An estimated 75 percent of women will have at least one episode of VVC, and 40 percent to 45 percent will have two or more episodes. A small percentage of women experience recurrent VVC or RVVC. Typical symptoms of VVC include pruritus and vaginal discharge. Other symptoms may include vaginal soreness, vulvar burning, dyspareunia, and external dysuria. None of these symptoms is specific for VVC.
Candida vaginitis can be diagnosed with suggested clinically by pruritus and erythema in the vulvovaginal area and white discharge may occur. The diagnosis can be made in a woman, who has signs and symptoms of vaginitis, and when either a wet preparation or Gram stain of vaginal discharge demonstrates yeasts or pseudohyphae, a culture or other test yields a positive result for a yeast species. Candida vaginitis is associated with a normal vaginal pH or less than or equal to 4.5. Use of 10 percent KOH in wet preparations improves the visualization of yeast and mycelia by disrupting cellular material that might obscure the yeast or pseudohyphae. To identify Candida by culture in the absence of symptoms should not lead to treatment, because approximately 10 percent to 20 percent of women usually harbor Candida sp. and other yeasts in the vagina. VVC can arise concomitantly with STDs or frequently following antibacterial vaginal or systemic therapy.

The topically applied azole drugs are more effective than nystatin. Treatment with azoles results in relief of symptoms and negative cultures among 80 percent to 90 percent of patients who complete therapy. Thus, topical formulations effectively treat VVC.
Preparations for intravaginal administration of butaconazole, clotrimazole, miconazole, and tioconazole are available OTC, and women with VVC can choose one of those preparations. The length for treatment with these preparations may be 1, 3, or 7 days. Self medication with OTC preparations should be advised only for women who have been diagnosed previously with VVC and who have a recurrence of the same symptoms. Any woman whose symptoms persist after using an OTC preparation or who has a recurrence of symptoms within 2 months should look for medical care.
A latest classification of VVC may help or facilitate antifungal selection as well as duration of therapy. Uncomplicated VVC, like mild to moderate, sporadic, nonrecurrent disease in a normal host with normally susceptible C. albicans responds to all the aforementioned azoles, even those that are short term or less than seven days, and single-dose therapies. In contrast, complicated VVC, like severe local or recurrent VVC in an abnormal host requires a longer duration of therapy, like ten days to two weeks with either topical or oral azoles. Additional studies confirming this approach are in progress.

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