What is a yeast infection?
The vagina is incredible! It literally delivers new life onto this planet, and it is also self-cleaning. Yes, the vagina can clean itself and maintains its own microbiome (which is a combination of healthy yeast and bacteria). Bacteria and yeast have lived together in harmony for many years – they keep one another in check. However, when this balance is out of whack and one too many yeast or bacteria molecules crash the party, that’s when we have a problem. When there is more yeast than there should be and not enough bacteria to control it, a yeast infection is born.
Are they common?
Yes, yeast infections are incredibly common in women and people with vaginas. About 66-75% of women (vulva owners) will have a vaginal yeast infection at some point in their life and many people will actually experience at least two yeast infections in their lifetime. It’s important to note that anyone can get a yeast infection and it is not necessarily a reflection of personal hygiene or sexual activity.
Though lesser-known, it is also possible to have yeast infections in the penis, in the mouth, on the corners of the mouth, on your nail beds, and between folds of skin. That said, this article will be focusing entirely on vaginal yeast infections.
Generally, yeast infections are a result of an imbalance of healthy yeast and bacteria which can have many potential causes. For example, imbalances can result from antibiotic use, pregnancy, unmanaged diabetes, an impaired immune system, oral contraceptive use, or certain hormone therapies. Other potential causes can include douching and the use of scented vaginal products (soap, body wash, menstrual products, lubricants, etc.)
Are they Sexually Transmitted Infections (STIs)?
While yeast infections can be spread from sexual contact or by sharing sex toys, they are not really considered a sexually transmitted infection. However, if you do have unprotected sex or share a sex toy with a partner while you have a yeast infection (or vice versa), it can be sexually transmitted to other people (whether they have a vulva and vagina or a penis).
Signs & Symptoms
Common symptoms of a vaginal yeast infection include vaginal itching, inflammation and swelling in/around the vaginal opening, painful urination, pain during sexual contact or masturbation, soreness, redness, rash, and discharge that is white/gray and clumpy (similar to cottage cheese… I’m so sorry for those of you who, until now, loved to eat cottage cheese).
How do I know it’s a yeast infection?
It can be difficult to discern if you have a yeast infection, especially if you’ve never had one before or if it’s been a while. The best way to know for sure if you have a yeast infection is to see a healthcare provider (HCP) and get a yeast test during which an HCP will perform a pelvic exam and then use a cotton swab to take a sample of discharge from the vaginal wall (which is not painful). The discharge is examined under a microscope to look at the presence of yeast; you may also get a fungal culture test. There are also home tests like this one from Stix, though tests done in medical facilities by HCPs are the most reliable and accurate. There are no risks or side effects to being tested and results are often interpreted during your doctor’s visit.
What else could it be?
As aforementioned, it can be difficult to know if you have a yeast infection without medical attention or testing, and your symptoms could be a sign of other conditions like Bacterial Vaginosis (BV) or certain STIs.
Bacterial Vaginosis (BV)
Bacterial Vaginosis (BV) is a bacterial infection that results from an imbalance in the ‘good’ and ‘bad’ bacteria found in the vagina. Most of these infections are mild and go away on their own, but some require treatment.
It could be difficult to differentiate between a yeast infection and BV because they can have similar symptoms. Symptoms of BV include gray or white vaginal discharge, a strong fishy odor that may be worsened by sexual activity, pain and/or itchiness in the vagina, and a burning sensation when urinating. Similar to a yeast infection, testing includes a pelvic exam and a sample of vaginal discharge. The primary difference in treatment between BV and yeast infections is that BV is treated with antibiotics, while yeast infections are treated with antifungals.
Sexually Transmitted Infections (STIs)
Some STIs can cause similar symptoms to yeast infections, such as irritation, itchiness, smelly discharge, or burning sensations when urinating. If you are or have recently been sexually active with a partner or partners, you should be regularly tested for STIs.
If you find yourself with frequent yeast infections and have a consistent sexual partner, you and your partner may be giving each other yeast infections in a ‘ping pong’ effect – meaning you are giving them back and forth to one another.
If the vagina is irritated, for example from recent sexual activity, it can also reflect symptoms of infections. Irritation can be caused by a new soap or laundry detergent, a small cut, and also from friction/dryness.
These types of irritation can be prevented by using generous amounts of personal lubricant and moisturizer and by using only mild soaps and water on your vulva and the surrounding areas.
There are prescription, over-the-counter, and homeopathic remedies available to treat yeast infections. Experts say “Simple infections clear up after a few days of locally applied treatment (vaginal suppositories or creams). Depending on the drug used, the treatment takes one, three or six days.” Yeast infections really are no big deal and no reason to sweat – they are simple and straightforward to treat and you will be back to your normal self again soon!
A common prescription treatment is Fluconazole (Diflucan) which is a one-time pill. This silver bullet treatment works by damaging “the cell wall of the fungus that creates the infection.” Neither antibiotics nor antivirals work as a treatment for yeast infections because they are not bacterial or viral infections, but rather, yeast.
Side effects of oral antifungals include headaches, dizziness, nausea, and diarrhea, but they are usually well-tolerated. It is important to note that oral antifungals, just like any other medication, can have potential interactions with other medications that you take: “These include certain allergy medicines, blood-pressure-lowering drugs and medications for psychological problems.” As an HCP about potential interactions and consult the information that comes in the packaging before use.
You may have heard of Monistat or Vagisil before – they are two brands that carry at-home, OTC treatments for yeast infections in the form of creams and suppositories that contain Nystatin, Ciclopirox, Clotrimazole, Miconazole, and/or Terconazole, all of which are antifungals that work to kill overgrowths of yeast.
Suppositories are little ‘eggs’ of medicine that dissolve after being placed deep into the vaginal canal (preferably before going to sleep). Some may provide you with an applicator, but regardless, follow the instructions for the best results. If you buy suppositories, you may also receive a “small tube of antifungal cream that you can apply to inflamed areas of the external (outer) genitals.”
Depending on the product, antifungal creams usually come with an applicator (like a tampon) and can often be inserted into the vagina as well as applied externally but consult an HCP or the packaging for guidance.
Regarding homeopathic remedies to yeast infections: “there’s hardly any research on whether these kinds of home remedies can help to get rid of vaginal yeast infections or prevent them. They are, however, associated with risks such as allergic reactions or irritated mucous membranes. Vaginal douches or female intimate hygiene products may irritate the skin, making the inflammation worse.” It’s safer and more effective to consult an HCP for diagnosis and treatment. As a sexuality educator, I’m here to tell you here and now that I would never recommend homeopathic treatments over existing medical treatments.
Probiotics are commonly used in conjunction with antifungals: “These products are designed to protect and restore the natural balance in the vagina. They may help to fight a yeast infection when used in addition to antifungal drugs. But it’s not clear whether they can effectively fight a yeast infection when used on their own.”
Treatment During Pregnancy
Yeast infections are common during pregnancy and can be easily treated with OTC creams, ointments, and suppositories, however, oral antifungals, like Fluconazole, “haven’t been approved for use in women who are pregnant or breastfeeding.”
There are some very simple ways in which you can prevent a yeast infection from developing, but sometimes things just happen. Below are some Dos and Don’ts for preventing yeast infections when you can.
Yeast Infection FAQ
Q: Can I masturbate/have sex while I have a yeast infection?
Yes, you can, though you should listen to your body and do what feels right for you, and also you should take a few extra precautions to prevent re-contracting the yeast infection. If using your hand to masturbate, be sure to wash your hands thoroughly immediately after. If you are using a sex toy, wash it immediately after with the appropriate cleaner or mild soap and water, or sanitize it per the instructions you have been given.
Q: Can I have partnered sex while I have a yeast infection?
Yes, you can, though there are precautions you should take to protect you and your partner(s). To prevent transmission of yeast infections orally, vaginally, or anally, you can use barrier methods of protection such as internal and external condoms and dental dams. Remember that a partner with a penis can contract and transmit a yeast infection whether or not they are symptomatic.
Q: Can you get a yeast infection from eating too much bread or sugar?
Not really. This myth stems from the fact that those living with uncontrolled diabetes, and thus have very high blood sugar, are more predisposed to yeast infections and thrush. So, go ahead and eat that last piece of garlic bread, you’ll likely be just fine as far as yeast infections are concerned.
Gillian ‘Gigi’ Singer, MPH
American Board Certified Sexologist, Sexuality Educator, and Sex Ed Content Specialist