“I have a yeast infection. I tried the over the counter cream, but it’s just not working!” This is one of the most common complaints I hear from patients when they call me. I will usually suggest that they come in for an office visit (often to their frustration), since self-diagnosis is not always accurate. In fact, studies show that up to 50% of women who think they have a yeast infection actually have another type of vaginitis. So before you pick up a yeast infection cream at the drug store, here are some pointers to help you decide what might be going on.
Yeast infection symptoms include:
- Itching – Itching is the most common symptom of a yeast infection. Sometimes the itching is so severe that patients scratch themselves until raw sores develop.
- Vaginal burning – Yeast can also cause vaginal irritation, burning and swelling, as well as pain with urination and sex. Occasionally, when I examine women with severe infections, their entire vulva are bright red and swollen, looking like they have the world’s most unfortunate sunburn.
- Vaginal discharge – The vaginal discharge of a yeast infection is most typically thick, white and clumpy almost a “cottage cheese” appearance, but some infections will be tricky and have a normal appearing discharge.
Symptoms often MISTAKEN for a yeast infection:
- Foul vaginal odor – A strong vaginal odor is not a typical symptom of a yeast infection, but more likely to be bacterial vaginosis (BV), which is an overgrowth of abnormal bacteria instead of yeast. BV is more common than yeast infections and causes a grey thin discharge and a pungent fishy odor that is most prominent after intercourse. BV is easily treated with an antibiotic and doesn’t cause any long term health issues.
- Vulvar blisters/ulcerations – Genital herpes causes blisters and ulcers that can sometimes be confused with a yeast infection because the both can cause a burning pain, swelling and irritation. Sadly, there is no cure for herpes, but there are antiviral pills available to treat the symptoms of the disease.
- Frothy vaginal discharge – Discharge that is frothy and bubbly could be a sign of trichomonas, a common sexually transmitted disease (STD). Trichomonas is highly contagious, but luckily can be easily treated with antibiotics and doesn’t cause any long term health issues. All sexual partners must be treated with antibiotics as well, or you can get re-infected easily.
When to see a doctor:
- Symptoms develop after a new sexual partner
- Symptoms don’t resolve with over-the-counter creams
- Symptoms associated with fever
- Getting more than 4 yeast infections a year
While yeast infections are not life threatening, recurrent yeast infections (more than 4 per year) can be a symptom of underlying medical conditions, like diabetes.
No woman wants to go through the day with unrelenting itching or feeling like her vagina is on fire. So if you’re having the classic symptoms of a yeast infection, treating with an over-the-counter cream makes sense (and does no harm if your self-diagnosis is wrong). But if it isn’t helping, or the infections keep coming back, call for an appointment with your provider to make sure there is nothing more serious going on.