerp (Brexafemme): Ibrexafungerp is an oral tablet that is taken twice a day for one day. It works by targeting the specific fungal cells behind the yeast infection. As with fluconazole, taking ibrexafungerp while pregnant can cause loss of pregnancy or serious birth defects. You should use effective birth control methods during treatment with ibrexafungerp and for 4 months after.
  
  ## Can I get vaginal yeast infection medication online?
  Good news! If deemed clinically appropriate, providers on Sesame can write a prescription for vaginal yeast infection medication to be picked up near you – often within the same day! Simply talk to a clinician and get your online doctor prescription or refill ordered right away for fast and convenient pickup from a pharmacy of your choice.

Note that all prescriptions are at the discretion of your healthcare provider.

How do I know if I have a vaginal yeast infection?

If you suspect that you have a vaginal yeast infection, it's important to consult a healthcare provider for an accurate diagnosis and appropriate treatment. Symptoms of a vaginal yeast infection such as the ones listed above can also be indicators of sexually transmitted diseases (STDs), bacterial vaginosis or other health problems, so a medical diagnosis from a gynecologist or other healthcare provider is essential for proper treatment.

You should also contact your healthcare provider if medication is not resolving your symptoms, or if you are experiencing side effects such as trouble breathing, rapid heartbeat, hives, or other conditions that cannot be otherwise explained while taking your medication.

Booking yeast infection treatment online with a doctor or nurse is typically the fastest way to address your vaginal yeast infection. Sesame offers same-day appointments, along with online doctor prescription and prescription refill appointments with board-certified healthcare professionals. Simply set up an appointment with a real doctor or clinician at your convenience so that you can discuss your vaginal yeast infection and get the care you need.

Sources:

• Atabek ME, Akyürek N, Eklioglu BS. Frequency of vagınal candida colonization and relationship between metabolic parameters in children with type 1 diabetes mellitus. J Pediatr Adolesc Gynecol**text in italic. 2013;26(5):257-260. doi:10.1016/j.jpag.2013.03.016.
  
• Health Link British Columbia. Recurrent vaginal yeast infections. healthlinkbc.ca/health-topics/d89735737.
  
• Vaginal yeast infections (thrush): What helps? (n.d.). ncbi.nlm.nih.gov/books/NBK543219/