Why Do Recurrent Yeast Infections Occur?

Our pharmacist answers the latest question regarding possible reasons for recurrent yeast infections.

Sep 27, 2017

House asked

I've had three yeast infections in the past 4 months now and I'm starting to worry. It can't be an std because I've only had sex with two guys and both were virgins and have tested negative for it. Another answer I found was me being a diabetic which I'm not really a diabetic I just have low blood sugar a lot.

Answer

There are many reasons as to why you may be having frequent yeast infections. Very often yeast infections are NOT associated with having either one or multiple sexual partners. Yeast infections caused by Candida albicans (the most common culprit) are not considered a sexually transmitted disease and is rarely acquired through sexual intercourse.

A yeast infection of the vagina is also known as vulvovaginal candidiasis. As I mentioned, the yeast Candida albicans is the most common infecting agent but it can be caused by other yeasts as well. The typical symptoms of a yeast infections are itching, vaginal soreness, painful urination, vaginal discharge and an abnormal odor. Yeast infections are very common and more than 75% of women will experience them during their lifetime. Almost 50% of people will have a recurring problem with them. Yeast infections in general are easy to treat with good outcomes but there are about 10-20% of cases that are considered complicated and are not resolved with initial therapy.

Firstly, you want to make sure you have treated the initial infection properly. There are a slew of over the counter products that are used for first line therapy.  All of the different products work just about the same and can clear 80-90% of yeast infections. In addition, the length of application for each product varies from 1 day to 7 days. Again, they are all about as effective as one another. In your case however, I would certainly recommend a 7 day course of therapy (Monistat-7 for example).  The longer day therapies are sometimes recommended because women who have recurrent infections respond better to longer therapies.

If you have appropriately completed a therapy similar to one I mentioned in the previous paragraph and you continue to get recurrent infections, you would have a yeast infection that is classified as complicated case. The reason behind recurrent infections isn't well understood and in many cases, women have no apparent predisposing factor or underlying condition that causes them. The most important thing you can do here is to visit your doctor and they will surely take a vaginal culture to confirm the diagnosis and to identify exactly what species is causing the infection. Conventional therapies often do not work for species other than candida albicans.

Once diagnosis and species are confirmed, therapy is started, which can differ dependent on the person. Most people respond well to therapy of prescription fluconazole taken by mouth for anywhere from 2 days to 14 days. There are other medications that are used as well if the doctor finds that fluconazole may not work for the specific yeast causing your symptoms.

While the exact reason as to why some people get more infections than others is not well known, there are some possible contributing factors. It's important to note that many women actually have the candida albicans yeast present in the vagina. The problem occurs when there is overgrowth. Here are some possible contributing factors:

  • Heavy washing of the vagina and vaginal douches

  • Being on oral hormonal contraceptives or other hormone replacement therapy

  • Constantly wearing tight fitting clothing that retains moisture in the vaginal area (e.g. swimwear, non-breathable undergarments)

  • Diets high in sugars (this is where diabetics may have problems. While diabetics typically don't have diets high in sugars, their body lacks the ability to properly regulate blood sugars and therefore often have high blood sugar levels)

  • Problems with the immune system

  • Antibiotic use

As you can see, there are multiple reasons as to why someone may have recurrent infections and that list is certainly not a complete one. Know that recurrent infections are common in many people and it typically is not a serious problem. I highly recommend seeing you doctor for proper diagnosis and treatment.

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