### Understanding Recurrent Yeast Infections and Their Long-term Treatment Yeast infections are caused by a type of fungus called candida. While it's normal for candida to be present in our bodies, an overgrowth in the vaginal area can lead to an infection. Recurrent yeast infections are defined as having four or more infections in a year that are not related to antibiotic use. #### Symptoms Common symptoms include a thick, white-to-yellow discharge that typically doesn’t smell bad, itching, discomfort, or a burning sensation around the vagina, especially during urination or sex. #### Causes Several factors can increase the likelihood of recurrent yeast infections: - **Antibiotics:** These can disrupt the natural flora of the vagina, allowing yeast to overgrow. - **Hormonal Changes:** Birth control pills, hormone replacement therapy, and spermicidal products can alter vaginal flora. - **Lifestyle Factors:** Wearing tight clothing, especially in hot or sweaty conditions, can create an environment conducive to yeast growth. - **Health Conditions:** High blood sugar and diabetes are less common but significant risk factors. #### Treatment The first line of treatment usually involves antifungal medications, either as a cream applied to the vagina or as oral pills. For recurrent infections, a typical regimen might include antifungal treatment for 10 to 14 days, followed by a weekly antifungal pill for six months. Pregnant women should avoid antifungal pills. For postmenopausal or permanently infertile women, a new FDA-approved medication called Oteseconazole (Vivjoa) can be used. This is taken alone or with fluconazole over 12 to 14 weeks. In cases involving uncommon yeast strains, doctors may recommend boric acid capsules inserted into the vagina for two weeks. #### When to See a Doctor If symptoms persist despite treatment, further testing may be needed to rule out other conditions like diabetes or HIV. Regular medication may be necessary to prevent recurrent infections, and stopping treatment prematurely can lead to recurrence in over half of the cases. Make an appointment with your doctor if you experience recurrent symptoms. They may examine a sample of vaginal discharge under a microscope to identify the specific type of yeast causing the infection.