Vaginal yeast infections are a common fungal infection caused by an overgrowth of the yeast Candida, most often Candida albicans. Yeast infections are significantly more common in pregnant individuals. While this condition is generally manageable and does not pose a severe threat to the pregnancy itself, proper treatment guided by a healthcare provider is important for maternal comfort and to mitigate minor risks associated with delivery.
Why Pregnancy Increases Susceptibility
The physiological changes of pregnancy create an environment favorable for the proliferation of Candida. Estrogen levels rise substantially throughout gestation, promoting the accumulation of glycogen within the cells of the vaginal lining. This increase in glycogen results in a sugar-rich medium that Candida can readily use as a food source, encouraging its growth. The hormonal environment also causes shifts in the normal vaginal pH balance, disrupting the delicate microbiome that typically keeps yeast populations under control. While approximately 20% of non-pregnant women naturally carry Candida, this colonization rate rises to as high as 30% during pregnancy.
Recognizing Symptoms and Seeking Diagnosis
The most common signs of a yeast infection include intense vulvar and vaginal itching and a burning sensation. These symptoms can sometimes be accompanied by pain during urination or intercourse. A characteristic symptom is a thick, white vaginal discharge often described as having a cottage cheese-like appearance. It is important to consult a healthcare professional immediately upon noticing these symptoms, even if a person has experienced yeast infections before. Symptoms of candidiasis can closely mimic those of other vaginal infections, such as bacterial vaginosis or certain sexually transmitted infections, which require different management. Diagnosis is confirmed by a healthcare provider, typically through a visual examination and microscopic analysis of a vaginal swab to confirm the presence and type of yeast.
Safe Treatment Options During Pregnancy
Treatment for candidiasis during pregnancy focuses on symptom relief and eradicating the infection while ensuring fetal safety. The standard of care involves topical antifungal medications, such as creams and vaginal suppositories. These topical treatments are preferred because they achieve minimal systemic absorption, meaning very little medication reaches the developing fetus.
Approved topical antifungals, such as miconazole and clotrimazole, are considered safe for use throughout pregnancy. These medications are applied directly to the affected area, often as a 2% cream or suppository. A longer course of therapy is generally required during pregnancy, with treatment duration typically lasting seven days or up to 14 days for recurrent cases.
Oral antifungal medications, such as fluconazole, are generally avoided, particularly in the first trimester, due to potential risks, including a possible link to miscarriage or birth defects. Pregnant individuals should never begin treatment without first consulting their obstetric provider, even if topical treatments are available without a prescription. Patients must complete the entire prescribed course of medication, even if symptoms clear up earlier, to ensure full eradication of the infection.
Prevention and Fetal Safety
While hormonal changes cannot be controlled, certain lifestyle adjustments can help reduce the likelihood of recurrence. Wearing loose-fitting clothing and undergarments made from breathable materials like cotton helps keep the genital area dry and minimizes the moist environment favored by Candida. Maintaining the natural vaginal environment requires avoiding irritants, such as scented feminine hygiene products, douches, and bubble baths. Including foods containing live cultures, such as yogurt, or taking a physician-approved probiotic supplement may also support a healthy microbial balance.
A vaginal yeast infection rarely poses a direct threat to the developing fetus during pregnancy. However, untreated candidiasis carries a small risk of transmission during vaginal delivery. This transmission can result in the newborn developing oral thrush, a yeast infection in the mouth. Effective treatment of the maternal infection prior to delivery lowers this risk.