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  • Writer's pictureSerita Newton

Vaginal Yeast Infection

Updated: Aug 24, 2022

June 1, 2021

Even though yeast infections are common, they can be hard to navigate in regards to:

(1) How do I tell the difference between a yeast infection and bacterial vaginosis?

(2) I used the over-the-counter cream, but I’m still having irritation so I don’t think it’s working

(3) Which doctor do I need to see to treat my yeast infection?

I’m going to to clear up these questions and a few others.

#1 What is a vaginal yeast infection?

A vaginal yeast infection, also known as Vulvovaginal Candidiasis, is a type of vaginitis.

Vaginitis consists of a spectrum of conditions that cause both:

  • Vulvar symptoms: itching, burning, irritation, odor

  • Vaginal symptoms: discharge

We can separate Vaginitis into 2 categories

  1. Non-infectious

  2. Infectious

1. Non-infectious Vaginitis

  • Atrophic Vaginitis

  • Irritant / Allergic Vaginitis

  • Vulvar Lichen Planus

Atrophic vaginitis

  • commonly seen in postmenopausal women

  • due to estrogen deficiency

  • symptoms: typical vulvar irritation, vaginal dryness, and pain with intercourse.

Irritant / Allergic Vaginitis

  • occurs after contact with substance (soap, cream, lubricant, condom, etc.)

  • symptoms: burning, irritation, or itching immediately upon contact

Vulvar Lichen Planus

  • common in perimenopausal and postmenopausal women

  • due to inflammatory skin condition

  • symptoms: irritation, pain with intercourse, and bleeding after intercourse.

2. Infectious Vaginitis includes

  • Yeast Infections

  • Bacterial Vaginosis

  • Trichomoniasis

Bacterial vaginosis

  • a bacterial infection due to an overgrowth of bacteria in the vagina that causes uncomfortable symptoms. [I'll discuss later below].


  • a sexually transmitted infection

  • caused by a parasite called trichomonas vaginalis.

  • symptoms: vaginal irritation, a green-yellow frothy vaginal discharge, and sometimes burning with urination

  • most will not have symptoms and it will be diagnosed incidentally after giving a urine sample for some other reason

#2 What causes a yeast infection?

The vagina contains an environment of "normal flora" consisting of bacteria and yeast [candida]. Other organs of the body also contain a flora of bacteria such as your skin and GI tract.

A yeast infection occurs when there is a disruption to the normal flora causing an increase in the number of yeast present leading to an infection.

The most common causes of a yeast infection includes:

  • Antibiotic use

  • Uncontrolled Diabetes

  • Prolonged wear of damp clothing

#3 What are the symptoms of a yeast infection?

Classic yeast infection symptoms consist of:

  • thick, white, cottage-cheese like vaginal discharge

  • vulvar / vaginal itching

  • no odor

#4 How do I tell the difference between a yeast infection and bacterial vaginosis (BV)?

The main difference is that with BV you will have an odor, but with a yeast infection there will be no odor.

Bacterial Vaginosis symptoms consist of:

  • thin, watery vaginal discharge

  • +/- vulvar itching

  • odor will be present (usually fishy)

#5 How do you diagnose a yeast infection?

If you have the classic symptoms, then we can give a clinical diagnosis.

In a clinical diagnosis, we are able to determine a diagnosis based on:

(1) your symptoms with or without a physical examination

The most common conditions that we can make a clinical diagnosis for include yeast infections, UTI's, and strep throat.

The other way we determine a diagnosis is with at least 3 of the following:

(1) the symptoms you tells us

(2) an examination

(3) labs

(4) imaging (chest x-ray, CT, MRI, ultrasound)

This is the way we diagnose most medical conditions. We often need an exam and labs to point us in the direction of the correct diagnosis along with the symptoms you tell us. Of course, there are some conditions that will also require imaging.

If you do not have the classic symptoms or have multiple yeast infections a year, this is an indication that you need to be seen in-person for an examination and testing.

#6 What are the types of treatments available?

A yeast infection can be treated with over-the-counter (otc) or prescription only medications.

OTC Creams come in 1, 3, and 7 day treatments.

There are also prescription creams that come in 3 and 7 day treatments.

For those that prefer a pill, Fluconazole can be prescribed. This is usually dosed as a 'one-time' pill.

All of the treatments listed above are equally effective. It will come down to personal preference when choosing which one to use. Some people prefer to just pick up something in the store and not have to see their physician for the medication. Others prefer to take the pill once and be done.

There are some things to consider when choosing your treatment.

OTC Creams

tend to be oil based and have preservatives in them that can cause irritation.

I notice some patients still experiencing irritation despite using otc creams and they feel as

if the medication is not working. When this happens, we have to consider that it's not that

the cream isn't working, but that the preservatives are causing irritation and discomfort.

The oral fluconazole pill

can cause drug-drug interactions with some medications. Also, there are some people who

will need to take 2 or 3 pills to completely resolve the infection even though it is usually

dosed as a 'one-time' treatment. If that is the case, then you would take one pill every 72

hours (3 days).

Those who are pregnant

will have to discuss the use of oral fluconazole with their OBGYN. In pregnancy, first-line

treatment is usually a cream. The oral pill can be taken once, but not in multiple doses as it

poses a risk to the fetus.

#7 Where do I go to be treated?

If you have the classic symptoms, then it would be appropriate to be treated via Telemedicine or at an outpatient medical clinic such as a family medicine, internal medicine, OBGYN, or Urgent Care clinic.

If you do not have the classic symptoms or have recurrent yeast infections, this is an indication that you need to be seen in-person for an examination and testing. At this point, telemedicine would no longer be appropriate and you need to be seen in an outpatient medical clinic for an examination and testing.

That is vaginal yeast infections in a nutshell.

1981MD, LLC provides direct primary care services to adults (18+) at a flat rate via Telemedicine [AL, FL, MS, TN] and in our Office servicing the Metro Birmingham, Al area.

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For more information on how to receive yeast infection treatment from 1981md, please visit

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