The Call-On-Doc Guide to Vaginal Yeast Infections

The vagina maintains a healthy microbiome made up of bacteria and fungi that normally coexist in balance. Protective bacteria—primarily Lactobacillus species—help maintain an acidic vaginal environment that prevents yeast from overgrowing.

A yeast infection occurs when this balance is disrupted and yeast are able to multiply beyond normal levels or penetrate deeper vaginal tissue layers. When harmful bacteria overgrow, the condition is called bacterial vaginosis (BV); when fungi overgrow, it is called vaginal candidiasis.

Common Contributors to Yeast Overgrowth

Antibiotic Use
Antibiotics reduce harmful bacteria—but they can also reduce beneficial Lactobacillus. When protective bacteria decline, yeast can multiply more easily.

Hormonal Changes
Estrogen increases glycogen in vaginal cells, which yeast use as fuel. This explains why yeast infections are more common during pregnancy, the luteal phase of the menstrual cycle, and with estrogen-containing contraceptives.

Weakened Immune System
Conditions such as HIV, chemotherapy, chronic steroid use, or immunosuppressive medications reduce the body’s ability to regulate yeast growth.

Uncontrolled Diabetes
Elevated blood sugar levels increase glucose in vaginal secretions, creating an environment that favors Candida growth.

Douching and Vaginal Irritants
Douching, scented soaps, vaginal deodorants, and harsh cleansers disrupt vaginal pH and strip protective bacteria.

Tight or Non-Breathable Clothing
Synthetic fabrics and tight clothing trap heat and moisture, creating ideal conditions for yeast proliferation.

Sexual Activity
Yeast infections are not sexually transmitted, but sexual activity can disrupt vaginal pH, introduce yeast, and cause micro-irritation that facilitates overgrowth.

Poor Moisture Control
Remaining in wet clothing (swimsuits, sweaty workout gear) increases moisture and risk.

Yeast infections are more common during pregnancy and can occur during any trimester. Hormonal changes, immune modulation, and shifts in vaginal pH all contribute. Oral antifungal medications are generally avoided in pregnancy; treatment usually involves topical therapies.

Yeast infections are not classified as STIs. However, sexual contact can contribute indirectly—especially if a male partner has balanitis or carries yeast on the skin. Friction, semen exposure, pH changes, and tissue irritation can all increase risk.

Yes. Unwashed hands can introduce bacteria, yeast, or irritants that disrupt the vaginal microbiome or cause micro-abrasions, increasing susceptibility.

Diet alone does not directly cause yeast infections, but high sugar intake may contribute—especially in people with insulin resistance or diabetes.

Foods that may worsen susceptibility include:

• Sugary foods and beverages

• Refined carbohydrates

• High-glycemic foods

• Excess alcohol

Balanced nutrition and blood sugar control support vaginal health.

Up to 20% of women may have yeast overgrowth without symptoms. When symptoms occur, they commonly include:

• Intense vaginal or vulvar itching

• Thick, white, cottage cheese-like discharge (usually odorless)

• Burning with urination

• Redness, swelling, or irritation

• Pain during intercourse

• External rash or skin irritation

Diagnosis may involve symptom review, pelvic exam, microscopy, or vaginal swab testing. In many uncomplicated cases, clinicians can diagnose based on symptoms alone—especially in telehealth settings when history is clear.

Most yeast infections respond quickly to antifungal therapy, including:

• Fluconazole (Diflucan) – oral

• Clotrimazole – topical

• Terconazole – topical

• Nystatin – topical

Using antifungals without an actual yeast infection may cause irritation and disrupt the microbiome.

• Clean only the external vulva with mild, unscented soap

• Never douche or wash inside the vagina

• Wear breathable cotton underwear

• Change out of wet clothing promptly

• Manage blood sugar if diabetic

• Limit irritants and scented products

• Seek evaluation if infections are frequent, severe, or don’t respond to treatment

Mild infections may occasionally resolve on their own, but most benefit from treatment.

CallOnDoc offers same-day, private online care and treatment for yeast infections—quickly and discreetly from home.