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Gynecologic Health

Recurrent Yeast Infections: Should You Worry?

Summary & Participants

While up to 75 percent of women will experience a yeast infection once in their lifetime, an unlucky 5 percent will have frequent, recurring episodes. Join our panelists as they tell us why yeast infections come back and what you should do if it happens to you.

Medically Reviewed On: July 23, 2008

Webcast Transcript

LISA CLARK: Are there any misconceptions about what can cause recurrent or frequent yeast infections?

JOSEPH APUZZIO, MD: I think one of the big issues with the recurrent infections, is it a documented recurrent infection? Often the patient starts to have symptoms, and she automatically thinks, "Well, it's a recurrent yeast infection." It may or may not be. In fact, probably half the time it's not a recurrent yeast infection. It may be something else. They need evaluation by the doctor.

LISA CLARK: What tests need to be performed in order to be sure that what this is is a recurrent yeast infection problem and not something else?

GLORIA BACHMANN, MD: There are two important tests. One is the wet prep, or looking at the secretions under the microscope. The other is taking these secretions and doing a culture of them to see if the yeast indeed does grow out.

LISA CLARK: Here's where we get into a bit of a tricky area, because there are many topical over-the-counter medications that a woman can buy in a drug store, and, say, they've had yeast infections before and they think, "Oh, I've had this. I know what to do," but it keeps coming back. Is self treatment a problem?

GLORIA BACHMANN, MD: I like self treatment for a few reasons. The number one reason is that the woman has an immediate pharmacologic intervention, and being very uncomfortable and having to go, for instance, from a Friday to a Monday is torture. The second is, I always tell women the first diagnosis should be with their doctor so that they understand what a yeast vaginitis is, and therefore they will know that if they have these same, exact symptoms, that's the time to go to an over-the-counter treatment. Only if they do not get the relief that they feel they should be getting should they again be seen by a physician to document whether or not it was truly yeast vaginitis.

LISA CLARK: What is maintenance therapy?

JOSEPH APUZZIO, MD: For patients who have documented recurrent yeast infections, there are several treatment plans. One is maintenance therapy, where the patient is given a prescription, and for three or six months she can take the medication. There are other treatment plans where you can do it maybe not continually every day, but you do it maybe once or twice a week for three or six months. It depends what works for a given patient. Each patient with recurrent disease is a little bit different, so you want to tailor the therapy to that patient.

LISA CLARK: Is there a benefit to topical versus pill in recurrent yeast infection patients, or vice versa?

GLORIA BACHMANN, MD: I think it depends on the patient and what her preference is and what she will be adherent to, so that if a woman will only use a vaginal and will be adherent with the vaginal, that's more important than saying, "Gosh, I always prescribe A, B or C," but rather, what the woman will stick with.

LISA CLARK: Are there any side effects with the oral medication or the topical medication that patients should be aware of?

JOSEPH APUZZIO, MD: Patients can be allergic to either. Also, there's the potential for drug interactions if one is taking a medication on a long-term basis. For example, for chronic recurrent disease, many individuals would prefer topical therapy rather than the oral, because the oral could interfere with some of the medications that the patient is taking. So it's important for the patient to tell her doctor what other medications she's taking.

LISA CLARK: What are some of the outside factors that a patient can control to reduce her risk for recurrent yeast infection?

GLORIA BACHMANN, MD: Again, if she has a medical condition, some of them may be out of her control. Antibiotic use, steroid use, obviously she can't control. If she's diabetic, trying to get the best blood sugar control is to her advantage. Hygiene, not wearing tight fitting jeans, not staying in wet bathing suits for long periods of time, after bowel movements making sure wiping from front to back. All of these will have an impact on reducing the yeast vaginitis incidence.

LISA CLARK: Again, bottom line, see your doctor if you've got any questions at all?

GLORIA BACHMANN, MD: Absolutely.

JOSEPH APUZZIO, MD: Absolutely.

LISA CLARK: Thank you both so much, Dr. Apuzzio and Dr. Bachmann. And thanks to all of you who have joined us for our webcast. I'm Lisa Clark.

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