Genital / vulvovaginal candidiasis (VVC)

Genital / vulvovaginal candidiasis (VVC) is also sometimes called a "yeast infection.” It is a common infection that occurs when there is overgrowth of the yeast called Candida. Candida is always present in and on the body in small amounts. However, when an imbalance occurs, such as when the normal acidity of the vagina changes or when hormonal balance changes, Candida can multiply. When that happens, symptoms of candidiasis may appear.

Who Gets Genital / Vulvovaginal Candidiasis?

Nearly 75% of all adult women have had at least one "yeast infection" in their lifetime. On rare occasions, men can also get genital candidiasis. VVC occurs more frequently and more severely in people with weakened immune systems. Other conditions that may put a woman at risk for genital candidiasis include:

• Pregnancy
• Diabetes
• Long-term use of broad-spectrum antibiotics
• Use of corticosteroid medications

How can I Prevent Genital / Vulvovaginal Candidiasis?

Wearing cotton underwear may help to reduce the risk of developing a yeast infection. For women who experience recurrent yeast infections (more than three per year), some evidence suggests that oral or intravaginal probiotics may help to prevent frequent infections.

Most cases of Candida infection are caused by the person’s own Candida organisms. Candida yeasts usually live in the mouth, gastrointestinal tract, and vagina without causing symptoms. However, when an imbalance occurs, such as when the normal acidity of the vagina changes or when hormonal balance changes, Candida can multiply and build up. When this happens, symptoms of a “yeast infection” may appear. Less commonly, Candida infections can be passed from person to person through sexual intercourse.

The symptoms of VVC are similar to those of many other genital infections, so it can be difficult to diagnose a yeast infection by physical examination only.  Usually the diagnosis is made by taking a sample of the vaginal secretions and looking at the sample under a microscope to see if an abnormal number of Candida organisms are present. A fungal culture may not always be useful because Candida species are normal inhabitants of the body.

How is Genital / Vulvovaginal Candidiasis Treated?

Several different antifungal medications are available to treat genital candidiasis.  Antifungal vaginal suppositories or creams are commonly used. The duration of the treatment course of creams and suppositories can range from one day to seven days of therapy. Mild or moderate infections can sometimes be treated with a single dose of oral antifungal medication. These types of medications usually work to cure the infection (80% to 90% success rate), but some people may have recurrent or resistant infections. Short-course treatments should not be used for recurrent or resistant infections.

Are Over-the-Counter Treatments Safe to Use?

Over-the-counter treatments for VVC are available. As a result, more women are diagnosing and treating themselves. However, it is important to be sure of the diagnosis before treating a genital / vulvovaginal candidiasis infection with over-the-counter or other antifungal medications. Overuse of these medications can increase the chance that they will eventually not work because the yeast can become resistant to treatment. Therefore, it is important to be sure of the diagnosis before treating a genital / vulvovaginal candidiasis infection with over-the-counter medications.

What Will Happen if a Person Does Not get Treated for Genital / Vulvovaginal Candidiasis?

Symptoms, which may be very uncomfortable, can persist. There is also a chance that the infection may be passed between sex partners.

How Can Someone Tell the Difference Between a Yeast Infection and a Urinary Tract Infection?

Because yeast infections and urinary tract infections can have similar symptoms, such as a burning sensation when urinating, it is important to see your doctor so that he or she can determine the cause of the symptoms and treat them with the correct medication.

For healthcare providers: the most up-to-date clinical practice guidelines for the treatment of VVC are available at the Infectious Diseases Society of America website.

Genital / vulvovaginal candidiasis (VVC) is relatively common. Nearly 75% of all adult women have had at least one "yeast infection" in their lifetime. On rare occasions, men may also get genital candidiasis. VVC occurs more frequently and more severely in people with weakened immune systems.

Publications:

Falagas, M. E., G. I. Betsi, et al. (2006). "Probiotics for prevention of recurrent vulvovaginal candidiasis: a review." J Antimicrob Chemother 58(2): 266-272.

Sobel, J. D., S. Faro, et al. (1998). "Vulvovaginal candidiasis: epidemiologic, diagnostic, and therapeutic considerations." Am J Obstet Gynecol 178(2): 203-211.

Additional Links

• IDSA clinical practice guidelines
• CDC information on diseases characterized by vaginal discharge