Why Do I Get Yeast Infections

Are you experiencing itching down under, white cheese-like discharge, stinging, and soreness when you pee and are wondering just what might be wrong? You might have a yeast infection.¹ Yeast infections can occur in both men and women but occur more frequently in women.¹ Yeast infections are usually nothing to worry about but in certain individuals, more serious infections can occur.²

Although the evidence that yeast infection can be transferred between sexual partners is limited, studies have shown that this is a clinically important route of transmission. ²Despite this, yeast infection is not considered to be a sexually transmitted disease.^1,2

You might be more likely to get a yeast infection if:^1,2,3

• You wipe from back to front when you go to the toilet
• If your diet is high in sugar
• If you don’t drink enough water
• If you dry your underwear in damp areas like the bathroom
• If you wear tight-fitting clothes and/or non-cotton
• If you use scented feminine products (tampons, pads, and feminine wash) or practice douching
• If you have medical conditions that weaken your immune systems such as diabetes or HIV
• If you take certain medications like antibiotics and steroids

Read on to learn more about yeast infections, how you can get yeast infections, how to know if you have yeast infections, what to do when you have them, and why some individuals are more likely to get yeast infections.

What are yeast infections

Yeasts are microorganisms that form part of the normal flora on our skin and inside our bodies.^2,4 The normal flora is a mix of microorganisms (bacteria, fungi, etc.) in and on the human body. The population of microorganisms that make up the microflora is tightly controlled by complex mechanisms in the body.

Candidiasis is the medical term used for infection caused by yeasts of the Candida spp. most commonly, by the yeast Candida albicans which causes the majority of yeast infections in humans.⁴,³ The symptoms of candidiasis are more likely to occur when there is an overgrowth of yeast due to environmental factors that cause an imbalance in the microflora.⁴

Candidiasis can occur in different parts of the body such as the male and female sex organs, causing vaginal or penile thrush, the mouth where it causes oral thrush, in the armpits, groin, and between the fingers.¹

Oral thrush usually presents as white patches on the inside of the mouth, tongue, and throat, which can be associated with significant pain and discomfort which can affect eating and drinking.⁴ Yeast infection in the armpits, groin, and between the fingers presents as an angry, red, itchy, painful rash covered with a white or yellow discharge.¹

Candidiasis affecting the male and female sex organs and the mouth is commonly referred to as “Thrush”. Thrush affecting the former is more common in adults while the latter appears to occur more in infants and individuals with compromised immune systems either caused by disease (HIV, diabetes) or by medications.⁴

The focus of this article will be on thrush affecting the male and female sex organs.

Causes of yeast infections

Thrush can be caused by several factors include:^1,4,3,5

Lifestyle factors:

• The intake of a high-sugar diet
• Wiping from back to front when you use the toilet – this is more significant in women as it introduces microorganisms from the anus to the area surrounding the vagina. This disrupts the normal flora and the pH of the area, which encourages the overgrowth of yeast
• If you wear tight-fitting clothes or non-cotton underwear this reduces the circulation of air down which supports the growth of yeast. Yeasts grow well in dark, moist, and less aerated areas
• If you use scented feminine products (feminine wash, pads, and tampons) or practice douching. This disrupts the normal flora and the pH of the area

Thrush infections due to secondary factors:

• Oral thrush is common in individuals with a weakened immune system either caused by infections or medication
• Oral antibiotics, especially broad-spectrum antibiotics can cause yeast infections because they reduce the population of the good bacteria in the microflora. This encourages the overgrowth of yeast
• The third trimester of pregnancy is characterised by high levels of female hormones. These hormones cause an increase in the sugar content (glycogen) of the vagina which supports yeast overgrowth
• Post-menopausal women on hormone replacement therapy (HRT) or women on birth control tablets are more prone to thrush
• Some individuals have a genetic predisposition to getting yeast infections

Anatomy:

• Anatomically, women are more likely to have yeast infections because the distance between their urethra and the anus is short so the likelihood of introducing microorganisms from the anus to the area surrounding the vagina is high

Signs and symptoms of yeast infections

The classical signs of thrush vary between sexes.¹

In women, signs may include:

• White cottage-cheese-like discharge which usually has no smell
• Itching and irritation affecting the vulva
• Burning or stinging sensation when urinating or during sex

In men, signs may include:

• Burning sensation and soreness around the head of the penis and under the foreskin
• There may be a white cottage-cheese-like discharge which may be accompanied by an unpleasant smell

Thrush can also present with no symptoms and with non-classical symptoms and often can get confused with other infections such as bacterial vaginosis or STIs.¹

Management and treatment for yeast infections

Although uncomplicated thrush can be managed easily using a combination of topical and oral medications together with lifestyle changes, chronic and intractable thrush commonly occurs in women and this requires long-term treatment with a combination of anti-fungal medications. The treatment of thrush includes:¹

• Antifungal medications in the form of capsules, creams, and pessaries (antifungal medication inserted into the vagina)
• Probiotic Supplements to support the maintenance of a balanced normal flora
• Treating sexual partners of individuals with thrush is recommended only if the partners of the affected individuals have symptoms

Thrush can be prevented and the likelihood of reoccurrence can be reduced by:^1,3,5,7

• Wearing Cotton underwear and loose-fitting clothes
• Use water to clean the vulva and if any cleaning agent must be used, it should be pH balanced, soap-free, and unperfumed
• Cutting down on sugar
• Keeping well hydrated
• Not practicing douching
• Practice abstinence during treatment, until symptoms resolve
• Keep the area as dry as possible
• Eating yogurt which contains good bacteria that help keep the microflora balanced and prevent yeast overgrowth

FAQs

Is yeast infection common

Yes, yeast infections are very common, and they tend to occur more in women than in men. It is estimated that 75% of women of childbearing age (20 to 40 years) will have at least one episode of vaginal thrush in their lifetime, and of those affected, 5-8% of them will experience recurrent episodes of vaginal thrush. In addition,  an estimated 10-20% of women of childbearing age with thrush will not have any signs and symptoms of infection.^4,3,5,7

Can a yeast infection be prevented

To prevent thrush, the goal is to adopt lifestyle changes that will prevent the overgrowth of yeast. These are mentioned in the causes of yeast infections section.¹

For thrush caused by certain disease conditions or a compromised immune system, boosting immunity and/or managing such conditions may prevent reoccurrence. 

How is yeast infection diagnosed?

Generally, due to the tell-tale signs of thrush, a diagnosis can be made by asking about your symptoms and carrying out a physical exam to view the affected area(s).¹

When non-classical signs and symptoms occur, your GP may request to take a sample from the affected area(s). This involves using a swab to wipe the affected area(s) and sending the sample to the lab to confirm if it is thrush.¹

When should I call my doctor?

You should book an appointment to see your family physician if you have the signs and symptoms listed above and:³

• This is the first time you’re experiencing them
• You’re under 16 years or over 60 years of age
• You have a compromised immune system due to medication or certain disease conditions
• You have treated thrush recently and have not observed any improvement in your symptoms, especially if it has been 7-14 days since you started your treatment
• You have had more than four episodes of thrush in a year
• You are pregnant or breastfeeding

Summary

Thrush is generally considered harmless but causes considerable loss of confidence in the affected individuals due to the discomfort associated with the infection.

In addition, thrush appears to have a good response to treatment but despite this, prompt treatment is recommended to avoid the progression from superficial to intractable thrush which is more likely to cause more serious infection affecting other parts of the body. This reinforces the need to see your pharmacist or family physician should you have any of the symptoms listed above.