Fungal Vaginitis, Yeast Infection or Candidiasis: How to keep your vagina healthy!

It is probable that all of you have heard of it and most of you have been visited by it at some point of your life, maybe in the summer. So let’s learn some things about Vulvovaginal Candidiasis.

What is Fungal Vaginitis?

75% of us will have Fungal Vaginitis at least once in our lives.

The bacteria that live naturally in our vagina are called Lactobacilli and they stabilize the vagina’s acidic PH. Nevertheless, when the appropriate conditions appear, the number of Lactobacilli is decreased and other microbes get the chance to multiply and cause Vaginosis, one of them is Candida spp.

Almost 50% of people will suffer from recurrent Fungal Vaginitis. Amongst the general population it is most common for people with diabetes, pregnancy or immunosuppression.

What Causes a Yeast Infection?

The primary cause of a yeast infection, or fungal vaginitis, is the fungus Candida albicans. Under normal conditions, this fungus lives in harmony with other microorganisms in the vagina. However, various factors can disrupt this balance, leading to an overgrowth of Candida and the subsequent development of an infection. Such disruptions can be caused by:

  1. Antibiotics: They can kill off beneficial bacteria that control Candida growth.
  2. Hormonal changes, especially an increase in estrogen levels.
  3. Impaired immune function.
  4. High sugar levels, commonly seen in uncontrolled diabetes.

Symptoms of Fungal Candidiasis

Fungal vaginitis, commonly known as a yeast infection, is caused by an overgrowth of the fungus Candida albicans in the vagina.

Fungal vaginitis, commonly known as a yeast infection, is caused by an overgrowth of the fungus Candida albicans in the vagina. While the presence of Candida is normal, imbalance in the vaginal environment can lead to its overgrowth, resulting in an infection. It can be asymptomatic (no symptoms), or it can cause symptoms like the following:

  1. Vaginal Itching: One of the most common and noticeable symptoms. It can range from mild to severe and is often persistent.
  2. Thick, White Discharge: Often described as having a “cottage cheese” consistency. It might be odorless, but sometimes it may have a mild yeast or bread-like smell.
  3. Redness and Swelling: The skin around the vagina may appear reddened and may feel sore or sensitive to the touch.
  4. Pain during Sexual Intercourse: Some women experience discomfort or pain during sexual activity.
  5. Burning Sensation during Urination: The act of urinating may cause a stinging or burning sensation due to the inflamed vaginal walls.

Risk factors of Fungal Candiasis

Several factors can increase the risk of developing a yeast infection:

  • Antibiotics: These medications can decrease the number of beneficial bacteria in the vagina, allowing yeast to flourish.
  • Hormonal Changes: Shifts in hormone levels, such as during pregnancy, menstruation, or with hormone-based medications, can create an environment conducive to yeast growth.
  • Diabetes: Women with poorly controlled diabetes have increased sugar levels in vaginal secretions, which can promote yeast growth.
  • Weakened Immune System: Those with a weakened immune response, such as HIV patients or those undergoing certain medical treatments, are more susceptible.
  • Frequent change of partners/Unprotected sex: While yeast infections are not considered sexually transmitted infections, having intercourse can introduce Candida from one partner to another.
  • Douching: This can disrupt the natural balance of bacteria in the vagina, making it easier for a yeast infection to develop.
  • Wearing panty-liners or pantyhose
  • Underwear made of lycra (or non-breathable synthetic material)
  • Damp bathing suits

How can I prevent fungal vaginitis?

If you experience symptoms of Vaginosis, don’t practice any sexual activity, until they are completely gone. Also, if you are using sex toys, make sure you clean them before and after use and don’t exchange them.

Often, preventing the recurrence is a significant part of the treatment strategy. This includes…

  1. Maintaining Vaginal pH: Avoid douching, as it can disrupt the vaginal pH and bacterial balance.
  2. Wearing Breathable Clothing: Choose cotton underwear and avoid overly tight pants.
  3. Changing Wet Clothing: After swimming or a workout, change out of damp clothes quickly.
  4. Diet: Limit the intake of sugary foods which can increase yeast growth, especially if you have diabetes.

How is fungal vaginitis diagnosed?

Diagnosis of a yeast infection usually involves lab tests: A sample of the vaginal discharge may be taken and examined under a microscope to identify the presence of the yeast. In some cases, the sample might be cultured to identify the specific type of fungus causing the infection.

In our femshop you will find the Vaginal Smear Culture Home Test in order to check the most common vaginal pathogens including Candida spp.

How do I take my sample?

Taking your sample is very easy and painless, follow the instructions below (also included in the kit) to use a swab and take a sample of your vaginal fluid. For the vaginal smear culture, you will take 3 samples.

  1. First, wash your hands.
  2. Open the STERILE R tube, take out the swab.
  3. In a comfortable position, hold the swab in one hand, and separate your labia with the other.
  4. Insert the swab 5cm (which is about half the size of your index finger) into the vaginal opening.
  5. Gently rub the swab against the walls of your vagina by turning it around for about 30 seconds.
  6. Put the swab back in the tube and close it tight.
The picture explains how to take your sample for fungal vaginitis.

Note: Follow the detailed instructions in the manual to ensure that all three samples are properly taken and preserved.

What happens if my results come in positive?

If you would like to discuss your results and/or receive a prescription from a certified doctor, head over to our telehealth page to view our list of recommended doctors and book an online consultation.

Therapy and alternative ways to treat yeast infections

The first line of treatment is Azoles and most commonly Fluconazole in the form of vaginal suppositories or oral pills. If that doesn’t reduce the symptoms, it could be a sign of rare Candida species, such as Candida krusei or C. glabrata. We shouldn’t forget that all off our sexual partners should also take medications, even if they are asymptomatic.

Effective treatment aims at reducing the overgrowth of the yeast and alleviating symptoms. Here are the common treatments:

  1. Antifungal Medications: These are the primary treatments for yeast infections and come in various forms:
    • Topical Creams and Ointments: Applied directly to the affected area, e.g., miconazole (Monistat) and clotrimazole.
    • Oral Medications: Fluconazole (Diflucan) is a common oral treatment.
  2. Probiotics: These can help restore the natural balance of bacteria in the vagina. Probiotic supplements or foods rich in lactobacilli, the beneficial bacteria, can be beneficial.

In all cases, it’s essential to consult with a healthcare provider to determine the best treatment approach. They will ensure that the symptoms are indeed due to a yeast infection and not another underlying condition.

Alternative therapies

Alternative medications might be anti inflammatories or probiotics and prebiotics, which can also help to prevent the infection.

Alternative medications might be anti inflammatories or probiotics and prebiotics, which can also help to prevent the infection.

  • Boric acid: you can find it in the form of vaginal suppositories.
  • Vinegar: although it can reduce symptoms of Vaginosis, its use is not recommended anymore.
  • Tea tree oil: put a drop of tea tree essential oil in 1ml of water and apply topically
  • Soda: make a bath using 6-12gr of baking soda in every liter of water and soak your vagina in it for 15 min, 2 times per day for 2-3 times per week, until symptoms are gone.

How common is fungal vaginitis amongst queer people?

In a research study in 2008, 708 queer people, mostly Lesbians and Bisexuals, were examined in order to determine if Vulvovaginal Candidiasis is common amongst them.

Vulvovaginal Candidiasis (either symptomatic or asymptomatic) was common in this sample of VSV people at 18.4%. Logistic regression (a statistical method to model a binary dependent variable) showed that Vulvovaginal Candidiasis was significantly associated with larger numbers of female sexual partners in the previous year, but not with specific sexual practices, or numbers of male partners, or the use of lubricants or vaginal douching.

How is it transmitted amongst queer people?

Fungi live naturally in our mouths, vagina and rectum, so the most common ways they can be transmitted are through oral sex, penetration with fingers in vagina or rectum and exchange of sex toys.

Recurrent yeast infection: What should I do?

The most common cause of recurrent Vulvovaginal Candidiasis are false positive lab test results. So, if you have 4 or more episodes in a year, you should confirm the result and the species of Candida that is isolated. 

If the Vulvovaginal Candidiasis is confirmed the first line of treatment is Triazole for 6 months. Another agent that might help is daily probiotics that help balance vaginal flora.

Stay tuned for more info in our next article, until then…take care of your vagina!


  1. Thais Chimati Felix1 & Denise Von Dolinger de Brito Röder2 & Reginaldo dos Santos Pedroso3. Alternative and complementary therapies for vulvovaginal candidiasis. 2018
  2. Bruna Gonc¸alves, Carina Ferreira, Carlos Tiago Alves, Mariana Henriques, Joana Azeredo, and So´nia Silva. Vulvovaginal candidiasis: Epidemiology, microbiology and risk factors. 2015.
  3. JULIA V. BAILEY. Vulvovaginal Candidiasis in Women Who Have Sex With Women. 2008.

About the author

In the first article we discussed the most common Vaginitis – Bacterial Vaginosis-, in this article we discussed the second most common which is Vulvovaginal Candidiasis (also known as thrush, yeast or fungal infection).

This is the second article on Ask Your Gyno with Dr Amalia