Discharge yeast infection during pregnancy

Answers to 6 burning questions about yeast infection during pregnancy | Your Pregnancy Matters

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Your Pregnancy Matters

September 20, 2022

Your Pregnancy Matters

Robyn Horsager-Boehrer, M. D. Obstetrics and Gynecology

Yeast infections occur in up to 30% of pregnant women because an increase in estrogen creates a more favorable climate for them.

Vaginal candidiasis, also known as a yeast infection, can be a real pain. The itching, burning, and discharge can be especially worrisome during pregnancy.

In most cases, though, vaginal yeast infections and most treatment options pose minimal risk to the patient or pregnancy.

After bacterial vaginal infections, yeast infections are the second most common cause of vaginal inflammation, and 75% of women will have at least one in their lifetime. Common symptoms can include redness, itching, or irritation on the external genital area (vulva), an increase in white or tan vaginal discharge, and a burning sensation during urination or intercourse.

There are a range of over-the-counter and prescription treatments, and an Ob/Gyn or gynecologist can help you choose the safest, most effective option during pregnancy.

I’ve invited Meredith McClure, M.D., a UT Southwestern gynecologist, to answer the top questions pregnant and breastfeeding patients ask about yeast infection treatment and prevention.

Meredith McClure, M.D.

Q: How common are yeast infections during pregnancy?

A: Studies have found that 20%-30% of women develop a yeast infection during pregnancy. An increase in the hormone estrogen creates a more hospitable climate for yeast to colonize the vagina because it binds to the protein factor H on the surface of the cells that cause vulvovaginal candidiasis.

Some women are more likely to develop yeast infections due to their genetics. Mutations of several genes can interfere with the immune system’s ability to defend against candida yeast, resulting in recurring infections for some people. This inherited predisposition is called familial candidiasis.

Q: Can a yeast infection harm my pregnancy?

A: No. A yeast infection won’t affect your developing baby – that’s why we don’t treat yeast infections that don’t have symptoms. However, most symptomatic yeast infections get worse when left untreated. This means more itching, redness, and inflammation. If the skin becomes cracked or torn from repeated scratching, a skin infection can result. In rare cases, an untreated yeast infection can lead to fatigue, oral thrush, or digestive problems.

Q: Do yeast infections appear throughout pregnancy?

A: Yeast infections can occur any time, but they are most common during the second trimester. Talk with your doctor if you notice signs of a yeast infection while pregnant, even if you have had one before. Some more serious infections have similar symptoms, so your doctor will perform a simple fungal culture swap in the office to check for the presence of yeast.

Q: What treatment options are available?

Talk with your doctor about the safest and most effective options for treating yeast infections during pregnancy.

A: Topical creams or vaginal suppositories are the recommended yeast infection treatment options during pregnancy or while breastfeeding. Over-the-counter medications such as Miconazole, Clotrimazole, and Terconazole have been shown to eliminate a yeast infection safely and effectively. They are usually applied for three to seven days. It is important to finish the entire course of medication to prevent the infection from coming back. Studies have demonstrated these medications are safe to use during pregnancy.

The oral medication Diflucan (fluconazole) is not recommended for most patients during pregnancy. Though taking a single pill is simpler, quicker, and less messy, some studies suggest fluconazole carries a slightly increased risk of miscarriage, birth defects, or stillbirth, especially at high doses taken over long periods of time.

While the increase is small – approximately 12 incidents per 10,000 births – the convenience of single-pill treatment might not outweigh the risk. However, in the event you have already taken or need to take fluconazole while pregnant, the additional risk at a normal dose is unlikely to pose any problems for your baby.

Q: Are yeast infection treatments safe while breastfeeding?

A: Yeast infections are less common among breastfeeding patients because estrogen levels drop dramatically in the postpartum period, making it hard for yeast to thrive. But if they occur, fluconazole may be taken by women who are breastfeeding as the levels secreted into breast milk are small.

It is possible for a breastfeeding mother and baby to pass thrush, a fungal infection that typically grows in the mouth and throat, back and forth between nipple and mouth. If that happens, both must be treated to stop the infection. Thrush is usually minor and is often caused by the same fungus – and treated with a 7- to 14-day course of the same antifungal medicines – as a yeast infection in the vagina.

Q: What steps can reduce the risk of yeast infection?

A: During pregnancy and otherwise, take the following precautions:

Wipe front to back after using the toilet.
Avoid using scented tampons, pads, and pantyliners.
Change tampons, pads, and pantyliners often.
Avoid very hot baths and hot tubs.
Wear underwear with a cotton lining to promote airflow.
Do not douche, which removes healthy vaginal bacteria that prevent infection.
Wear loose fitting clothing.
Manage your blood sugar if you have diabetes or gestational diabetes.
Remove wet workout clothes and swimsuits as soon as possible after activities.

If you’re pregnant and notice signs of a yeast infection, discuss treatment options with your doctor so you can eliminate these disruptive symptoms. To request an appointment, call 214-645-8300 or request online.

Yeast Infections During Pregnancy: What To Do

Written by Camille Peri

What is a Yeast Infection During Pregnancy?

Yeast infections (also known as candidiasis) are common in women, especially when you're pregnant. Increased estrogen in your pregnant body can throw off the normal balance of yeast and bacteria in your vagina. This may let the yeast overgrow. Most yeast infections during pregnancy result from the fungus candida albicans. Two other kinds of yeast that can also cause them are candida glabrata and candida tropicalis.

Yeast infections aren't pleasant, but they won't hurt you or your baby. And they can be safely treated, usually with a topical cream.

Symptoms of a Yeast Infection During Pregnancy

You might notice:

Itching
Burning
Redness or swelling in your vulva, the area outside your vagina.
Thick, white vaginal discharge that looks like cottage cheese.

Causes of a Yeast Infection During Pregnancy

Taking antibiotics, which can cause that can change the balance of yeast and bacteria in your vagina.
Diabetes that isn’t well controlled
Conditions like HIV or medications, like corticosteroids that make it harder for your immune system to work well.
If your sexual partner has a yeast infection, it can be passed to you during vaginal sex.

Treating a Yeast Infection During Pregnancy

It's safe to treat a yeast infection with over-the-counter (OTC) vaginal creams or suppositories that contain miconazole or clotrimazole.

Don’t take an oral fluconazole tablet to treat a yeast infection during pregnancy. It may cause birth defects.

If you think you have a yeast infection, call your doctor before using over-the-counter medications to treat it.

Preventing a Yeast Infection During Pregnancy:

Wear cotton underwear and pantyhose with a cotton crotch to keep your vaginal area dry and let it "breathe."
Always wipe from front to back after you go to the bathroom.
Don't douche. It can upset the balance in your vagina. In late pregnancy, it may also cause your water to break.
Avoid tight pants and pantyhose.
Change out of a wet swimsuit or sweats immediately. This keeps the genital area dry.
Avoid toilet paper, feminine sprays, bubble bath, and sanitary pads that are scented.
Keep good control of your blood sugar if you have diabetes.
Eat yogurt with live cultures; some research suggests this can help.

Ecofucin for the treatment of thrush during pregnancy.

Thrush is a disease of the vaginal and vulvar mucosa caused by yeast-like fungi of the genus Candida, which affects 35% of women during pregnancy ¹ .

At risk for the occurrence of a recurrent form of thrush are those pregnant women who have already had episodes of thrush in their anamnesis the level of estrogens rises, in connection with which glycogen accumulates in the vaginal mucosa - a nutrient medium for yeast-like fungi of the genus Candida.

Lactobacilli are the predominant microorganisms in the vaginal microflora of a healthy woman. A normal concentration of lactobacilli provides the necessary acidity in the vagina, which inhibits the growth of fungi. Lactobacilli also participate in the formation of local immunity

In addition, during thrush, the vaginal microflora is disturbed - the number of lactobacilli decreases sharply. These changes lead to the growth and reproduction of pathogenic fungi of the genus Candida, which leads to an increase in the number of manifestations of acute and recurrent forms of thrush.

Symptoms of thrush in a pregnant woman:

itching and burning in the vulva and/or vagina, swelling and irritation in the vulva
vaginal discharge with a "curdled character" and occasional foul odor
pain during and after intercourse
urination disorder and pain

The appearance of at least one of the symptoms is a reason for an unscheduled visit to the doctor.

Why is it important to diagnose and treat thrush in a pregnant woman in time?

Some women are asymptomatic carriers of yeast-like fungi of the genus Candida and experience neither discomfort nor manifestations of the disease throughout the entire period of pregnancy ²

A pregnant woman with thrush (including an asymptomatic carrier) is a source of infection for her unborn child. Infection from mother to child occurs in 75-80% of cases ³ . Infection of a newborn occurs when passing through the birth canal (the skin of the child comes into contact with the infected mucous membranes of the mother's birth canal). In newborns, candidiasis is manifested by lesions of the mucous membranes and skin ² , which can lead to negative consequences. For premature babies, infection with fungi of the genus Candida is especially dangerous ² .

Timely and effective treatment of thrush in a pregnant woman is an important task

Treatment of thrush

Safety and efficacy are the main criteria for choosing a drug in the treatment of thrush in pregnant women

The earlier a pregnant woman is diagnosed and treated for thrush, the less the risk of negative consequences and complications for the course of pregnancy and for the health of the mother and her unborn child. In the treatment of thrush, experts recommend an integrated approach to therapy.

It is important to follow the recommendations of a specialist, following the prescribed dosage and regimen.

Comprehensive treatment should be aimed at solving two problems: eliminating the cause of thrush (fungi of the genus Candida) and restoring the vaginal microflora. It is important to know that not all drugs are approved for use during pregnancy. For example, most oral (systemic) drugs and some topical drugs for treating thrush are contraindicated during pregnancy.

Ecofucin

^® in the treatment of thrush in pregnancy

Ecofucin

^® is allowed at all stages of pregnancy and lactation ⁴

allowed during pregnancy from the 1st trimester

allowed while breastfeeding

Natamycin

practically not absorbed into the blood and has no systemic effect
has a fungicidal effect - causes fungal cell death
resistance to it does not develop
does not inhibit the growth of natural microflora

Prebiotic ⁵

actively fermented by the normal microflora of the vagina, stimulating the growth of lactobacilli ⁶
causes restoration of the vaginal microflora, stimulates local immunity ⁶

The active substance ⁷ of Ecofucin ^® eliminates the cause of thrush, and the prebiotic ⁵ in Ecofucin ^® promotes the restoration of the vaginal microflora and strengthens local immunity ⁶ .

Efficacy and safety of the drug Ecofucin has been proven by clinical studies

Ecofucin promotes faster recovery of patients with thrush.

More details

For pregnant women

Moscow 40 patients

For non-pregnant women

St. Petersburg 36 patients

Clinical cure occurred significantly earlier in the group of patients who used Ecofucin.

Kuzmin V.N., Bogdanova M.N. Ecofucin® is the first drug for the eradication of Candida fungi with the effect of stimulating the growth of lactobacilli in pregnant women. breast cancer. 2020; 1; 28-33

Ecofucin helps to increase the number of own lactobacilli in the vagina and reduce the risk of recurrence of thrush.

More details

For pregnant women

Moscow 40 patients

For non-pregnant women

St. Petersburg 36 patients

Clinical cure occurred significantly earlier in the group of patients who used Ecofucin.

Dosage and Administration

The regimen for the use of Ecofucin ^® in a pregnant woman is prescribed by the attending physician individually.

Additional conditions for effective treatment of thrush are: giving up bad habits, a carbohydrate-restricted diet, wearing underwear made from natural fabrics, etc.

It is important to consult a gynecologist in a timely manner and exclude self-medication.

1. Tikhomirov A.L., Sarsania S.I. Features of candidal vulvovaginitis in pregnant women at the present stage. // Farmateka No. 9, 2009, p. 64-70.

2. Prilepskaya V.N., Mirzabalaeva A.K., Kira E.F., Gomberg M.A., Apolikhina I.A., Bairamova G.R. Federal clinical guidelines "Urogenital candidiasis". // 2013.

3. Kupert A.F., Akudovich N.V., Khoroshikh O.V., Vereshchagina S.A., Khmel T.V. Features of the clinic and treatment of vaginal candidiasis in pregnant women, depending on the type of fungi of the genus Candida. // Gynecology. v. 05, N 5b, 2003.

4. Instructions for use of the drug Ecofucin ^® .

5. Excipient, lactulose.

6. Dikovskiy A.V., Dorozhko O.V., Rudoy B.A. Pharmaceutical composition of antimycotics and prebiotics and a method for the treatment of candidal vaginitis. // International publication WO 2010/039054 A1.

7. Active ingredient, natamycin.

5 important questions about yeast.

Almost every woman has experienced an unpleasant visitor - a vaginal yeast infection, which can be indicated by pain, itching in the vulva and unpleasant discharge. This infection is most commonly seen in women of reproductive age, and excessive stress, reduced immunity, antibiotic use, and certain chronic illnesses can contribute to its development. What is a yeast fungus, what causes it and how to deal with it, says gynecologist Elizaveta Murzina, Veselības Centrs 4.

What is yeast?

Yeast fungus or Candida albicans is one of the common inhabitants of the normal vaginal microflora. This bacterium also lives in humans on the skin, in the mouth, and in the intestines. A vaginal yeast infection, or vaginal candidiasis, develops when the bacteria overgrows and causes symptoms.

How to recognize it?

Yeast bacteria in the vagina have overgrown and caused an infection:
- burning sensation and discomfort in the vulva;
- painful urination;
- painful intercourse;
- significant whitish or granular discharge.

Usually these complaints are worse before menstruation. In some cases, when the yeast infection is advanced, there may be swelling in the vulva or spotting caused by damage to the vaginal mucosa.

What are the most common causes of yeast infections?

Taking antibiotics. Yeast infections often appear after taking antibiotics, because they destroy not only the causative agents of various infections, but also the good bacteria in the vagina - lactic acid bacteria (Lactobacillus). When the microflora of the vagina changes, instead of the good lactic acid bacteria of the vagina, the fungus multiplies.
Weakened immunity. An exacerbation of Candida albicans can also begin during a period of weakened immunity. It can be weakened by other common infectious diseases, such as influenza, etc., or diseases that affect the immune system (eg, HIV infection).
Pregnancy. The chance of contracting a yeast infection also increases during pregnancy, when the body's natural defenses are weakened.
Regular medication. Yeast should be avoided with regular use of various medications, such as corticosteroids, which can weaken the immune system. If corticosteroids are used on the skin (for example, for the treatment of psoriasis), special precautions are necessary only in cases of their use in the vulva, where they can adversely affect the natural microflora of the genital organs.
Chronic diseases. Yeast can be a frequent visitor if a woman has a chronic disease, such as diabetes, when the fungus in the vagina multiplies due to high blood sugar.

How to get rid of yeast?

Yeast infection is treated only when its overgrowth causes the specific complaints of itching, pain and increased discharge. However, if there are complaints, you should not delay visiting a doctor - if the yeast has caused inflammation of the vagina that is not treated, inflammation can develop, which means a longer period of treatment and recovery.

Two types of preparations are now available for the treatment of fungus:
1. Oral prescription preparations containing the active substance fluconazole. If the infection is not running, it is enough to take one capsule. In the most severe cases, two capsules can be taken three days apart.
2. Topical preparations (active substance clotrimazole, econazole or miconazole) in the form of vaginal suppositories or cream. Depending on the concentration of the active substance, treatment usually lasts from 1 to 7 days. Popular among women is Canesten, available from pharmacies without a prescription, a vaginal cream that only needs to be applied once.

Attention! Over-the-counter antifungals are only useful in cases where it is not possible to get to a doctor quickly enough, or for women who have had a yeast infection and are familiar with the symptoms. Dr. E. Murzina warns: when faced with the characteristic symptoms of a yeast fungus for the first time, you need to see a doctor, because there are many infections with yeast-like symptoms and secretions, but their treatment is different.