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All About Yeast Infections: The Complete, Unabridged Guide to Vaginal and Other Yeast Infections

at November 17, 2018
Candida is a yeast (a type of fungus) commonly found on the skin and in the body, including the mouth, throat, gut, and vagina. In fact, research indicates that Candida yeast colonizes the vagina of at least 20 percent of all women — and 30 percent of all pregnant women — without causing symptoms.





But if Candida yeast (especially Candida albicans) becomes overgrown, a vaginal yeast infection may develop. These infections — also known as candidal vaginitis, vaginal candidiasis, or vulvovaginal candidiasis — typically cause a number of noticeable symptoms, which are the same for nonpregnant and pregnant women.
What Are the Symptoms of a Vaginal Yeast Infection?

  1. Itching in the vaginal area and around the vulva (the opening of the vagina)
  2. Burning in the vaginal area
  3. Swelling of the vulva
  4. White or gray vaginal discharge that may be thick (sometimes described as looking like cottage cheese) but does not have a bad smell
  5. Greenish or yellowish vaginal discharge that's also similar to cottage cheese and smells like yeast or bread
  6. Burning during urination
  7. Pain during sexual intercourse
  8. Vulvar rash
Most vaginal yeast infections do not produce a strong vaginal odor. Fishy vaginal odors are more common with bacterial vaginosis, a type of bacterial infection of the vagina.
Severe yeast infections may also cause redness and tears or cracks (fissures) in the wall of the vagina.

How Is a Yeast Infection Diagnosed?





As straightforward as it might seem, most doctors will discourage you from diagnosing and treating a yeast infection yourself.

This is because vaginal infections caused by bacteria, as well as some sexually transmitted infections (STI), may have symptoms very similar to those caused by yeast, but they require different treatments. Since yeast infection treatments have become available over the counter (OTC), many women simply visit the closest drugstore and buy an antifungal cream.

But sometimes these products are bought and used by women who don't actually have a vaginal yeast infection, wasting time and money and potentially worsening the vaginal itchiness and irritation.

One study published in the journal Obstetrics & Gynecology showed that only 34 percent of study participants who purchased OTC antifungal products accurately diagnosed themselves with a yeast infection.




The other women in the study actually had other types of vaginal inflammation, including bacterial vaginosis and the STI trichomonas vaginalis.

This misdiagnosis of vaginal infections is an important issue: Just as some bacteria are becoming resistant to certain antibiotics, yeast that normally lives in the vagina can become resistant to antifungal medication.

If this happens, it can become very difficult to treat a yeast infection when one actually does develop.

Because of this, the American Academy of Family Physicians recommends that, for a first episode of a possible yeast infection, women see a physician to get a proper diagnosis.

If a woman has had a physician-diagnosed yeast infection in the past and feels certain that her current symptoms are caused by a yeast infection, it's reasonable to ask her doctor about self-treatment with an OTC medication.




However, if symptoms don't improve or they come back again, or if symptoms are different from past yeast infections, an office visit is warranted.

What Doctors Look For When They Suspect a Yeast Infection

At your doctor's office, your doctor will ask you about your symptoms and your overall medical history, including past vaginal infections and sexually transmitted diseases.
You doctor will then conduct a gynecological exam to check for redness, swelling, discharge, and odor.
Your doctor will perform a pelvic exam, which will include inspecting your vagina and vulva to see if there are external signs of infection, such as swelling and redness, and cracks in the skin of the vulva.
Your doctor will also examine your cervix for swelling and redness, and your vaginal walls for dry, white spots.
To get a concrete diagnosis, your doctor will likely take a sample of your vaginal secretions and examine it under a microscope.

Tests That Help Determine Yeast Infection Presence

The two most common tests for a yeast infection are the vaginal wet mount and the KOH test.

For the vaginal wet mount, your doctor or a lab technician will mix a sample of your vaginal discharge with a salt solution, put it onto a glass slide, and look at it under a microscope.

If there are an abnormally large number of Candida microbes and white blood cells (which indicate your body is fighting an infection), you have a yeast infection.

The wet mount can also help rule out other infections, including bacterial vaginosis and trichomoniasis.

Instead of using a salt solution, the KOH test uses potassium hydroxide.

This solution kills bacteria and vaginal cells, leaving only the fungus that may be present in your vagina. If a fishy or amine odor arises from the KOH, you may have bacterial vaginosis.

If, after diagnosis, your infection doesn't get better with treatment or comes back several more times within a year (a condition called recurrent or chronic yeast infection), your doctor may order a culture test of your yeast.




A culture test will help determine if a Candida species other than C. albicans is causing your chronic infection (such as C. glabrata or C. krusei) — some yeast species are resistant to the drugs used to treat a C. albicans infection.
Symptoms of Other Types of Yeast Infections





Though the term "yeast infection" most often refers to those affecting the vulvovaginal area, symptomatic yeast infections can also develop on the skin (cutaneous candidiasis), in the mouth and throat (thrush), in the esophagus (candida esophagitis), and on the penis (balanitis).

Cutaneous candidiasis most often causes intense itching, as well as a pimple-like infection of the hair follicles and a rash on various areas of the skin, including the skin folds, genitals, abdominal region, buttocks, and under the breasts.

Common symptoms of thrush and candida esophagitis include:
  1. White patches on various parts of the mouth and throat
  2. Redness or soreness and pain while eating or swallowing
  3. Feeling like you have cotton in your mouth
  4. Loss of taste
  5. Cracking at the corners of the mouth




In men, balanitis can cause:
  1. Inflamed, red glans (rounded part at the end of the penis)
  2. Painful urination
  3. Itching and unpleasant smell
  4. Foreskin issues, such as a thick and lumpy discharge or a tightness that prevents pulling back the foreskin to its original position

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