The majority of people with vaginas will get a yeast infection at least once, or maybe even twice, in their lifetime. But is it normal for them to practically be a regular thing?
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Vaginal yeast infections are caused by an overgrowth of the fungus candida albicans. They’re typically marked by intense vaginal itching or irritation, redness or swelling, burning while urinating and vaginal discharge that can be watery or white and cottage cheese-like, according to the Mayo Clinic.
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Yeast infections are considered recurring if a person has four or more of them per year. When that happens, they’re typically triggered by an underlying cause that needs to be addressed.
Here are the most common culprits behind recurrent yeast infections and what you can do to find relief.
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Antibiotics can kill off bad bacteria that’s causing an infection, but they can kill off beneficial bugs too, including good bacteria in the vagina.
That can set the stage for yeast like candida to grow out of control and cause an infection, especially if someone is taking antibiotics frequently, says Felice Gersh, MD, ob-gyn and founder and director of the Integrative Medical Group of Irvine in Irvine, California.
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Fix it: If you’re taking antibiotics regularly or often, reducing your use (or switching to another antibiotic) can help bring your vaginal bacteria back into balance, making it harder for yeast infections to develop. (Eating certain foods while taking antibiotics might help too.)
Talk with your doctor before making any changes to your antibiotic regimen.
Hormonal fluctuations caused by birth control options like the pill can create a vaginal environment that’s more prone to yeast infections, according to the Cleveland Clinic.
“Birth control pills reduce the efficiency of white blood cells to deactivate the pathogen,” Dr. Gersh explains.
Fix it: Recurring yeast infections may be a sign that your birth control isn’t a good fit. “The best thing to do is discontinue it,” Dr. Gersh says.
Talk with your gynecologist about trying a lower-dose hormonal contraceptive. Research in the November 2012 issue of Contraception suggests that the vaginal ring may be a better fit.
Both can disrupt the vagina’s normal bacteria environment and increase the chances for yeast overgrowth or other infections like bacterial vaginosis, according to the Office on Women’s Health.
And if you have an existing yeast infection, douching could actually make the problem worse.
Fix it: When showering or bathing, wash your vulva (the outside of your vagina) with warm water and, if you’d like, a mild, unscented soap, the Office on Women’s Health recommends.
The vagina is self-cleaning, so there’s no need to use cleanses or sprays to wash it. If you’re concerned about vaginal odor, talk with your gynecologist.
Insulin resistance caused by prediabetes, diabetes or polycystic ovary syndrome (PCOS) is another common trigger for recurring yeast infections, Dr. Gersh says. Blood sugar imbalances can cause excess sugar to accumulate in the urine, which can affect the vaginal environment and set the stage for yeast growth.
Fix it: Talk with your primary care provider if your blood sugar isn’t well controlled. Together, you can determine whether lifestyle changes like diet and exercise can address the problem or whether you need to take medication to get your blood sugar back into balance, per the Centers for Disease Control and Prevention (CDC).
The normal (but very extreme) hormonal fluctuations that happen during pregnancy can disrupt the vagina’s natural acidity levels and make yeast infections more likely, the Mayo Clinic notes.
Pregnancy can also weaken the immune system, making it harder for the body to fight off developing infections, Dr. Gersh says.
Fix it: Pregnancy-related yeast infections will typically ease up after giving birth, once your hormones stabilize.
In the meantime, practice habits to reduce your chances for infection (more on those below) and talk with your provider about taking an over-the-counter cream, ointment or suppository such as clotrimazole, miconazole or terconazole. These medications are safe to take during pregnancy, according to the Mayo Clinic.
Medical conditions such as HIV or using certain medications (like chemotherapy, steroids or post-organ transplant drugs) can weaken the immune system, making it harder for the body to fight off infections, including yeast infections, per UpToDate.com.
Fix it: Talk with your doctor if you’re experiencing recurrent yeast infections alongside a condition or medication that’s suppressing your immune system. Together you can decide on the best steps to reduce your infection risk and discuss whether it’s possible to change medications.
Frequently wearing tight bottoms — especially ones made of synthetic materials — won’t alone cause a yeast infection. But it can increase your odds, especially if you have other risk factors.
“If all of the variables are aligned with an infection, it’s possible that recurring yeast infections will be the default position and occur continuously,” Dr. Gersh says.
Fix it: Start by talking with your doctor to address any potential underlying issues that could be setting the stage for yeast infections, like those mentioned above. While you take steps to address those, make it a point to wear bottoms that are made of natural, breathable materials (like cotton) and have a looser fit.
Yeast infections can typically be treated with over-the-counter antifungal creams, ointments, suppositories or tablets. But if you keep getting yeast infections, you may need to be treated with a six-month course of prescription antifungals, per the Office on Women’s Health.
“Some newer vaginal yeast infection medications have come out for the treatment of resistant strains,” Dr. Gersh says.
Lifestyle changes won’t clear an existing infection, but they can help reduce the likelihood that a cleared infection comes back. Some strategies to try:
Related Reading
The 3 Best Natural Remedies for a Yeast Infection, and 7 to Avoid
See your doctor if you’re experiencing more than four yeast infections a year, or if at-home treatments haven’t been enough to clear your yeast infection after two weeks, Dr. Gersh recommends.
Your provider can prescribe a more powerful antifungal to help clear the infection, and if needed, help you address any underlying factors that could be causing the yeast infections to recur.
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