How to deal with yeast infections during pregnancy

Yeast infections are never fun, but when they happen during pregnancy, they may create extra worry. Thankfully, although uncomfortable, yeast infections while pregnant are not harmful to the fetus, and there are effective and safe treatments available to pregnant individuals. Keep reading to learn the causes and symptoms of yeast infections while pregnant, why they are more common during pregnancy, and some provider-approved options for preventing and treating them.

What causes yeast infections during pregnancy?

Yeast infections are caused by overgrowth by a kind of fungus called Candida whether you are pregnant or not. Everyone has Candida in their bodies and it usually doesn’t cause any issues because it lives in balance with bacteria; however, certain conditions can cause that balance to change. When too much Candida proliferates in the vagina, it causes a vaginal yeast infection.

Pregnancy itself doesn’t cause yeast infections, but some aspects of pregnancy may make you more vulnerable to developing one, says Michael Green, MD, OB-GYN and co-founder at Winona. “While the underlying cause remains the same whether or not you are pregnant, some factors can make pregnant individuals more susceptible to yeast infections, such as hormonal changes, a weakened immune system, and increased vaginal secretion,” he says. 

Why are yeast infections more common during pregnancy?

If you notice yourself getting more yeast infections while pregnant, you are not alone. Research has found that up to 20% of non-pregnant individuals experience Candida overgrowth, but in pregnant women this increases to 30%. The majority of these occur during the second and third trimester of pregnancy. There are several reasons that vaginal yeast infections are more common during pregnancy:

• Hormonal changes: “Candida seems to be increased in women in their reproductive years as well as women with elevated levels of estrogen,” says Adi Davidov, MD, associate chair of obstetrics and gynecology at Northwell Staten Island University Hospital in New York. “That is likely why it is more common in pregnancy.”
• Physical changes: “Physical changes in the vaginal area, like increased blood flow and secretions, create a warm, moist environment ideal for yeast,” explains Shandra Scruggs, RN, registered labor and delivery nurse, doula, and founder of Simply Birthed.
• Weakened immune system: Pregnancy suppresses the immune system. This can make expectant mothers more susceptible to any type of infection.
• Pregnancy complications: For example, if you develop gestational diabetes during pregnancy, elevated blood sugar levels can promote yeast growth. 
• Antibiotics: If you are given antibiotics during pregnancy to treat an infection, this can disrupt vaginal flora, allowing yeast to grow, Scruggs explains. 
• Dietary changes: Finally, any changes in your diet because of pregnancy cravings or otherwise, can make you more vulnerable to a yeast infection. This is especially true if you are consuming more sugary foods, as these can raise blood sugar levels, resulting in more yeast growth.

Can having a yeast infection while pregnant hurt the fetus?

Rest assured that there is very little risk of yeast infections harming fetuses, especially when treated promptly. That’s because yeast infections are localized. “Yeast infections typically do not harm the pregnancy as the infection is in the vagina and does not extend inside the uterus where the pregnancy is located,” Dr. Davidov explains. 

However, emerging research indicates that if the infection is not treated there may be some risk to fetuses. “Severe or recurring infections can increase the risk of preterm birth or a low birth weight baby, so it’s essential to seek out the guidance of a healthcare provider,” Dr. Green says.

What are the symptoms of a yeast infection? 

Although some yeast infections can be asymptomatic, most of the time, if you have a yeast infection, you’ll know it. That’s because yeast infections can present with some very irritating, uncomfortable symptoms.

Signs of yeast infections are the same during pregnancy as when you are not pregnant. According to the American College of Gynecologists and Obstetricians (ACOG), the most common signs are:

• Vaginal and vulva itching
• Burning sensations, which may feel worse with urination or sex 
• A red, inflamed, swollen vulva
• Soreness in the vaginal area
• Increase in vaginal discharge
• Vaginal discharge that looks like white and lumpy, like cottage cheese, but with no odor

Yeast infection symptoms tend to start out mild and get worse as the infection progresses, especially when not treated. 

There are other conditions that may resemble yeast infections, such as bacterial vaginosis, trichomoniasis, and sexually transmitted infections (STIs) like chlamydia and gonorrhea; however, these infections have slightly different symptoms. For example, bacterial vaginosis usually presents with thin gray, foul-smelling, fishy discharge. Trichomoniasis and other STIs often have yellowish discharge. Before you use any medications or treatments, it is important you visit your health care provider for examination, screening, and to determine the source and appropriate treatment.

How to treat yeast infections during pregnancy 

If you have a vaginal yeast infection during pregnancy, it’s important to treat the infection. “Leaving a yeast infection untreated can lead to discomfort, pain, and potentially more severe symptoms,” says Dr. Green.

Treating yeast infections while pregnant usually involves antifungal medication that’s applied topically to the vulva and vaginal area, often as vaginal creams or vaginal suppositories. Dr. Green says the following over-the-counter medications can be safely used to treat a yeast infection during pregnancy:

• Monistat (miconazole nitrate)
• Monistat 7 (miconazole nitrate)
• Gyne-Lotrimin (clotrimazole)

Although these medications are over-the-counter, it is a good idea to discuss with your healthcare provider before using them because if it is not a yeast infection, these treatments can make the condition worse and it is important to be screened for other infections that may harm a fetus.

For more severe infections, an oral medication, like Diflucan (fluconazole) may be used. But there is a caveat. “Fluconazole is typically avoided in the first trimester and used cautiously in the later stages of pregnancy,” Dr. Davidov explains. This is because research indicates possible dangers of using oral antifungals in early pregnancy, including the risks of birth defects and miscarriage.

Before you need these treatment options there are steps you can take to prevent yeast infections from recurring, or from occurring in the first place. The ACOG recommends:

• Maintaining a dry vulva and vaginal area
• Refraining from washing your vulva with soap or using any cleansers and sprays inside your vagina
• Avoid soaking in hot tubs or taking long baths/soaks
• Wearing breathable cotton underwear
• Eating probiotic-rich foods like yogurt or taking a probiotic supplement
• Avoiding douching; this can disturb the bacterial and fungal balance in your vagina
• Only using antibiotics when necessary

If you have any further questions or concerns about yeast infections during pregnancy, don’t hesitate to reach out to your healthcare provider.