What to Know About Yeast Infections During Pregnancy

Pregnancy brings about many physical, mental and emotional changes that makes for an exhausting nine-month journey. Between morning sickness and flare ups of sciatic pain, the last thing you need is to deal with infections. Unfortunately, yeast infections, a type of fungal infection pregnant women are prone to, is one of the more common ailments you can deal with during a pregnancy. This blog will shed light on what causes these infections and how you can safely treat them without worrying about harming your baby.

What causes yeast infections?

Your body contains small amounts of a single-celled fungus called candida albicans that lives in mucus membranes, such as the mouth, stomach, intestines and vagina. Candida albicans is a species of candida, a type of yeast that is usually harmless and kept in check by other good bacteria such as lactobacillus.

For some women, a rapid overgrowth of candida can occur in the vagina and lead to a yeast infection, also called vaginal candidiasis or candidal vaginitis.

The following are all risk factors of yeast infections:

• Pregnancy
• Certain antibiotics or steroids
• Sexual intercourse
• Diabetes
• Weakened immune system
• Contraceptives that disrupt hormones

Candida albicans is the most common type of fungus responsible for vaginal yeast infections.

Why are yeast infections common during pregnancy?

As many as a third of pregnant women will develop a yeast infection at some point during their pregnancy. This type of infection is so common because hormone changes create a favorable climate for yeast to grow out of control. Yeast infections are most common during the second trimester

Estrogen and progesterone are two important hormones in women that assist in sexual and reproductive development. As it relates to pregnancy, estrogen and progesterone production increases to support a healthy pregnancy – estrogen helps develop sexual traits, while progesterone helps thicken the uterine lining (endometrium) to help implant and grow a fertilized egg.

The release of progesterone can suppress the ability of white blood cells called neutrophils to control candida growth. Additionally, an increase in estrogen makes it harder for the inner lining of the vagina (epithelial cells) to fend off candida albicans. 

Aside from hormones, vaginal secretions contain higher amounts of sugar during pregnancy. Yeast feeds on sugar, so these secretions also create a conducive environment for infections.

Genetics can also play a role and lead to familial candidiasis, a condition in which changes to the immune system can make it harder to regulate candida from overgrowing. 

What does a yeast infection feel like?

Not all yeast infections produce symptoms. When they do, they typically cause itching and a change in vaginal discharge. 

Here are some tell-tale signs you may have a yeast infection:

• Vaginal redness, itching or irritation 
• Vaginal discharge that is thick and white, similar to cottage cheese
• Vaginal discharge that smells sour or acidic like yeast or bread
• Increase in vaginal discharge
• Pain or burning during intercourse
• Burning when urinating

Can a yeast infection cause harm to my baby?

While yeast infections can be off putting to your eyes and nose, while also causing discomfort, the reassuring thing to know is they won’t harm your baby’s development. 

Doctors don’t always treat asymptomatic yeast infections. However, symptomatic yeast infections will get worse without treatment. A yeast infection during the third trimester, especially close to your delivery date, should be treated so it doesn’t affect your child. In some cases, a yeast infection may be passed on to your newborn during delivery and cause oral thrush (fungal infection of the mouth that causes white lesions). 

How to treat yeast infection during pregnancy

While yeast infections tend to be harmless, they won’t go away on their own and need an anti-fungal medication to halt the infection. Medications are either oral, topical or administered via a suppository. They can take 10 to 14 days to clear up the infection.

For women who aren’t pregnant, a single-dose oral dose of fluconazole is usually the best option to treat mild or moderate yeast infections. However, the use of fluconazole in pregnant women has been linked to complications such as miscarriage, birth defects or stillbirth. The risk of side effects is small (12 per every 10,000 births or 0.12 percent), but the convenience of a single pill still usually doesn’t outweigh the risks. The CDC doesn’t recommend pregnant women taking single-pill fluconazole.

Topical creams or suppositories are the preferred treatment methods for women who are pregnant. The type of drug used depends on whether the yeast infection is uncomplicated or complicated. In general, uncomplicated yeast infections produce mild or moderate symptoms, while complicated yeast infections involve recurrent infections or ones that involve severe symptoms.

Most yeast infections are uncomplicated and can be treated with over-the-counter (OTC) topical medications. These drugs come in one-day, three-day and seven-day treatment options – the shorter the treatment, the stronger the medication. Complicated yeast infections may require a prescription. The CDC recommends topical therapies for seven days.

Common over-the-counter examples include:

• Clotrimazole (Lotrimin, Mycelex) – available in both vaginal cream and suppository
• Ketoconazole (Nizoral, Xolegel, Extina)
• Miconazole (Monistat, Micatin, Zeasorb, Triple Paste AF) – available in both vaginal cream and suppository
• Tioconazole (Vagistat-1, Trosyd, Gyno-Trosyd) – available in both vaginal ointment and suppository

Common prescriptions include: 

• Butoconazole (Gynazole-1) – available in both vaginal cream and suppository
• Terconazole (Terazol) –  available in both vaginal cream and suppository
• Nystatin suppositories

Ultimately, the choice between a cream or ointment and a suppository is personal – some women don’t want to put an object in their vagina and opt for a cream or ointment.

Although yeast infections can be treated with OTC medications, it’s always important to see your doctor if you suspect an infection to rule out other conditions. Yeast infections can share similar symptoms with STDs such as chlamydia, gonorrhea and trichomoniasis or bacterial vaginosis. These conditions can increase your risk of pregnancy complications and require treatment from your doctor.

Contact your OB/GYN if you experience any vaginal pain or notice changes to your discharge at any point during your pregnancy. During an office visit, they can swab the vagina and examine the discharge under a microscope to test for fungus growth.