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Many women are affected by yeast infections which seem to keep coming back. It is important to be able to tell when it is not a yeast infection, but an allergy or other type of infection and to seek a professional diagnosis and treatment.

It is estimated that 5% of women are troubled by recurring yeast infection of the vagina.  Recurring is defined as four or more episodes, unrelated to antibiotic treatment (more about that later) in one year.  Yeasts are a type of fungus and the one most commonly responsible for vaginal infections is called Candida albicans. It is normally present in the vagina and does not normally cause any problems, as it is kept under control by other organisms such as bacteria. 

But if the balance of organisms is disturbed, for example by ill health, medications or other factors, this yeast can ‘overgrow’ and be abundant enough to cause an irritating infection.

What are the symptoms?

Each woman’s experience of a yeast infection may differ.  Common symptoms are intense itchiness, soreness, burning and irritation of the vagina and external genital area (the vulva). There may be redness and swelling of the area, as well as pain on urination, and during sex.  Not everyone has the white ‘curd-like’ discharge traditionally thought to indicate a yeast infection.  The condition is not normally associated with a bad-smelling discharge – this can indicate other infections and needs investigation by a doctor.

What causes overgrowth of yeast?

Unfortunately there is a long list of likely candidates and in the case of recurring infections it may be the same, or different factors, each time.  The most common culprits are:

Ill health – if you are stressed, generally run- down, or have conditions such as diabetes, or HIV/AIDS, then you are more at risk of yeast infections.  This is because your own immune system which helps to keep yeasts in check and prevents overgrowth, may be weakened.

Medications- there is a link between some medications, particularly antibiotics, and yeast infections. This is because antibiotics, especially those effective against a wide range of bacteria (‘broad spectrum’) upset the balance of organisms in the vagina, wiping out the bacteria which normally prevent yeasts from multiplying.  Medication affecting the immune system such as steroids, or those taken following organ transplant, or to treat auto-immune diseases, can also be linked with yeast overgrowth.

Estrogen – there is a strong link between high levels of estrogen and overgrowth of yeasts.

This is why pregnant women and those taking high dose estrogen contraceptive pills are more susceptible.  Some women are troubled by yeast infection at particular times in the menstrual cycle, because of the connection with estrogen.

Clothing- tight or ‘sweaty’ underwear or clothing, and staying in wet swimwear too long may encourage overgrowth of yeasts by creating a damp environment.

Douching may disrupt the balance of organisms in the vagina, leading to yeast overgrowth.

What is used to treat yeast infections?

Creams, ointments and pessaries (solid dose forms inserted into the vagina) containing the anti-fungal fluconazole, are available to buy without a prescription.  These work well against infections caused by Candida albicans. Doctors have a range of other anti-fungal treatments, including tablets, which they can prescribe.   

Continue reading after recommendations

  • www.womenshealth.gov/publications/our-publications/fact-sheet/vaginal-yeast-infections.cfm