Fungal Infections: Origins, Signs, and Remedies
Vaginal yeast infections are a common type of fungal infection, often characterised by symptoms such as itching, burning, and irritation in the vagina or vulva. Medical professionals often recommend the use of condoms or other barrier methods if a sexual partner has yeast symptoms, as the main cause of a vaginal yeast infection is the overgrowth of yeast in the vulvovaginal area.
Balanced levels of yeast and bacteria are found in the vagina, but disturbances in this delicate balance can lead to the development of an infection. Lactobacillus usually maintains an environment that does not encourage yeast overgrowth, but if yeast becomes dominant, symptoms of a yeast infection may emerge.
Anyone who believes they have symptoms of a yeast infection should speak with a doctor for an accurate diagnosis as soon as possible, even if they have had a prior yeast infection. A doctor will ask about a person's medical history, including a history of any STIs or previous yeast infections, and perform a pelvic exam to inspect for signs of infection. Examining a swab of vaginal discharge under a microscope can reveal if high levels of yeast are present.
Treatment for a yeast infection includes contacting a doctor, and short-course medication for uncomplicated cases. Treatment options for an uncomplicated yeast infection include vaginal therapy (such as butoconazole, clotrimazole, miconazole, terconazole) and oral antifungal (fluconazole). For recurrent cases, long-term antifungal maintenance therapy with oral fluconazole is often prescribed.
Risk factors for a vaginal yeast infection include recent use of antibiotics, pregnancy, use of hormonal contraceptives, diabetes, being immunocompromised, moisture in the genital area, and any activity that can cause changes in typical vaginal flora. Recurrent vulvovaginal candidiasis (RVVC) is a condition characterized by multiple episodes of vaginal yeast infection, primarily caused by the fungus *Candida albicans*, with occasional involvement of non-*albicans* species.
In the case of a complicated yeast infection, treatment will include the use of long-course vaginal therapy or multidose oral formulations. If maintenance medications are necessary, they may include weekly treatment with oral fluconazole for 6 months or weekly treatment with vaginal clotrimazole.
It is important to note that while yeast infections of the vagina are not sexually transmitted infections (STIs), they can spread through oral-genital contact or during intercourse. Addressing lifestyle factors, improving hygiene, and treating sexual partners can reduce recurrence risk. Due to concerns about antifungal resistance, it is advised to avoid unsupervised over-the-counter antifungal use.
In cases of fluconazole intolerance or resistance, alternative antifungal agents or combination regimens may be considered, often under specialist supervision. Effective management requires accurate diagnosis, tailored antifungal therapy, attention to modifiable risk factors, and supportive hygiene and partner treatment measures.
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