That said, there are also a few unique factors that could up your likelihood of a yeast infection or bacterial vaginosis. On the yeast front, Candida “loves warm, moist environments,” Dr. Gleaton says, so wearing tight or damp clothing (like a wet bathing suit or sweaty workout clothes) for a long period of time might leave you abnormally yeasty. These microbes also go ham for sugar, so if you have an elevated blood-sugar level (as with diabetes) or use flavored or warming lubes containing a type of sugar called glycerin, you could be at higher risk. For the same reason, having extra-high estrogen levels—like during pregnancy or while taking estrogen therapy—could set off yeast overgrowth, as estrogen raises the level of glycogen (a stored form of glucose) in your vagina. As for BV-specific risk factors? There’s evidence to suggest smoking could directly reduce your levels of helpful Lactobacillus bacteria, allowing for the BV-causing bugs to overpopulate.
A correct diagnosis is important, because treatment for a yeast infection vs. bacterial vaginosis looks pretty different.
Because yeast infections and BV involve overgrowth of two distinct organisms, curbing that excess requires two different types of medication: an antifungal for yeast and an antibiotic for BV.
In the case of yeast, there are a bunch of popular OTC antifungal creams and suppositories (which dissolve inside your vagina), including miconazole (Monistat) and tioconazole. If you feel confident that you’re dealing with yeast (perhaps you’ve gotten this type of infection before), it’s generally okay to treat your symptoms on your own with one of these solutions over the course of three to 7 days. Just note that if you’re still dealing with pain and discharge past that period, it may be a sign that you’ve taken the wrong medication; if, for instance, it’s actually BV, and you’re using OTC yeast infection treatments, you won’t get any relief…and you could even make things more uncomfortable down there.
That’s why it’s generally a good idea to give your doctor a call if you’re at all unsure of what’s plaguing you. An ob-gyn can often pinpoint a yeast infection based on symptoms alone, but they can also gently swab your vagina and use a microscope to check your discharge for signs of yeast or bacterial overgrowth. And if they suspect that something else might be in play, they can send that swab out for a culture test, too. This typically checks for a bunch of heavy hitters at once, Dr. Ross says, including, yes, BV and yeast, but also trichomoniasis, chlamydia, and gonorrhea. (If you can’t get in to see your doc for whatever reason, there are also at-home culture and vaginal pH tests available OTC that can give you insight into what’s going on and, in some cases, connect you to a telehealth provider to interpret the results and prescribe you meds if needed.)
If a yeast infection is the culprit, your doc can prescribe an antifungal called fluconazole (Diflucan), which is a one-time pill that can knock out Candida overgrowth. (Dr. Ross favors it over the OTC creams, given that ingredients in the latter can sometimes trigger allergic reactions.) And as for BV? The only treatments are prescription antibiotics—typically metronidazole (Flagyl). It comes in the form of a pill, which you’d take twice a day for a week, or you can get it as a vaginal gel that you insert every night for five nights, Dr. Ross says. Other common options include clindamycin (Cleocin, Clindesse), which comes as a pill, cream, or suppository, and Tinidazole (Tindamax), which is taken as a pill.
It’s especially important to see a doc if you’re dealing with recurrent infections—whether yeast or BV.
Getting either one of these infections at some point is basically a fact of life for people with a vagina and is generally NBD, given that the above antifungals and antibiotics can usually knock them out. But in some cases, your vagina might struggle to find a happy state of balance post-infection, leading to repeat appearances of BV or yeast—both of which will require a personalized treatment plan created by your doctor to resolve.
Read the full article here
