Vaginal yeast infection

A fungal infection of the vagina is also called vaginal mycosis. The disease can manifest itself as discharge, burning, or itching. Often, the external genital organs such as the labia also become inflamed. Sometimes there are no symptoms at all.  With the disease, yeast fungi multiply in the vagina and trigger an inflammation. In addition to bacteria, which can lead to bacterial vaginosis, yeast fungi most commonly cause inflammation of the vagina and external genital organs.

Women are particularly susceptible to fungal infections of the vagina during certain phases of life, for example, during pregnancy. A weakened immune system and certain medications can also promote vaginal fungus. It is often sufficient to treat the infection briefly with vaginal suppositories or creams so that it subsides. In some cases, tablets are also helpful.

Unpleasant burning, itching, and pain are among the typical symptoms of a vaginal yeast infection. The vaginal mucosa is reddened and has a whitish coating. Symptoms can intensify a few days before menstruation. If the infection spreads to the external genital organs, the labia, for example, are also red and swollen.

The disease is often accompanied by a white-yellowish discharge from the vagina. The discharge may be watery or crumbly and resemble curdled milk. During the infection, sexual intercourse may be painful. If the urethra also becomes inflamed, affected women also experience pain when urinating.

The disease is mainly caused by yeast fungi, or more precisely by the pathogen Candida albicans. These fungi are part of the natural vaginal flora. However, they are normally present only in small numbers and do not cause any symptoms. 

However, if the vaginal flora is out of balance, the fungi can cause an infection of the vagina:

• Increased estrogen levels during pregnancy can change the vaginal flora and promote vaginal fungus.
• In addition, women who use birth control pills have an increased risk of vaginal fungus. The reason is that the pill changes the body’s hormone balance similar to that of a pregnant woman.
• Diseases that weaken the immune system also increase the risk of vaginal fungus. These include diabetes mellitus, for example.
• There are also medications and treatments that can promote vaginal infection, including antibiotics, cortisone, and hormone, radiation, or chemotherapy treatments.

Other factors that promote a vaginal yeast infection are:

• stress
• excessive intimate hygiene
• synthetic and tight-fitting clothing
• sweating
• the use of air-tight panty liners or pads

Vaginal yeast infections can also be caused by infection if very large numbers of yeast fungi enter the vagina from outside. This can happen, for example, during sexual intercourse with a man who has a fungal infection of the glans.

Infections caused by vaginal fungi are the second most common cause of vaginitis after bacterial infections. Up to 75 out of every 100 women will have a vaginal yeast infection at least once in their lives.  Women of childbearing age are most commonly affected. The cause of vaginal mycosis in post-menopausal women may be related to medications, for example, if estrogen-containing drugs are taken.

Often, those affected have only mild symptoms or even no symptoms at all. In rare cases, severe symptoms occur that require more intensive treatment. More intensive treatment is also necessary if vaginal mycosis occurs several times a year or is due to an immune deficiency.

If the vaginal mucosa is inflamed or the itchy skin around the labia is scratched, other pathogens can settle more easily and aggravate the symptoms. Then neighboring tissue such as the urethral orifice can also become inflamed more easily.

Serious complications are very rare. They usually only occur in connection with a weakened immune system, for example, in patients who are being treated for cancer or who have AIDS. In such cases, the inflammation can intensify and spread further.

In pregnant women, vaginal infections can slightly increase the risk of complications, such as premature labor, miscarriage, and premature birth. In addition, the baby can become infected during birth. In newborns, fungi can cause inflammation of the oral mucosa or diaper rash, among other symptoms.

If the immune system is weakened, antifungals can prevent a fungal infection in some cases. Some women use preventive antifungals while undergoing antibiotic treatment. However, the preventive effect has not been well studied. Women who are otherwise healthy do not need special prevention. To avoid infecting a partner, affected women should refrain from sexual intercourse until the infection has cleared.

Some women also use special probiotic supplements to support the natural vaginal flora. Such supplements are taken orally or inserted into the vagina. However, their preventive effect has not been well studied.

Some methods do more harm than good, for example, women should not rinse their vagina or use intimate sprays. This damages the natural vaginal flora and promotes infections.

A vaginal fungus can usually be identified by the symptoms and the visible changes in the vaginal mucosa. If uncertain, the doctor can take some vaginal fluid and examine it for yeast fungi. If the fungal infections occur frequently or cause severe discomfort, additional examinations may be necessary. The doctor then checks whether certain risk factors such as an immune deficiency are present. If a woman repeatedly suffers from fungal infections, it may make sense for her partner to be examined as well.

As a rule, treatment with an antifungal medication is sufficient: a suppository or cream is inserted into the vagina with the help of an applicator. The medication can then act on the inflamed mucosa. Some medicines can also be taken once as a tablet.

In the case of frequently recurring infections, severe pain, or an increased risk of complications (for example, in the case of an immune deficiency) it is advisable to consult a doctor. Generally speaking, the partner does not need to be treated as well. This is only necessary if it is certain that he or she also has a yeast infection of the genital area. Suppositories or capsules with live lactic acid bacteria (probiotics) are also considered treatment options. However, their effectiveness has not been sufficiently proven. Some women also insert tampons soaked in tea tree oil, for example, or garlic cloves. Some use natural yogurt to acidify the vaginal flora. However, it has not been studied whether such means are effective and safe. Possible risks could be allergic reactions or irritation of the mucous membrane. In no case is it advisable to rinse out the vagina, as this can intensify inflammation.

For more information, e.g., about what can be done to relieve vaginal yeast infections, visit gesundheitsinformation.de.