Vaginas are remarkable. Not only because of everything they do, but because of everything they contain! For instance, the vaginal microbiome is FULL of bacteria! And that’s a good thing. Did you know vaginas clean themselves? This is low-key amazing.
And while we all carry yeast in and on our bodies, it usually exists in balance with things like bacteria. Sometimes, it can overgrow and cause a vaginal yeast infection. For anyone who’s had a yeast infection, you know they can be wildly uncomfortable. So it’s fair to wonder what causes them, how to prevent them and how to quickly treat them.
What is the main cause of a yeast infection?
Yeast infections typically occur in those with female genitalia anytime right before puberty up until menopause, when estrogen is circulating in our bodies.
Estrogen signals the cells that line the vagina to produce a sugar called glycogen, which in turn creates protective bacteria (lactobacilli), which keep your vagina acidic and work to fend off unhealthy bacteria.
About 20% of people walk around with yeast just hanging out in the vaginas without experiencing any symptoms. Sometimes there can be an overgrowth of this yeast, which can, in turn, cause symptoms.
Yeast infection myths
Let’s dispel some common misconceptions about what can cause a yeast infection.
- Diet impacts yeast infections. We don’t have strong data to support that any one diet is better than another as far as yeast infection prevention goes. One caveat is a person with diabetes, where sugars can be too high in the body (and, thus, create a haven for yeast to feed). So go ahead and indulge in that piece of cake if it brings you joy.
- Probiotics help prevent yeast in the vagina. This has been shown to help the gut microbiome, which may indirectly help with reducing vaginal yeast infections.
- You can get a yeast infection from sex or “dirty” fingers. Products used around the time of sex can disrupt the vaginal microbiome, but typically lead to bacterial vaginosis, not a yeast infection.
- Bubble baths cause yeast infections. They can disrupt the vaginal microbiome, which again could lead to bacterial vaginosis.
- Cotton undies or loose-fitting clothing prevents yeast infections. While you can irritate your vulva with other fabrics or tight bottoms, they do not lead to yeast growth. Yeast does love to grow in dark, warm places, so avoid staying in your workout clothes or poolside in a wet bathing suit for extended periods of time.
- Antibiotic use causes yeast infections. Not for everyone. Antibiotics kill a range of bacteria, including the healthy ones in your vagina, which can lead to an overgrowth of yeast.
While we understand how they occur, many times, neither the patient nor the provider can pinpoint exactly what caused a specific yeast infection. We don’t have great scientific evidence that any lifestyle changes prevent yeast infections, yet there is a lot of shame when we get an infection. It’s misdirected and a waste of time thinking it’s in our control, so don’t sweat it! There IS some evidence to suggest stress can play a role in vaginas producing less of that protective lactobacilli.
How do I know if I have a yeast infection?
Yeast infection symptoms typically show up as burning and/or itching, during urination or simply when walking around. You may also notice swelling and/or irritation in the vagina or at the vaginal opening. And for those who have been taught about that one supposed end-all, be-all symptom: you can have a raging yeast infection and NOT have white, clumpy cottage-cheese-like discharge.
A hard truth (and this is not meant to gaslight, but it’s a fact!) is that 50% of people who self-diagnose with a yeast infection are incorrect. This isn’t surprising given the overlap of symptoms with another common vaginal infection, bacterial vaginosis. It’s an understandable mistake considering the common confusion between the vagina (the interior tube that connects your vulva with your cervix and uterus) and the vulva (the external genitalia that includes the labia, clitoris, vaginal opening and urethra opening). Let’s look at the differences a little more closely.
Bacterial vaginosis vs yeast infection
- Symptoms include: vaginal discharge (thin, gray, fishy odor), itching or irritation, burning, pelvic pain and/or bleeding after intercourse.
- Caused by: an imbalance of the “good” bacteria and the “bad” bacteria. It can be associated with sexual activity, especially with a new partner, and any products that affect the vagina’s biome, such as soaps, perfumes and feminine wipes. When it comes to the vagina, less is more!
- How to treat: oral or vaginal antibiotics, prescribed by a provider. There are no over-the-counter medications to treat bacterial vaginosis. It is possible that the antibiotics you take for this will cause a yeast infection and your provider can provide both an antibiotic and an antifungal to prevent this.
- Recovery time: about a week for symptoms to go away once treated; avoid intercourse during this time both for comfort and because you’re more susceptible to STIs.
- Symptoms include: burning, irritation, itching, discomfort during urination and/or pain during sex. Additionally, the vagina may look swollen or red.
- Caused by: an overgrowth of yeast.
- How to treat: oral or vaginal antifungal, either prescribed by a provider or purchased over-the-counter.
- Recovery time: 24 hours for initial symptom relief and up to 5 days for full recovery with the pill, or up to 7 days with the cream. When treating, avoid intercourse to give the vagina some time to rebalance, and for your comfort.
Because people so often get these two confused, it is recommended to see a provider when you experience any of these symptoms to get the condition properly diagnosed and treated.
What is the fastest way to get rid of a yeast infection?
How long a yeast infection lasts depends on the method of treating it. The fastest way to get rid of a yeast infection is to see your provider or visit an urgent care clinic, either of which will prescribe a one-dosage pill. With this, you’ll feel symptom relief within 24 hours, and they should fully subside in 5 days.
Knowing that not everyone can afford healthcare access when needed, or be seen immediately, there are effective over-the-counter treatments for yeast infections so you can treat a yeast infection yourself. Which also comes in handy if you’re traveling.
These options include one-, three- or seven-day vaginal antifungal creams (e.g. Monistat). My recommendation? Go for the seven-day option because the others can cause extra vaginal irritation since they’re more concentrated.
If you don’t see an improvement in symptoms after a week, follow up with your provider. And if you accidentally misdiagnose—like using a yeast infection treatment but it turns out you don’t actually have one—the treatment won’t cause any extra harm. If you still have symptoms, you should see a provider because it could be bacterial vaginosis, which requires antibiotics.
How do I stop recurring yeast infections?
It’s understandable that those who experience recurrent yeast infections live in constant concern about their next one, making the person hyper-aware of everything they do or don’t do and creating terrible anxiety along the way.
Recurring yeast infections are those that occur three to four times per year. They affect 5-8% of people with vaginas and happen for a variety of reasons. Figuring out why becomes detective work between you and your provider because the cause can be elusive.
Providers often look at hormones first, especially if the yeast infections happen cyclically. Other causes may include:
- Weakened immune systems (including diabetes)
- Emotional stress
- Low iron
- Resistant strains of yeast
For recurring yeast infections, providers treat the active infection then typically prescribe weekly oral Diflucan for four to six months to try and prevent another yeast infection from happening.
Can I give my partner a yeast infection if I have one?
Nope! No matter your partner’s genitalia, you cannot pass on a yeast infection to another person, nor do they have to be treated if you are, unless a partner with a vagina also has symptoms. Penis owners need not be treated for yeast infections.
How can I treat a yeast infection while pregnant?
About 20-30% of people experience a yeast infection during pregnancy because immunity is weakened.
The common oral medication used to treat yeast infections (Diflucan) is not recommended as first-line therapy in pregnant people. Instead, a vaginal cream is prescribed and may need to be used for longer than a week.
Many parents also worry that a yeast infection can harm the baby during pregnancy. Rest assured: a yeast infection will not affect your developing baby.
If you suspect you have a yeast infection or experience recurrent yeast infections, my goal as a provider is to get you to a point where you’re not thinking about your vagina all the time—only when you want to be thinking about your vagina! Your experience and discomfort are valid, and there are solutions. Get curious about what’s happening with your body, and your provider will help you treat what needs to be treated. You can make an appointment here.