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Yeast infections: when to see a doctor

Most women will have a yeast infection at some point: 75 per cent of women get at least one during their lifetime. While there are plenty of over-the-counter treatments, there are times when it’s wise to see a doctor.

It’s perfectly normal to have yeast present in the vagina. It’s present about 20 per cent of the time, and it’s usually nothing to worry about, says Dr. Amanda Selk, a gynecologist at Women’s College Hospital. It’s only when it becomes overgrown and causes symptoms that it’s called a yeast infection. Symptoms can include itching, burning, painful intercourse, painful urination and a thick white clumpy discharge.

But it’s important to note that just because you have one or more of those symptoms, it doesn’t necessarily mean you have a yeast infection. Studies have shown that women frequently misdiagnose themselves.

“When people have never had a yeast infection before, they only diagnose themselves right about 11 per cent of the time, and when they’ve had one before they diagnose themselves right only about 35 per cent of the time,” says Dr. Selk. “Even if a doctor looks at it and thinks it’s yeast without actually doing a swab or a slide and looking under a microscope, it’s not really a very accurate diagnosis.”

If you have symptoms, and you’ve never had a yeast infection before, Dr. Selk recommends seeing a doctor, who can do either a slide or a swab to get a solid diagnosis. She also recommends seeing a doctor if you’ve had a yeast infection before and you think it’s the same thing, but your symptoms do not get better with over-the-counter treatment.

“If you’re not getting better, make sure there’s not something else going on,” Dr. Selk says. Your symptoms may be caused by another condition. “They can be bladder infections, they can be gonorrhea or Chlamydia, they can be just normal discharge, they can be all kinds of things.” In some cases, it turns out to be a skin issue such as eczema or contact dermatitis.

“Lots of people think they have a yeast infection and they don’t have one,” Dr. Selk says. “It’s really important to know, as opposed to just treating yourself. If you do treat yourself and you don’t get better, please go and get seen.”

Yeast infections are not sexually transmitted. Also, some women may be more susceptible to yeast infections. Women who have diabetes, who are pregnant, or who are taking steroids or antibiotics are more likely to get yeast infections. These women, and women who get more than four yeast infections per year, may be harder to treat and should speak to their doctor.

“When those people get yeast infections, they are more complicated and sometimes they’ll need longer courses of treatment,” Dr. Selk says.

Over-the-counter treatments for yeast infections are safe to use as directed, and come in antifungal single- or multi-day creams and tablets and one single-dose oral pill. The oral pill should not  be used by pregnant women, nor should it be used more frequently than directed.

There isn’t any convincing evidence showing that alternative treatments such as garlic, teatree oil, lactobacilis, probiotics or dietary changes are effective remedies for yeast infections.

“There aren’t good studies so we just don’t know,” Dr. Selk says of alternative treatments, adding that women can spend a lot of money on them. “If you’re going to spend money on stuff, then there’s stuff we know works.”

If proven yeast infection treatments aren’t working, see your doctor for a definite diagnosis.

This information is provided by Women’s College Hospital and is not intended to replace the medical advice of your doctor or healthcare provider. Please consult your healthcare provider for advice about a specific medical condition. This document was last reviewed on: Feb. 28, 2013

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