A vaginal yeast infection, or candidiasis, occurs due to an overgrowth of Candida, a fungus naturally present in the body. Up to three out of four women experience at least one yeast infection, with about half experiencing two or more. Symptoms commonly include itching, burning, redness, and a thick, white discharge resembling cottage cheese. While treatable, some yeast infections persist.
Normal Course and When It Lingers
Most yeast infections clear up within a few days to a week with antifungal medication, whether over-the-counter or prescription. Mild cases might resolve in as few as three days, though more severe infections can take one to two weeks to fully clear. A yeast infection is persistent if symptoms don’t improve after treatment, return quickly, or show no response to medication.
Common Causes for Persistence
Several factors can contribute to a yeast infection that does not resolve as expected. Misdiagnosis is a common reason; yeast infection symptoms can mimic other vaginal conditions like bacterial vaginosis (BV) or sexually transmitted infections (STIs). Treating the wrong condition means the yeast infection remains unaddressed, allowing it to persist. Many women who purchase over-the-counter medication do not actually have a yeast infection, highlighting the potential for misdiagnosis.
Incomplete or inadequate treatment also plays a role. Not finishing the full course of prescribed medication, even if symptoms improve, can allow Candida to regrow. Additionally, the initial treatment might not have been strong enough or appropriate for the specific yeast strain.
Antifungal resistance is another significant factor. Some strains of Candida can become resistant to common antifungal medications, particularly azoles like fluconazole, making standard treatments ineffective.
Underlying health conditions can also predispose individuals to persistent yeast infections. Uncontrolled diabetes, for instance, leads to higher sugar levels, which can feed the yeast and promote its overgrowth. A weakened immune system, from conditions like HIV or medications such as corticosteroids, reduces the body’s ability to keep Candida in check. Hormonal changes, such as those during pregnancy or from high-estrogen birth control, can also disrupt the vaginal balance, increasing susceptibility.
Lastly, reinfection can lead to recurring symptoms. While not typically STIs, they can be passed between partners. Poor hygiene, like improper wiping or not changing out of wet clothing promptly, can reintroduce yeast or create a conducive environment.
What to Do Next
When a yeast infection does not respond to initial treatment, consulting a healthcare provider is the next step. A medical professional can accurately diagnose the issue, as symptoms can overlap with other conditions like bacterial vaginosis, which requires different treatment. Self-treating without a confirmed diagnosis can lead to delayed resolution and potentially worsen the situation.
Further testing, such as a vaginal swab or culture, can identify the specific Candida species and determine if it has developed resistance. This helps guide the selection of the most effective treatment.
Based on the diagnosis, prescription treatments might be necessary. This could involve stronger antifungal medications, different classes of drugs, or longer courses of treatment than typically used for uncomplicated infections. Oral medications, such as a single or multidose of fluconazole, may be prescribed, or a longer course of vaginal creams or suppositories might be recommended. For recurrent infections, a healthcare provider might suggest a weekly oral medication for an extended period, such as six months, to prevent future occurrences.
If an underlying health condition, like uncontrolled diabetes or a compromised immune system, contributes to the persistent infection, managing it becomes part of the treatment plan. Addressing these root causes is important for resolving the current infection and preventing future episodes.
Strategies to Avoid Future Occurrences
Proactive measures can help reduce the likelihood of future yeast infections, especially for individuals prone to recurrence. Choosing breathable clothing, especially cotton underwear, is beneficial. Cotton absorbs moisture and allows air circulation, discouraging the warm, damp environment where yeast thrives. Avoiding tight-fitting clothing like jeans or pantyhose can also help prevent heat and moisture buildup.
Good hygiene practices are also important. Washing the genital area with mild, unscented soap and water helps maintain cleanliness without disrupting the natural pH balance of the vagina. It is also advisable to wipe from front to back after using the toilet to prevent the spread of yeast or bacteria. Changing out of wet swimwear or sweaty workout clothes promptly can prevent yeast overgrowth.
Dietary considerations can play a role in managing yeast populations. Limiting sugar intake is often suggested, as yeast feeds on sugar, and high blood sugar levels can promote Candida growth. Incorporating probiotic-rich foods like yogurt with live cultures can help maintain a healthy balance of beneficial bacteria, which naturally keep yeast in check.
Managing chronic health conditions, such as diabetes, is also important for prevention. Keeping blood sugar levels within a healthy range can significantly reduce the risk of yeast infections. Additionally, being aware of medication use is helpful; for example, antibiotics can disrupt the natural balance of bacteria, increasing the risk of yeast overgrowth. If frequent yeast infections occur with antibiotic use, discussing preventative antifungal medication with a healthcare provider might be an option.