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Vaginal yeast infections, or vaginal candidiasis, are common in women.  Many healthy females have yeast colonization in their vaginas such as Candida.  However, sometimes these yeasts may overgrow leading to yeast infections.  

Risk Factors for Yeast Infections

Certain conditions and medications can make women more susceptible to yeast infections including:

  • Recent use of antibiotics
  • Oral contraceptives (especially those with higher estrogen content) 
  • Pregnancy (most often in the second trimester)
  • Diabetes (especially if not controlled)
  • Weakened immune system

Symptoms of a Vaginal Yeast Infection

Vaginal yeast infections can present in many ways including:

  • Itching and burning in the genital area
  • Redness, swelling and soreness of the vulva
  • Burning and pain during urination
  • Painful intercourse
  • Some women may experience a cottage-cheese like discharge, while others watery discharge, and some women may have little to no discharge

Treatment options

If you suspect you have a yeast infection you should see your primary care prescriber to confirm and prevent misdiagnosis.  

Treatment is indicated to relieve symptoms, women without symptoms and sexual partners do not need treatment. 

Most yeast infections can be treated with over-the-counter antifungals.

  •  Clotrimazole or miconazole vaginal creams or vaginal suppositories. They are available as 1, 3 or 7-day treatments and are equally effective. Choice can depend upon convenience and the severity of symptoms.  These treatments tend to provide relief quickly and are usually tolerated well.
  • An oral pill called fluconazole taken as a single 150mg dose is a convenient option.  Side effects are mild and may include headache, nausea and rash.  However, it is not appropriate for all women and may interact with certain medications.  Talk to your pharmacist or physician prior to taking it.  It does not provide relief of symptoms as quickly as the vaginal products. 

Several studies have shown that both types of treatments are equally as effective.

This post was co-authored by Mandy Kang, BScPharm, BCGP, Erin Manchuk, BScPharm, BCGP and Stephanie Liu, MD, MSc, CCFP, BHSc.

References

Patient Self Care. First Edition.  Canadian Pharmacist Association

Compendium of Therapeutics for Minor Ailments. Canadian Pharmacist Association

Fan et al. The efficacy and safety of miconazole vaginal suppository 1,200mg versus oral fluconazole 150 mg in treating severe VVC. Gynecol Obstet Invest. 2015;80(2):113-8)

Li et al. A randomized clinical trial of the efficacy and safety of terconazole vaginal suppository versus oral fluconazole for treating SVVC. Med Mycol. 2015;53(5):455-61.

 Sobel JD. Vaginal Yeast Infections. UpToDate 2019®. Last update February 2019

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