Anyone who’s experienced the itching, swelling, and vaginal pain of a yeast infection will tell you: One infection is more than enough! Yet some unfortunate individuals experience vaginal yeast infections at least four times a year. Called chronic yeast infection, this women’s health condition is not only uncomfortable and may cause embarrassment, it can also make you miss out on life.
Luckily, once you identify what’s causing your yeast infections to keep coming back, you can take action to prevent them and return to a fuller, more comfortable life.
In this article, I’ll explain what chronic yeast infections are, what causes them, and how to treat and prevent recurring yeast infections. I’ll also share when to see a doctor rather than trying to manage the condition yourself.
What Are Chronic Yeast Infections?
The gut isn’t the only place in our bodies with a microbiome. The vagina also has its own microbiome composed of trillions of microbes (such as the bacteria lactobacillus and a fungus called candida albicans) that keep us healthy and make sure everything is functioning well.
When all of the microbes are in balance, there’s nothing to worry about. But when something upsets this delicate balance, it can trigger an overgrowth of candida, leading to a vaginal yeast infection. Also called vaginal candidiasis, this fungal infection is very common, affecting up to 75% of people with vaginas at some point during their lifetimes.
Symptoms of a yeast infection include:
- Itching or irritation of the vagina and vulva
- Thick, white, odorless vaginal discharge with a cottage cheese-like texture
- Watery discharge
- Pain or burning during urination
- Pain during sex
- Swelling and redness around the vulva
A yeast infection is considered chronic when it occurs at least four times in the span of one year. You may also hear this called a recurring yeast infection, complicated yeast infection, or recurrent vulvovaginal candidiasis.
Certain factors can make you more likely to develop recurrent yeast infections. This includes:
- A previous yeast infection: Sometimes what seems like a new yeast infection is actually an old infection that did not completely resolve. Or, in rare instances, you may be dealing with a type of fungus that is resistant to most treatment options.
- Genetics: If someone in your family gets recurrent yeast infections, you might have a genetic mutation that makes you more likely to get them as well.
- Autoimmune conditions: People with chronic conditions like lupus or HIV may have weakened immune systems due to their condition or medications to manage it. This can make it harder for the body to fight off a fungal infection.
- Pregnancy: The hormonal changes that occur during pregnancy can alter the vaginal pH and create an environment where yeast thrives.
- Oral contraceptives: Taking hormonal birth control pills can alter estrogen levels, and high levels of estrogen can increase the risk of yeast infections.
- Hygiene practices: Wearing the same pair of underwear, sweaty leggings, or a wet bathing suit for too long creates an environment that yeast loves.
- Sexual activity: Although it’s not considered a sexually transmitted infection, yeast infections can be transmitted between partners during oral, vaginal, or anal sex.
- Diabetes: Uncontrolled diabetes (both type 1 and type 2) leads to high blood sugar and a weakened immune response. Both can promote the growth of vaginal yeast.
- Antibiotic use: While antibiotics kill bad bacteria, they can also kill off some good bacteria, leading to an imbalance in vaginal flora. This can increase the risk of yeast infections and vaginitis (inflammation of the vagina).
How to Get Rid of Chronic Yeast Infections: What Are Your Treatment Options?
Over-the-counter medications can work for occasional yeast infections. But for chronic yeast infections, it’s best to see a healthcare provider for an accurate diagnosis and medical advice. They will first determine if you’re in fact dealing with a yeast infection or another condition—such as a sexually transmitted infection (STI), bacterial vaginosis, or urinary tract infection (UTI)—that has similar symptoms.
Once the doctor confirms you have recurrent yeast infections, they will work with you to identify the underlying cause. If it’s something that can be changed with lifestyle adjustments (like a new type of birth control, managing your blood sugar, or changing out of sweaty clothes more quickly), that’s a great place to start.
In addition, your doctor may prescribe a longer course of topical antifungal medication to use daily for two weeks and then weekly for up to six months. Or they may prescribe a two- or three-day dose of the oral antifungal fluconazole (Diflucan) as long as you are not pregnant. Lastly, boric acid capsules inserted into the vagina like suppositories may work if nothing else does.
Whatever your healthcare provider recommends, be sure to follow their directions. Doing so gives you the best chance of knocking out the current yeast infection and preventing future infections.
Although you cannot control every risk factor for chronic yeast infection, by addressing those that you can control, you may lower your risk of infection.
- If your sexual partner has a yeast infection, avoid having sex with them until after the infection clears.
- If you have diabetes, work with an endocrinologist to manage your blood sugar.
- Wear breathable, cotton underwear and change it daily.
- Change out of sweaty clothes after a workout and damp bathing suits after hitting the pool or beach.
- Talk to your doctor about whether any antibiotic use could be contributing to your recurring yeast infections.
- If you have an autoimmune condition, ask your doctor if your medication might be a factor.
- Avoid douching and the use of scented tampons, detergent, and other products that might affect your vaginal pH.
When to See A Doctor
It’s smart to seek an expert’s medical advice anytime you experience symptoms consistent with a vaginal infection. Because many of these infections present with similar symptoms, a doctor can help make an accurate diagnosis so you can use the proper treatment, feel better sooner, and avoid any complications.
In the case of a yeast infection that keeps coming back, it’s even more important to see a healthcare provider. They can determine the underlying cause of your infections and work with you to create a plan to get your health back on track.
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