Yeast Infection Recurrence: Causes, Prevention & What to Do

Recurrent vulvovaginal candidiasis (RVVC) = ≥4 episodes/year. Contributing factors:

• Antibiotic use (disrupts lactobacilli)
• Uncontrolled diabetes (hyperglycemia)
• Pregnancy (estrogen ↑ glycogen)
• Immunosuppression (HIV, steroids)
• Tight/synthetic clothing, moisture
• Non-albicans species (C. glabrata — azole resistant)

Prevention

• Avoid unnecessary antibiotics.
• Cotton underwear, loose clothing, prompt change after swimming.
• Glycemic control if diabetic.
• Probiotics (oral/vaginal Lactobacillus) — evidence mixed but low risk.
• Boric acid suppositories (600 mg nightly × 14 days) for azole-resistant strains.

Management

Confirm with culture/speciation. Maintenance fluconazole (150 mg weekly × 6 months) for RVVC. Partner treatment not routinely recommended. See gynecologist for tailored plan.