Vaginal Yeast Infection: What Is It, What Are Its Symptoms, What Causes It, and How Can It Be Treated?

Vaginal infections are one of the most common problems among gynecological diseases. The physiological vaginal flora has a balanced microbiota that contains numerous bacteria and microorganisms. However, certain conditions such as extensive antibiotic use, inadequate genital hygiene, and unhealthy dietary habits can disrupt the floral balance of the vagina. In this case, beneficial microorganisms in the vagina decrease, while the concentration of harmful microorganisms increases. The most frequently encountered infection in this context is vaginal candidiasis, also known as a vaginal yeast infection.

Vaginal infections are one of the most common problems among gynecological diseases. The physiological vaginal flora has a balanced microbiota that contains numerous bacteria and microorganisms. However, certain conditions such as extensive antibiotic use, inadequate genital hygiene, and unhealthy dietary habits can disrupt the floral balance of the vagina. In this case, beneficial microorganisms in the vagina decrease, while the concentration of harmful microorganisms increases. The most frequently encountered infection in this context is vaginal candidiasis, also known as a vaginal yeast infection.

Vaginal infections are one of the most common problems among gynecological diseases. The physiological vaginal flora has a balanced microbiota that contains numerous bacteria and microorganisms. However, certain conditions such as extensive antibiotic use, inadequate genital hygiene, and unhealthy dietary habits can disrupt the floral balance of the vagina. In this case, beneficial microorganisms in the vagina decrease, while the concentration of harmful microorganisms increases. The most frequently encountered infection in this context is vaginal candidiasis, also known as a vaginal yeast infection.

What Is Vaginal Yeast Infection?

A vaginal yeast infection is a vaginal mucosal infection that occurs in approximately 75% of women worldwide and is usually caused by a microorganism called Candida albicans. This microorganism is one of the naturally occurring microorganisms in the oral cavity, throat, intestines, and vaginal flora of healthy individuals and is responsible for about 90% of infections. However, certain conditions such as pregnancy, the presence of systemic diseases like HIV, diabetes, and obesity, as well as the use of medications like antibiotics, oral contraceptives, and steroids can disrupt the floral balance in these structures, leading to an increase in the concentration of Candida albicans. As a result, a yeast infection occurs.

What Are the Symptoms of Vaginal Yeast Infection?

Severe itching in the vagina is one of the most common symptoms of a vaginal yeast infection. Swelling due to itching, erythema, and sensitivity may develop on the vulva. Additionally, the disruption of the healthy vaginal flora leads to changes in physiological vaginal discharge, and particularly, a yeast infection causes vaginal discharges that have a white, curdled, or cheesy appearance.

Vaginal infections are widespread conditions that affect the entire urogenital system. Therefore, the urinary system is also affected in the presence of a vaginal yeast infection. Symptoms such as pain and burning during urination may occur. Moreover, pain during sexual intercourse (dyspareunia) is another common complaint associated with the presence of a vaginal yeast infection. Symptoms like pain, burning, stinging, itching, and discomfort, particularly in the groin area during sexual intercourse, are defined as dyspareunia and are generally caused by an underlying vaginal infection.

What Causes Vaginal Yeast Infection?

Fungi are organisms that are naturally present in a person's oral cavity, throat, intestines, and vaginal flora. However, in some cases, the balance of the microbiota is disrupted, and the concentration of fungi in these organs increases.

When the immune system of an individual weakens, the number of beneficial microorganisms decreases, resulting in the development of a yeast infection. The aim of antibiotic use is to control the harmful microorganisms that proliferate in the body; however, some antibiotics can also affect beneficial microorganisms. In this situation, the beneficial microorganisms that regulate the concentration of fungi decrease, leading to the development of a fungal infection in the affected organ.

One of the most important conditions for maintaining a healthy vaginal flora is keeping the pH of the environment at an optimum level. The pH value of the vaginal environment varies according to many factors, such as age, hormone levels, presence of sexual activity, preferred birth control methods, presence of metabolic diseases, medications used, antibiotics, and surgical interventions. Normal vaginal flora has an aerobic environment, which is largely maintained by organisms called Lactobacillus. A decrease in Lactobacillus density weakens the aerobic environment and disrupts the balance of bacteria established in the vaginal flora.

Hormonal imbalance also plays a significant role in the development of vaginal yeast infections. Particularly, the low or high levels of estrogen hormone are closely related to the occurrence of vaginal infections. Some secretions that continuously exist within the vagina are extremely important for maintaining a healthy pH level in the vaginal environment. Normal vaginal secretions consist of sebaceous secretions originating from the vulva, physiological secretions from the Bartholin and Skene glands, secretions from glands within the uterus and cervix, watery secretions leaking from the vaginal epithelial tissue, cellular structures shed from the cervix and vaginal tissues, microorganisms, and their metabolic waste products. The estrogen hormone is responsible for the proliferation, renewal, and maturation of the vaginal epithelium, as well as for the storage of glucose in epithelial cells. The storage of glucose in epithelial cells results in the production of lactic acid, which reduces the vaginal pH to levels between 3.5 and 4.5, maintaining it at an optimum level. Due to the low secretion of estrogen before puberty and after menopause, the vaginal epithelium cannot proliferate and renew, and cannot store excessive amounts of glucose. This leads to a thinner vaginal epithelium and less vaginal secretion during these life stages. Consequently, the susceptibility to vaginal infections increases in these age groups.

How is Vaginal Yeast Diagnosed?

The diagnosis of vaginal yeast infection is generally made based on the patient's complaints and the examination findings of the vaginal area. Swelling in the external and internal genital organs, known as the vulvovaginal area, especially accompanied by itching and sensitivity within the vagina, as well as complaints of burning and stinging during urination, are common symptoms that can arise with many vaginal infections. Therefore, the characteristics of the discharge from the vagina are typically considered when diagnosing vaginal infections. Healthy vaginal secretions are usually transparent or light-colored, odorless, fluid in consistency, and present in amounts that do not cause discomfort. However, microorganisms such as bacteria, yeast, viruses, and parasites can alter the physiological characteristics of vaginal discharge. Infected vaginal secretions are generally yellow-green or gray, purulent in appearance, denser in consistency, and foul-smelling. A yeast infection often causes a white, curd-like or cheesy discharge.

In addition to the clinical features of the disease, the vaginal pH is evaluated, and in suspicious cases, vaginal secretions are examined with a 10% potassium hydroxide solution.

Vaginal Yeast Treatment

Vaginal yeast treatment should be applied only to individuals who have received a definitive diagnosis and have clinical findings; otherwise, healthy vaginal flora can be disrupted. Treatments that are completed quickly or not regularly followed through will not be successful and can make the individual more susceptible to the disease. Therefore, vaginal yeast treatment should be conducted under the supervision of a specialist physician from start to finish.

Treatment is planned based on the patient's age, the presence of any underlying systemic diseases, and the severity of yeast-related complaints. Considering the relationship between yeast infections and antibiotic use, it is expected that antibiotic treatment will be completed before antifungal treatment.

Antifungal tablets that can be administered orally or intravaginally are preferred in the treatment. The antifungal tablet treatment is administered for 7 or 14 days by placing one tablet inside the vagina before going to bed. It is crucial that the entire treatment plan is carried out by the physician to effectively treat the disease and prevent it from recurring and becoming chronic. Incorrect applications can lead to treatment resistance and frequent recurrences of the disease, while a disrupted vaginal pH makes the individual more susceptible to other vaginal infections.

How to Prevent Vaginal Yeast?

To prevent the development of vaginal yeast infections, uncontrolled antibiotic use should be avoided first. After antibiotic use, supplements that support the body’s disrupted microbiota should be taken. Probiotics that prevent the proliferation of pathogenic microorganisms throughout the body also strengthen the mucosal immune system and provide protective effects. To prevent the development of vaginal yeast, especially during periods when the immune system is weakened, probiotic supplements containing lactobacilli can be used.

Genital hygiene habits must also be regulated to prevent vaginal yeast. It is important for individuals to prefer cotton underwear as much as possible and to avoid tight-fitting and non-breathable garments. One should also avoid vaginal douching, which can lead to the loss of healthy microorganisms.