Cystic Fibrosis: Vaginal Yeast Infections

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Vaginal yeast infections are very common. About 75% of all women (with or without CF) get at least one yeast infection during their lives. About half of 15-24 year old women with CF have had a yeast infection. Yeast infections can happen at any age and some women experience many yeast infections over their lifetime.

What causes yeast infections in women with CF?

Yeast infections are typically caused by an overgrowth of a type of fungus called Candida (also called yeast). Yeast is normally found in many parts of your body, including your mouth, digestive tract and vagina. A vaginal yeast infection occurs when there is an overgrowth of yeast. There are many reasons why the level of yeast becomes too high.

In women with CF, one of the most common reasons for vaginal yeast infections is the use of antibiotics. Antibiotics kill normal bacteria in your vagina and allow the yeast to grow. You are most likely to get a yeast infection after puberty, around the time of your menstrual period, or when you start or change antibiotics.

Other causes for a vaginal yeast infection include: use of steroid medication, diabetes, pregnancy, being overweight, HIV infection, use of contraceptives, or wearing tight underwear made of material that traps moisture and heat (such as silk or rayon).

What are the signs and symptoms of a vaginal yeast infection in women with CF?

Women with CF experience the same symptoms as any woman with a vaginal yeast infection. The most common symptoms are itching, burning and/or irritation in and around the vagina and a change in your vaginal discharge. When you have a yeast infection, your vaginal discharge may become thick and white, but it usually does not have an odor. Sex may be painful and you may feel sore when you pee. If you are having any of these symptoms, you should talk with your CF team. It’s important to be evaluated for a yeast infection and/or other possible causes of your symptoms as well.

How is a vaginal yeast infection treated when you have CF?

Yeast infections can be treated with a pill you swallow or with a vaginal cream or suppository (a pill that you insert in your vagina where it dissolves and releases medicine). Your health care provider can explain what the choices are and help you decide which one is best for you. Here are a few things to remember:

  • You should NOT use tampons if you are being treated with a vaginal cream because the tampon will absorb the medication and make it less effective.
  • Some vaginal creams or suppositories are oil-based and may weaken latex condoms and diaphragms, so they are more likely to break. You should talk to your health care provider about whether to use a polyurethane condom or not have sex during your treatment.
  • Some anti-yeast medications are available over the counter in pharmacies (you don’t need a prescription). Do not use anti-yeast medications without seeing your CF team, unless you’ve been diagnosed with a yeast infection more than once and you’re really sure of the symptoms and signs. Anti-yeast medications will not treat other vaginal infections, such as bacterial vaginosis, which requires a different prescription medicine.
  • If you take Orkambi or Kalydeco and have a vaginal yeast infection, make sure you talk with your CF team before starting any treatment. Many anti-yeast medications may not work when taken with these medications. You may also need to decrease your dose of Kalydeco while you are being treated for your yeast infection.
Vaginal yeast infections can be treated, but even with treatment, they can return or not improve completely. If you have CF, you may need to take your anti-yeast medication for a longer amount of time. If you often get yeast infections when you take antibiotics, you may be able to start anti-yeast medication at the same time that you begin your antibiotics.

How can I prevent getting a vaginal yeast infection? 

You can lower your risk of getting a yeast infection by:

  • Never using vaginal douche products
  • Wearing cotton underwear and loose fitting pants
  • Changing out of a wet bathing suit or workout clothes as soon as you can

Some women with CF find that using probiotics or eating one cup of yogurt (which contains acidophilus bacteria) a day is helpful in preventing yeast infections.

It’s important to realize that doing these things alone will NOT necessarily cure or prevent vaginal yeast infections. If you have to take antibiotics on a regular basis and you are getting a lot of yeast infections, talk to your CF team about using an anti-yeast medication every time you have to take antibiotics.

It may be hard to start a conversation with your CF team about sexual and reproductive health. Here are some specific talking points and tips that may help you discuss vaginal yeast infections with your provider(s):

  • Tell your team what your symptoms are. CF providers are all familiar with yeast infections because they happen so often in women with CF. Do not be embarrassed to say that you are having symptoms and state that you are worried that it might be a yeast infection.
    • Example: “I have vaginal itching/my vaginal discharge is thicker and white (or whatever your symptoms may be). I am worried that I have a yeast infection.”
  • Remind your CF team if you take Orkambi or Kalydeco. These medications can have interactions with certain anti-yeast medications. You may need to avoid certain medicines or change your medication doses.
    • Example: “I take Orkambi/Kalydeco. I know this medicine may have an interaction with certain types of medication used to treat a yeast infection. Are there medicines I should not use? Should my dose of Orkambi/Kalydeco change?”
  • If you get vaginal yeast infections often, ask your CF team if you should take anti-yeast medication to try to prevent infections from happening.
    • Example: “I get vaginal yeast infections a lot when I am on antibiotics. Should I be using an anti-yeast medication to try to prevent this from happening?”

There is a lot of information to think about when you have CF and get a vaginal yeast infection. You can print out this guide or have your provider review this webpage during your visit.

More information on CF and yeast infections can be found on the Cystic Fibrosis Foundation (CFF) website: www.cff.org.