Yeast infection risk factors: who is more likely

What a vaginal yeast infection is

A vaginal yeast infection is an infection of the vagina that causes itching and burning of the vulva, the area around the vagina. It is caused by an overgrowth of the fungus Candida. The vagina may have small amounts of yeast at any time without causing symptoms; an infection happens when too much yeast grows (OWH).

MedlinePlus explains that the immune system usually keeps yeast under control, but if you are sick or taking antibiotics it can multiply and cause an infection. Yeast infections can also affect the mouth (thrush), the esophagus, the skin and the bloodstream (MedlinePlus). This page is about vaginal yeast infections.

How common it is

Women and girls of all ages can get vaginal yeast infections. OWH says three out of four women will have one at some point in their life and almost half of women have two or more. They are rare before puberty and after menopause (OWH). The CDC STI treatment guidelines give similar figures: an estimated 75% of women will have at least one episode and 40% to 45% will have two or more (CDC).

Who is more likely to get a yeast infection

OWH says your risk for yeast infections is higher if (OWH):

• You are pregnant.
• You have diabetes and your blood sugar is not under control (see type 2 diabetes risk factors).
• You use a type of hormonal birth control that has higher doses of estrogen.
• You douche or use vaginal sprays.
• You recently took antibiotics such as amoxicillin, or steroid medicines.
• You have a weakened immune system, such as from HIV (see our HIV screening check).

The CDC guidelines add that most healthy women with an uncomplicated yeast infection have no identifiable trigger (CDC). They also say yeast infections occur frequently during pregnancy (CDC).

A yeast infection is not considered an STI, because you can get one without having sex. But you can get a yeast infection from a sexual partner, and condoms and dental dams may help prevent getting or passing one (OWH).

Repeat (recurrent) yeast infections

OWH says about 5% of women get four or more vaginal yeast infections in one year, which is called recurrent vulvovaginal candidiasis (RVVC). It is more common in women with diabetes or weak immune systems, such as with HIV, but can also happen in otherwise healthy women. If you get four or more in a year, OWH advises talking to your doctor or nurse (OWH).

The CDC guidelines define recurrent infection as three or more episodes with symptoms in less than a year and say it affects fewer than 5% of women. It can be related to frequent antibiotic use, diabetes or other underlying factors, but most women with recurrent infections have no apparent predisposing or underlying condition (CDC). The CDC classes an infection as complicated when it is recurrent or severe, is caused by a Candida species other than C. albicans, or happens in women with diabetes, HIV or another immunocompromising condition, or immunosuppressive treatment such as corticosteroids; about 10% to 20% of women will have a complicated infection (CDC).

Symptoms

The most common symptom is extreme itchiness in and around the vagina. Other signs and symptoms OWH lists (OWH):

• Burning, redness and swelling of the vagina and the vulva
• Pain when urinating
• Pain during sex
• Soreness
• A thick, white vaginal discharge that looks like cottage cheese and does not have a bad smell

You may have only a few of these symptoms, and they may be mild or severe (OWH). The CDC notes that none of these symptoms is specific to a yeast infection (CDC).

Why to check with a doctor or nurse first

OWH says seeing your doctor or nurse is the only way to know for sure that you have a yeast infection and not a more serious infection such as an STI or bacterial vaginosis (BV). Studies show that two out of three women who buy yeast infection medicine do not really have a yeast infection. Treating an infection you do not have can make your body resistant to the medicine, and some yeast infection medicines may weaken condoms and diaphragms (OWH).

Yeast infections are usually treated with antifungal medicine, as creams, tablets, ointments or suppositories, or a single dose of an antifungal taken by mouth (OWH). During pregnancy, OWH says vaginal creams or suppositories with miconazole or clotrimazole are safe and the oral fluconazole tablet should not be taken because it may cause birth defects (OWH). The CDC guidelines recommend only topical azole treatment for 7 days in pregnancy (CDC).

Lowering your risk

OWH lists these steps to lower your risk of yeast infections (OWH):

• Do not douche, and do not use scented feminine products such as bubble bath, sprays, pads and tampons.
• Change tampons, pads and panty liners often.
• Do not wear tight underwear, pantyhose, pants or jeans, and wear underwear with a cotton crotch.
• Change out of wet swimsuits and workout clothes as soon as you can.
• After using the bathroom, always wipe from front to back.
• Avoid hot tubs and very hot baths.
• If you have diabetes, be sure your blood sugar is under control.

On yogurt and probiotics, OWH says studies suggest they can help prevent infection, but more research is needed to say for sure (OWH).

Common questions

Can antibiotics cause a yeast infection?

Recently taking antibiotics such as amoxicillin is on the OWH list of factors that raise the risk (OWH). MedlinePlus explains that when you take antibiotics, yeast can multiply and cause an infection (MedlinePlus).

Does diabetes make yeast infections more likely?

Yes, when blood sugar is not under control. OWH also says repeat yeast infections are more common in women with diabetes (OWH).

Can men get a yeast infection from a partner?

The risk is low. OWH says about 15% of men get an itchy rash on the penis after unprotected sex with a woman who has a yeast infection, and men who have not been circumcised and men with diabetes are at higher risk (OWH).