Vaginal yeast infection

The symptoms of vaginal yeast infection are fairly typical, although some may be common to other vaginal infections.
The most common signs include:

• Intense itching of the vulva and vagina, sometimes felt like burning.
• Pain during intercourse (dyspareunia) or urination (dysuria).
• Swelling, redness or irritation of the vulvar region.
• A thick, white, lumpy vaginal discharge, often similar to cottage cheese, with no unpleasant odor.

It should be noted that some women present no abnormal discharge at all, making a purely clinical diagnosis more uncertain. Confirmation by microscopic examination or culture is often necessary to avoid misdiagnosis.

Vaginal yeast infections are caused by an excessive proliferation of fungi of the Candida genus, mainly Candida albicans, which is responsible for 90% of cases. Normally, these yeasts coexist with the beneficial bacteria of the vaginal flora, notably lactobacilli, which maintain an acidic environment unfavorable to their multiplication. However, an imbalance in this flora can favor the transformation of Candida from a saprophytic to a pathogenic state.

Several mechanisms may explain this transition, including disruption of the vaginal microbiota, pH modification, or weakening of local immune defenses.
In addition, certain non-albicans species, such as Candida glabrata, are more frequent in diabetic patients or those on prolonged antibiotic therapy, and can lead to more discreet infections that are sometimes more resistant to standard treatments.

Vaginal yeast infection often results from an imbalance in the vaginal flora, but certain factors significantly increase the likelihood of developing this infection. Some of these factors are well documented.

Stress has also been identified as a factor likely to favor the occurrence of mycotic episodes. Although evidence on this link is still developing, it deserves to be taken into account in an overall prevention approach.

Finally, certain contraceptive devices such as IUDs (intra-uterine devices), diaphragms or vaginal sponges have been associated with an increased risk of candidiasis, although the evidence remains variable depending on the study.

Diagnosis is based on a combination of clinical examination and laboratory tests. Assessment begins with an interview about symptoms, followed by a pelvic examination.
In the office, an analysis of the vaginal pH, generally normal (between 4.0 and 4.5) in the case of candidiasis, helps to distinguish this infection from other causes such as bacterial vaginosis.
A sample of vaginal secretions is often examined under the microscope, revealing budding yeasts. In case of doubt or treatment failure, a culture is recommended to identify the exact strain of Candida, particularly in the case of resistant forms such as C. glabrata.

Treatment depends on the severity of the infection and whether it is sporadic or recurrent. In most cases, local or oral antifungal therapy provides rapid resolution of symptoms.
Topical treatments include vaginal creams, ova or tablets, applied for one to seven days.
An oral antifungal, taken in one or two doses spaced three days apart, is an effective alternative. For recurrent infections (four or more episodes per year), prolonged weekly treatment over several months is often necessary.

In the majority of cases, vaginal yeast infection heals rapidly with appropriate antifungal treatment. However, certain situations can complicate its evolution. A so-called recurrent form is diagnosed when the patient presents three to four or more episodes per year. This situation affects around 5-9% of women and requires a prolonged therapeutic approach.
Possible complications include vulvar lesions (fissures, erosions), persistent irritation or lasting discomfort during intercourse. Non-albicans Candida species are often involved in forms resistant to conventional treatments, increasing the risk of chronicity.

Prevention relies above all on limiting known triggers. Strict control of blood sugar levels in diabetic patients, reduction of non-essential antibiotic treatments, and adjustment of hormonal therapies can reduce the risk of recurrence.

Avoid irritating products such as scented soaps, douches and sanitary pads. Although these are often considered good hygiene practices, they disrupt the natural vaginal flora with no proven benefit in preventing mycosis.

It is strongly recommended to consult a health professional when :

• symptoms appear for the first time
• infections become frequent or recurrent;
• symptoms are intense or unusual (fever, pelvic pain, foul-smelling discharge).

Consultation is also indicated when in doubt about the origin of symptoms, as candidiasis can mimic other infections (vaginosis, trichomoniasis, dermatitis, etc.).

Hôpital de La Tour offers personalized care for gynecological infections such as vaginal yeast infection. With specialized gynecology consultations enabling rapid treatment, patients benefit from a responsive and comprehensive medical response.

The modern infrastructure of Hôpital de La Tour and the commitment of its medical teams guarantee high-quality care, based on the latest scientific recommendations, in a confidential and caring environment.

Une mycose vaginale peut-elle disparaître sans traitement ?
Dans certains cas légers, la candidose peut se résorber spontanément. Cependant, un traitement antifongique permet de soulager plus rapidement les symptômes et d’éviter les récidives.

Est-ce que les rapports sexuels aggravent la mycose ?
Les rapports peuvent accentuer l’irritation en période symptomatique. Bien que la mycose ne soit pas une MST, le contact sexuel, surtout oral-génital, peut contribuer à son déclenchement dans certains cas.

Peut-on utiliser un traitement en vente libre sans avis médical ?
Il est déconseillé d’entamer un traitement sans confirmation médicale. L’autodiagnostic est souvent inexact, et une mauvaise prise en charge peut masquer une autre pathologie sous-jacente.

Pourquoi les mycoses sont-elles plus fréquentes pendant la grossesse ?
La grossesse entraîne une hausse du taux d’œstrogènes, ce qui altère la flore vaginale et favorise la multiplication de Candida.

Quels aliments éviter en cas de candidose ?
Aucune recommandation nutritionnelle stricte ne s’applique. Toutefois, en cas de diabète, un bon contrôle glycémique est essentiel pour limiter les récidives.

Existe-t-il des formes de mycoses résistantes aux traitements classiques ?
Oui, certaines espèces sont moins sensibles aux antifongiques usuels. Une culture permet d’adapter le traitement.