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Yeast Infections: What’s Normal, and When Should You Call Your OB/GYN?

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Vaginal yeast infections are a pretty common condition that a lot of women must deal with. While having a yeast infection is an annoyance and can cause unpleasant symptoms, it is not usually a serious condition that causes lasting complications. Many women can effectively treat symptoms and resolve the infection themselves using over-the-counter medication, but what if that doesn’t work. When should you call your OB/GYN when you have a yeast infection?

What is a Yeast Infection?

Vaginal yeast infections are fungal infections that affect the vagina and vulva. The vulva is the exterior tissues surrounding the vaginal opening. It is estimated that 3 out of 4 women will experience at least once in her life, but many women have more than one. It is usually not serious and can be treated easily.

Sometimes the condition is referred to as vaginal candidiasis because candida albicans is the fungus responsible for most cases. The vagina always has a mix of different yeasts like candida as well as bacteria. When there is no infection, the vagina naturally balances these fungi and bacteria. There are even bacteria called lactobacillus that prevent yeast overgrowth. 

If things are out of balance, then an overgrowth of candida can occur or the fungus will penetrate deeper vaginal cell layers. This overgrowth and penetration lead to a yeast infection, which causes discomfort and other unpleasant symptoms.

There are several things that can contribute to or cause yeast overgrowth, including:

  • Antibiotics, which can kill too much of the lactobacillus bacteria in the vagina
  • Uncontrolled diabetes
  • A weakened immune system, due to chronic or acute illness or certain medication
  • Increased estrogen levels caused by hormone therapy or birth control
  • Pregnancy
  • Douching or the use of scented feminine products
  • Exposing the vulva and vagina to wet or moist clothes for an extended period, including bathing suits or sweaty workout clothing
  • Wearing tight-fitting pantyhose or underwear
  • Wearing underwear without a breathable cotton crotch

Symptoms of a Yeast Infection

The symptoms of a vaginal yeast infection may be mild, moderate, or severe depending on how bad the infection is and your individual reaction to it. Some women experience only some of the below symptoms and have only mild discomfort, while others can have a different combination of symptoms and more discomfort. Common symptoms of yeast infections include:

  • Itchiness and irritation in the vagina and the vulva
  • Redness and swelling in the vulva
  • Vaginal pain and/or soreness
  • A burning sensation, especially while urinating or having vaginal intercourse
  • Vaginal rash
  • Thick and white odorless vaginal discharge with the texture and appearance of cottage cheese
  • Watery vaginal discharge 

When to See Your OB/GYN

Many times a simple yeast infection can be treated with over-the-counter medications like Monistat, which will kill the candida fungus and relieve symptoms like itchiness and pain. However, there are certain situations in which it is necessary to see a doctor.

Call your OB/GYN if:

  • You have possible complications
    • Pregnancy
    • Uncontrolled diabetes
    • A weakened immune system
  • You have more than four yeast infections in a year
  • Your symptoms are severe
    • Swelling
    • Extreme redness
    • Intense itchiness that leads to tears from scratching
    • Cracks
    • Sores
  • Your symptoms are not relieved by over-the-counter treatments
  • You develop other symptoms or your symptoms worsen
  • You have never had a yeast infection before
  • You are unsure whether your symptoms are caused by a yeast infection

Treating Yeast Infections

Depending on the severity of the yeast infection, there are a few treatment options. The doctor will also take into account how frequently you get them while deciding on a treatment plan.

Infrequent with Mild to Moderate Symptoms

  • Vaginal therapy: A topical antifungal can be used for between three and seven days to clear the infection. This is referred to as short-course therapy. These medications come in several forms including ointments, creams, suppositories, and tablets. Common antifungals used include terconazole and miconazole and can either be prescribed or purchased over the counter at a drugstore.
  • Single-dose oral medication: Available only by prescription, an oral antifungal medication called fluconazole, known by the brand name Diflucan, is taken orally. For infrequent and mild to moderate yeast infections, one dose is sufficient. You should only take the oral antifungal if you are not pregnant.

Frequently Occurring or Severe Infections

  • Long-course vaginal therapy: Antifungal medication is prescribed to be used every day for up to two weeks. For those who have frequent infections, the medication should also be used once a week for six months to prevent a recurrence.
  • Multi-dose oral medication: The oral medication fluconazole is taken by mouth in two or three doses over a span of several days. 
  • Therapy for antifungal resistant candida: If you develop an infection that is resistant to the standard antifungal medications, then your doctor may give you a capsule of boric acid to insert into the vagina. The boric acid is potentially fatal if taken orally, but can be effective in treating resistant fungus when used vaginally.

Make an Appointment

At Green Valley OB/GYN, we have decades of experience providing both obstetric and gynecological care to the women of the Greensboro, NC area. Our physicians have over 200 years of combined experience, so you can feel confident you are receiving the best care possible, whether you need a yearly well-woman checkup or are experiencing a high-risk pregnancy. If you have questions or concerns about any gynecological issues, including yeast infections, call us at (336) 378-1110 to make an appointment.