Candida albicans, a yeast fungus often called simply candida, grows in the rectum and vagina. It grows best in a mildly acidic environment. The pH in the vagina is normally more than mildly acidic.
However, when we menstruate, take birth control pills or some antibiotics, are pregnant, or have diabetes, the pH becomes more alkaline. In a healthy vagina, the presence of some yeast may not be a problem. When our system is out of balance, yeast-like organisms can grow profusely and cause a thick white discharge that may look like cottage cheese and smell like baking bread. Sometimes this causes intense itching while at other times it just causes intermittent burning or a sense of irritation.
One study about the risk of recurring yeast infections found that sexual behaviors, rather than the presence of candida fungus on the male partner, were associated with recurrences. Women who had not had candida infections in the vulvovaginal area during the previous year were able to masturbate with saliva without increasing their risk of a candida infection, whereas women with a recent history of such infection in the vulvovaginal area increased the likelihood of a recurrent infection if they masturbated with saliva.
The only way to be sure that an infection is caused by candida and not something else is to have vaginal secretions analyzed under a microscope. In some cases, it helps to get a lab culture done. Other conditions causing vaginal irritation may respond temporarily to treatment for candida and then recur a short time later, so accurate diagnosis is important. Self-diagnosis is inaccurate more than half the time, so hold off from self-treatment until diagnosis by a healthcare provider.
Medical Treatments for Yeast Infections
Treatment usually consists of some form of vaginal suppository or cream or an oral antifungal. The former is available over the counter, while pills require a prescription. Antifungal external creams such as clotrimazole may reduce or even eliminate the symptoms, sometimes without actually curing the infection. A small percent of women have recurrent or chronic yeast infections. Prolonged oral treatment is sometimes required but should be based on a yeast culture.
Suppositories and creams have fewer side effects than oral medications, and they can be used during pregnancy. If a woman has a yeast infection when she gives birth, the baby will be likely to get yeast in its throat or digestive tract. This is called thrush and is treated orally with nystatin drops.
Other treatments for candida infection involve boric acid capsules or painting the vagina, cervix, and vulva with gentian violet. The latter is bright purple and stains, so a sanitary pad must be worn. This procedure can help, but in occasional cases, women have a severe reaction to gentian violet.
Side effects are rare with boric acid, but it may cause vaginal burning and itching. Do not use boric acid near any cuts or abrasions, as it can enter the bloodstream and may cause nausea, vomiting, diarrhea, dermatitis, and kidney damage. Boric acid is never taken orally and is typically used only after other FDA-approved treatments have failed.
Some women have had success with the following remedies: acidifying the system by drinking eight ounces of unsweetened cranberry juice every day, or taking cranberry concentrate supplements; inserting plain, unsweetened, live-culture yogurt in the vagina; inserting garlic suppositories (to prevent irritation, peel but don’t nick a clove of garlic, then wrap in gauze before inserting). But there is no good research on whether these home remedies are effective.
Since yeast thrive on sugar, it may be helpful to reduce the amount of sugar in your diet. Avoid douches and don’t use tampons for your period when you have an infection. If you have a male sex partner, have him apply antifungal cream to his penis twice a day for two weeks, especially if he’s not circumcised.