• If you keep getting yeast infections, it could be because your urine contains sugar from diabetes.
  • Wearing tight underwear, staying in a wet bathing suit, and douching can also cause infections.
  • Taking antibiotics can also cause infection since antibiotics can kill good bacteria.
  • Visit Insider's Health Reference library for more advice.

A yeast infection is an overgrowth of the fungus, candida, in the vagina. Candida naturally exists in the vagina, but an overgrowth of it can cause symptoms including vaginal burning, itching, and discharge. Yeast infections are common, affecting an estimated 75% of women at some point in their lives. 

In most cases, a yeast infection can be easily treated with antifungal medications or creams. But if you are experiencing recurring yeast infections, defined as four or more in a year, it could be a sign of an underlying health condition. Here are six causes of chronic yeast infections and how to treat them. 

1. Uncontrolled diabetes

Rapid spikes in blood sugar can fuel the growth of yeast, says Michael Ingber, MD, a urologist with the Center for Specialized Women's Health. Blood sugar levels that are not well managed can result in too much sugar present in the urine, which can then disrupt the balance of candida in the vagina. 

Other signs your diabetes may not be well-managed include:

  • Extreme thirst
  • Frequent urination
  • Fatigue 
  • Unexplained weight loss

How to treat it: The first step is to treat the infection itself with an over-the-counter antifungal medication. In some cases, your doctor may prescribe a stronger prescription medication.

To prevent future yeast infections due to diabetes, work with your endocrinologist to control your blood sugar levels and keep your blood glucose readings between certain levels provided by your doctor. This will decrease the amount of sugar in your urine. 

2. A weakened immune system

Your immune system helps fight off harmful organisms that can make you sick, including an overgrowth of yeast in the vagina. If your immune system is weakened, your body may not be as effective at warding off yeast infections and you may experience them more often. 

A weakened immune system may be caused by:

  • Certain medications, like antibiotics and steroids 
  • Cancer treatments
  • Autoimmune diseases, like HIV/AIDS 

How to treat it: If you experience recurring yeast infections as a result of a weakened immune system, you may need more intensive treatment than the standard over-the-counter antifungal creams and medications. Your doctor may prescribe an oral dose of an anti-fungal medication called fluconazole, which you may be instructed to take for a few weeks or months. 

3. Insufficient hygiene

Inconsistent hygiene practices, like not showering or cleaning the vaginal area regularly, can contribute to recurring yeast infections

Yeast also thrives in moist and humid conditions, so anything that traps moisture in the vagina, like tight-fitting underwear, can increase the risk of yeast infections, Ingber says.

How to treat it: Regularly wash the vaginal area with mild, unscented soap. Do not attempt to clean the vagina with other methods, like douching or perfumed powders and sprays as these practices can disrupt the natural pH balance of the vagina and increase the risk of yeast infections.

Wear underwear made with breathable fabric, like cotton, and change your underwear after working out to avoid moisture from sweat building up in the vaginal area. Sitting in a wet swimsuit for hours can also contribute to yeast infections, Ingber says, so change out of swimsuits or other wet garments as soon as you're done swimming for the day. 

4. Pregnancy

The hormonal changes you go through during pregnancy can disrupt the natural balance of estrogen and progesterone which influence the growth of candida yeast, says Kimberly Langdon, MD, an OB-GYN with Medzino, a telehealth provider.

Pregnant women also have higher amounts of sugar in their vaginal secretions which can also fuel the growth of candida. 

How to treat it: Yeast infections during pregnancy are difficult to treat because the hormonal changes that can cause infection are present for the duration of the pregnancy. 

The infections should clear up once you deliver and in the meantime, your doctor may recommend vaginal creams or suppositories to keep infections at bay during your pregnancy. 

5. You have a different kind of infection

If you are experiencing recurring yeast infections that are not responding to treatment, you may actually have an infection that mimics a yeast infection but is something else, like bacterial vaginosis, Langdon says. 

Both bacterial vaginosis and yeast infections are caused by an overgrowth of certain microbes in the vagina that can cause inflammation, itching, burning, and discharge. But bacterial vaginosis is the result of an overgrowth of bacteria while a yeast infection is the overgrowth of a fungus.

The symptoms of bacterial vaginosis are: 

  • Vaginal burning and itching
  • An unpleasant vaginal odor
  • An increase in vaginal discharge that may appear milky white or gray  

Bacterial vaginosis presents with many of the same symptoms as a yeast infection, like burning, itching and irritation. It can be tough to tell the difference, but if you notice an unpleasant "fishy" odor and grayish discharge, these may be signs you have bacterial vaginosis and not a yeast infection. 

How to treat it: If you believe you have a yeast infection that isn't responding to over-the-counter treatment or seems to improve but then comes back, consult with your doctor who can determine if you actually have another type of infection. Bacterial vaginosis is typically treated with medications, such as antibiotics or vaginal creams and gels. 

6. Antibiotics 

Antibiotics are a common cause of yeast infections, Langdon says. When you take an antibiotic, the "good" bacteria in the vagina that helps keep yeast in check may also be harmed. Frequent antibiotic use can allow the yeast to thrive, leading to recurring yeast infections

How to treat it: Consuming probiotics while you are taking an antibiotic or after finishing antibiotics can help restore the beneficial bacteria that help keep yeast infections away. The probiotic strain lactobacillus, in particular, can be especially beneficial in restoring balance in the vagina, says Kecia Gaither, MD, an OB-GYN, and director of perinatal services at NYC Health + Hospitals

You can increase your consumption of probiotics by eating foods rich in probiotics, including:

  • Yogurt
  • Fermented foods like kimchi, kombucha, sauerkraut, and pickles
  • Miso soup
  • Sourdough bread

Insider's takeaway

Yeast infections are common, but if you experience four or more in a year, you may have chronic yeast infections that require more intensive treatment than standard antifungal medications. 

Treatment options for chronic yeast infections may include long-term antifungal medications, maintenance medications, improving personal hygiene, or treating an underlying condition contributing to yeast infections, like diabetes. 

Read the original article on Insider