What Is A Yeast Infection?

Vaginal yeast infections, also known as vaginal candidiasis or thrush, are incredibly common, affecting as many as 3 in 4 women during their lifetime. They cause discomfort, discharge, and serious itchiness around the vagina and the vulva.

These unpleasant infections are mainly triggered by the fungus candida albicans. Your vagina naturally hosts a balanced blend of yeast and bacteria that contribute to your fertility and well-being. Among these, certain bacteria, like lactobacillus, work to prevent yeast from going overboard. However, when this delicate balance tips, there can be an overgrowth of candida (yeast).

Thrush is the second most common cause of vaginal discharge. Several factors can prompt a yeast infection, with the usual suspects being antibiotic use, escalated oestrogen levels, and a weakened immune system. There are effective oral and topical treatments available to tackle vaginal yeast infections.

What Are The Symptoms Of Thrush?

Some thrush symptoms are mild, and they clear up by themselves. However, others can be stubborn, sticking around unless treated by antifungal medication. These symptoms can be anywhere from mild to moderate and may include:

• Itching and irritation in the vagina and vulva (the external skin folds around the vagina)
• Vulvar soreness and possible burning sensations, especially during sex or while urinating.
• A thick, white, odour-free vaginal discharge that's similar to cottage cheese, adding to the itch and discomfort.
• Severe thrush symptoms can result from a complicated yeast infection, including extensive redness, swelling, and itching, leading to vaginal fissuring, cracks, or sores.

How Are Yeast Infections Diagnosed?

Often, yeast infections are diagnosed based on typical symptoms and signs. If self-treatment doesn't do the trick, it's time to visit your doctor. They may examine you and recommend further tests, including:

• A pH test to determine if the discharge is due to bacterial vaginosis or thrush.
• A swab test to analyse a sample of vaginal discharge, helping to identify if it's thrush or another infection and pinpointing the type of candida.
• Urine tests to check for diabetes signs, which could make you more prone to thrush.
• Blood tests - if your thrush is severe or recurrent, you might need a blood test to check for underlying conditions like diabetes or HIV.

What Causes Yeast Infections?

Thrush is triggered by an overgrowth of a fungus called candida. This fungus is often a natural inhabitant of the vagina, but good vaginal bacteria, like Lactobacillus, keep its numbers under control. However, when that balance is interrupted, the fungus can multiply and bring about thrush symptoms.

Factors that can tip the scales and lead to thrush include:

• Antibiotic use - These medications can wipe out both bad and good bacteria (including the beneficial ones in your vagina), leading to an overgrowth of yeast.
• Increased oestrogen levels - Women with higher levels of this hormone are more likely to get thrush. Hence, it's more common in pregnant women or those taking high-dose oestrogen contraceptive pills or hormone therapy.
• Uncontrolled diabetes - Women struggling to control their blood sugar levels are at a greater risk of getting thrush.
• Impaired immune system - If your immunity is low, you're more likely to get yeast infections. This could be due to undergoing chemotherapy, high-dose steroid use, or having HIV.

How Are Yeast Infections Treated?

Thrush can be treated either with topical or oral medications.

Topical Treatments

Topical treatments involve pessaries and creams that you insert into the vagina. These are usually available over the counter and contain antifungal medicines like clotrimazole, econazole, miconazole, or fenticonazole. 

A single large dose or a smaller one spread over several days can be enough to get rid of a bout of thrush. Also, applying some antifungal cream on the skin around the vulva for a few days can help ease symptoms.

Tablets

Although topical and oral treatments are generally equally effective, tablets offer more convenience. The two common treatment tablets are fluconazole (a single dose) and itraconazole (two doses over a day). These are available on prescription, and fluconazole can even be purchased without a prescription in the UK.