AUA Summit - What are Yeast Infections?


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What are Yeast Infections?

Yeast infections are among the most common medical annoyances. Luckily, most can be cured or controlled with clean habits and OTC (over-the-counter) drugs.

The 3 most common are:

  • Jock itch: a red rash that spreads from the penis out over the inner thighs, anal area and buttocks.
  • Vaginal yeast infections: often happen in women 20 to 40 years old, and are often linked to the use of antibiotics or birth control. Hormonal changes from your period, pregnancy or high blood sugar can also add to your risk.
  • Penile inflammation (balanitis): involves swelling and redness of the head of the penis. It is not easy to control and often comes back in uncircumcised males.

Infants and children can also get yeast infections. Common diaper rash in infants and toddlers is most often a superficial infection caused by the same fungi as other yeast infections in moist parts of the body. The rash can be controlled by frequent changing and, if needed, medicated powders.


Superficial Infections

For most people, the signs are skin redness and itchiness. Some have linked feeling tired and having low spirits to yeast infections, but this is not based on scientific study.

  • In men, jock itch causes itching. You may also have a burning feeling in the groin. Penile inflammation involves redness and swelling.
  • In women with vaginal yeast infections the signs are most often redness and swelling of the vagina or labia and nearby tissue. But some have no signs, and others may have some signs but they may be painless and long-lasting. Some infections can also cause strong itching or burning that leads to pain with sex and voiding. The infection may also result in a thick, white fluid that looks like cottage cheese.

Invasive Infections

The signs of these infections are not definite. Some involve fever and chills that do not go away. If the infection spreads to other parts of the body, other signs may appear, depending on the location. Environmental fungi can cause minor breathing issues or flu-like signs.


The term "yeast" is often used with infections caused by fungi, which:

  • appear in nature as molds, mildews, mushrooms and yeast
  • are more complex than viruses or bacteria
  • number more than 100,000 species, with only 200 causing disease

Candida albicans is the most likely cause. Even though yeast infections happen in millions of people, if you are healthy, they should not be a major health problem.

Superficial Infections

  • involve the skin
  • are not spread easily
  • are caused by Candida that are always in and on the body, but can multiply with a change in pH or hormone balance

Invasive Infections

While yeast infections are mostly harmless, some enter the bloodstream and cause infection inside your body. You are at greater risk if you:

  • have high blood sugar
  • use steroids
  • have had an organ transplant
  • have a weakened immune system
  • have a major illness like AIDS, cancer, liver disease, inflammatory bowel disease or rheumatoid arthritis

Many infections are called secondary or opportunistic because they take hold when your immune system is weak. Fungi can also become invasive in some clinical settings. Long stays in hospitals add to your risk. The fungus may also gather in the urinary tract in patients who use catheters for a long time.

Opportunistic infections can also be from environmental fungi, e.g., aspergilla and Cryptococcus. Some other fungi can be found in soil, animals or trees, and include:

  • Blastomyces: found in the Midwest, on the shores of lakes, rivers and ponds
  • Coccidioides: found in the hot, dry climate of deserts
  • Histoplasma: found in building sites, bird sanctuaries or caves with bats


  • Superficial infections are found with physical exam and, if needed, microscopic exam and fungal culture.
  • Invasive or opportunistic infections can sometimes be found with standard lab tests. Repeat urine tests that show red or white blood cells (signs of swelling) will alert your health care provider to an underlying problem. You may need ultrasonography or CT to check for effects on your kidney or bladder.


Superficial Infections

Skin and groin infections can be cured or controlled with good clean habits. Frequent bathing and washing/changing your clothes are recommended, especially during hot weather or after sweating.

  • For most people a superficial infection like jock itch can be controlled with antifungal creams that can be put on the skin. These creams are available as OTC drugs. They have many names such as butoconazole, clotrimazole, miconazole and terconazole. For long-term infections you may need a stronger drug such as nystatin, or drugs taken by mouth such as fluconazole or Lamisil®.
  • Most vaginal infections can be treated with vaginal suppositories or creams. For an ongoing infection, drugs taken by mouth such as fluconazole or ketoconazole can help. For vaginal infections that last a long time or come back, you may need to change your type of birth control.
  • If an infection of the head of the penis on an uncircumcised male does not do well with creams put on the skin, then circumcision may be needed.
  • For urinary fungal infections, in about a third of cases removing or changing a catheter will get rid of the infection. Flushing the bladder with antifungal drugs (amphotericin B) or taking systemic medication (oral or IV fluconazole, or IV amphotericin B) will work well in 60% of patients.

Invasive Infections

Invasive yeast infections call for systemic antifungal therapy (that works on the whole body) like amphotericin B, fluconazole, itraconazole and caspofungin, as well as newer drugs related to fluconazole (posaconazole).

Role of Food and Herbal Cures

Experts are not sure about the role of one's diet or how herbal remedies could help. But they do know that people with high blood sugar are more likely to get these infections. So many suggest that if you have high blood sugar, you should skip high carbohydrate foods. Also, yogurt can be a source of helpful bacterial for the genitourinary tract, so many recommend it to help stop or treat yeast infections.

After Treatment

Superficial Infections

While most superficial skin or vaginal infections do well with creams and ointments, they often come back. In particular, vaginal infections can be hard to cure, like if they are due to a resistant strain of yeast.

Invasive or Chronic Systemic Infections

Controlling these infections may involve weeks to months of systemic antifungal drugs. Your health care provider will watch for overall health issues, as well as related issues like nutrition, blood sugar and catheters, that might be causing the problem. If your overall health gets better and you find an antifungal therapy that works, chronic systemic infections can be stopped. But in some cases a long-term infection means that you have some other health problem that must be treated before the yeast infection can be cured.

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