Vaginal Candidiasis

About

Candidiasis is an infection caused by a yeast (a type of fungus) called Candida. Candida normally lives inside the body (in places such as the mouth, throat, gut, and vagina) and on skin without causing any problems. Sometimes Candida can multiply and cause an infection if the environment inside the vagina changes in a way that encourages its growth. Candidiasis in the vagina is commonly called a “vaginal yeast infection.” Other names for this infection are “vaginal candidiasis,” “vulvovaginal candidiasis,” or “candidal vaginitis.”

Symptoms

The symptoms of vaginal candidiasis include:1,2

  • Vaginal itching or soreness
  • Pain during sexual intercourse
  • Pain or discomfort when urinating
  • Abnormal vaginal discharge

Although most vaginal candidiasis is mild, some women can develop severe infections involving redness, swelling, and cracks in the wall of the vagina.

Contact your healthcare provider if you have any of these symptoms. These symptoms are similar to those of other types of vaginal infections, which are treated with different types of medicines. A healthcare provider can tell you if you have vaginal candidiasis and how to treat it.

Risk & Prevention

Who gets vaginal candidiasis?

Vaginal candidiasis is common, though more research is needed to understand how many women are affected. Women who are more likely to get vaginal candidiasis include those who:

  • Are pregnant
  • Use hormonal contraceptives (for example, birth control pills)
  • Have diabetes
  • Have a weakened immune system (for example, due to HIV infection or medicines that weaken the immune system, such as steroids and chemotherapy)
  • Are taking or have recently taken antibiotics

 How can I prevent vaginal candidiasis?

Wearing cotton underwear might help reduce the chances of getting a yeast infection.2 Because taking antibiotics can lead to vaginal candidiasis, take these medicines only when prescribed and exactly as your healthcare provider tells you. Learn more about when antibiotics work and when they should be avoided.

Sources

Scientists estimate that about 20% of women normally have Candida in the vagina without having any symptoms.2 Sometimes, Candida can multiply and cause an infection if the environment inside the vagina changes in a way that encourages its growth. This can happen because of hormones, medicines, or changes in the immune system.

Diagnosis & Testing

Healthcare providers usually diagnose vaginal candidiasis by taking a small sample of vaginal discharge to be examined under a microscope in the medical office or sent to a laboratory for a fungal culture. However, a positive fungal culture does not always mean that Candida is causing symptoms because some women can have Candida in the vagina without having any symptoms.

Treatment

Vaginal candidiasis is usually treated with antifungal medicine.3 For most infections, the treatment is an antifungal medicine applied inside the vagina or a single dose of fluconazole taken by mouth. For more severe infections, infections that don’t get better, or keep coming back after getting better, other treatments might be needed. These treatments include more doses of fluconazole taken by mouth or other medicines applied inside the vagina such as boric acid, nystatin, or flucytosine.

If you are a healthcare provider, please refer to:

Statistics

Vaginal candidiasis is common. In the United States, it is the second most common type of vaginal infection after bacterial vaginal infections.2 An estimated 1.4 million outpatient visits for vaginal candidiasis occur annually in the United States.4 The number of vaginal candidiasis cases in the United States is unknown.

References
  1. Goncalves B, Ferreira C, Alves CT, Henriques M, Azeredo J, Silva S. Vulvovaginal candidiasis: Epidemiology, microbiology and risk factors. Critical reviews in microbiology 2016;42:905-27.
  2. Sobel JD. Vulvovaginal candidosis. Lancet 2007;369:1961-71.
  3. Pappas PG, Kauffman CA, Andes DR, et al. Clinical Practice Guideline for the Management of Candidiasis: 2016 Update by the Infectious Diseases Society of America. Clinical infectious diseases : an official publication of the Infectious Diseases Society of America 2016;62:e1-50.
  4. Benedict K, Jackson BR, Chiller T, Beer KD. Estimation of direct healthcare costs of fungal diseases in the United States. Clin Infect Dis. 2018 Sep 10.