Vaginal yeast infection

Vaginal yeast infection
Other names	Candidal vulvovaginitis, vaginal thrush
Gram stain showing the spores and pseudohyphae of Candida albicans surrounded by round vaginal skin cells, in a case of candidal vulvovaginitis.
Specialty	Gynaecology
Symptoms	Vaginal itching, burning with urination, white and thick vaginal discharge, pain with sex, redness around the vagina[1]
Causes	Excessive growth of Candida[1]
Risk factors	Antibiotics, pregnancy, diabetes, HIV/AIDS[2]
Diagnostic method	Testing the vaginal discharge[1]
Differential diagnosis	Chlamydia, gonorrhea, bacterial vaginosis[3][1]
Treatment	Antifungal medication[4]
Frequency	75% of women at some point[1]

Vaginal yeast infection, also known as candidal vulvovaginitis and vaginal thrush, is excessive growth of yeast in the vagina that results in irritation.^[5][1] The most common symptom is vaginal itching, which may be severe.^[1] Other symptoms include burning with urination, a thick, white vaginal discharge that typically does not smell bad, pain during sex, and redness around the vagina.^[1] Symptoms often worsen just before a woman's period.^[2]

Vaginal yeast infections are due to excessive growth of Candida.^[1] These yeast are normally present in the vagina in small numbers.^[1] Vaginal yeast infections are typically caused by the yeast species Candida albicans. Candida albicans is a common fungus often harbored in the mouth, digestive tract, or vagina without causing adverse symptoms.^[6] The causes of excessive Candida growth are not well understood,^[7] but some predisposing factors have been identified.

It is not classified as a sexually transmitted infection; however, it may occur more often in those who are frequently sexually active.^[1][2] Risk factors include taking antibiotics, pregnancy, diabetes, and HIV/AIDS.^[2] Tight clothing, type of underwear, and personal hygiene do not appear to be factors.^[2] Diagnosis is by testing a sample of vaginal discharge.^[1] As symptoms are similar to that of the sexually transmitted infections, chlamydia and gonorrhea, testing may be recommended.^[1]

Treatment is with an antifungal medication.^[4] This may be either as a cream such as clotrimazole or with oral medications such as fluconazole.^[4] Despite the lack of evidence, wearing cotton underwear and loose fitting clothing is often recommended as a preventive measure.^[1][2] Avoiding douching and scented hygiene products is also recommended.^[1] Probiotics have not been found to be useful for active infections.^[8]

Around 75% of women have at least one vaginal yeast infection at some point in their lives, while nearly half have at least two.^[1][9] Around 5% have more than three infections in a single year.^[9] It is the second most common cause of vaginal inflammation after bacterial vaginosis.^[3]