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Yeast Infection of the Vagina and Vulva
Yeast Infections Yeast is a fungus that is often a normal inhabitant of the vagina. It has been found in up to 70% of healthy females. The vagina is not a sterile environment: it plays host to a multitude of microorganisms. Normally, these tiny life forms do not disturb their host. When the balance between the different organisms is disrupted, however, one overgrows the others and causes problems. This is precisely the case with yeast infections. Roughly 80% of yeast infections are caused by Candida albicans.
What Symptoms Do Yeast Infections Cause? When yeast overgrows, it causes itching, redness, and a thick white discharge in most females. It can occur inside the vagina, on the vulva, or in both locations at once. Systemic (throughout the body) yeast infections also occur, but they are rare in healthy females. They are seen more often in people with compromised immune systems, like those with cancer or AIDS.
What Are the Risk Factors for Getting a Yeast Infection? A yeast infection can happen at any time, but certain factors increase a woman's risk. These include taking antibiotics (for example, to treat a bladder infection), using high dose birth control pills, having diabetes, or being pregnant. Females with depressed immunity, from disease such as AIDS or because of medications (e.g., steroids), will likely have more yeast infections. Even wearing tight-fitting pants or shorts may increase a woman's chances of developing a yeast infection.
How Is Yeast Diagnosed? The most common symptom of a yeast infection is genital itching; it can be quite intense. Many females also experience an increase in their discharge and burning with urination, caused by irritation of the vulva. Examination of the vagina and/or vulva often will show discharge and some degree of redness, swelling, and tenderness. There is an absence of "lumps, bumps, or craters," which might suggest warts, herpes, or other diagnoses. There is no odor from yeast.
To diagnose a yeast infection, the gynecologist will take a small sample of the thick, "curdy" discharge from the vagina or vulva and examine it under a microscope. About 80% of infected females will have yeast organisms visible on microscopic exam. A measurement of pH (acidity) of vaginal fluid also can be done to exclude other diagnoses. A woman with a yeast infection will usually have a normal pH unless she also has other infections. It helps us make a diagnosis if no vaginal medications or douches are used for two days before the exam. This is because these chemicals obscure the signs of infection we're looking for.
How Is Yeast Treated? Antifungal medications such as Creams or suppositories work equally well when applied directly to the genital area. It's important to use the medication for the full treatment course (usually seven days) to avoid a relapse. In cases of extreme discomfort, a corticosteroid cream can be added. Married females should avoid sexual intercourse until the treatment is completed. These medications can be used without concern during a pregnancy. A longer treatment course (ten days instead of seven) may be necessary if the woman is pregnant since pregnancy promotes the growth of yeast. New single-dose yeast infection treatments with consultation of a gynecologist should be obtained before use.
Caution: Do not use over-the-counter antifungal treatments without first consulting a gynecologist. Young girls may mistake normal vaginal fluids for an infection or misdiagnose the type of infection they have. Severe side effects occur after using OTC products, especially when they were used when a yeast infection was not present. Yeast infections should not be taken lightly just because you can buy antifungal medications as easily as cold medications.
What If Yeast Infections Keep Coming Back? Frequent recurrences of yeast are a fairly common problem - and a very exasperating one. Contributing factors may be:
· Partial treatment Females who do not use the medicine for the necessary number of days put themselves at risk for recurrence.
· Frequent douching Females increase their risk of yeast infections if they douche more than once a month. Females should not douche at all unless a gynecologist prescribes it.
· Use of irritating chemicals in the vagina Scented toilet paper, soaps, tampons, and vaginal sprays can “set up” yeast infections by irritating the genital area. The only things that should come in contact with a female’s vulva and vagina are clean water and air and if necessary then only pure cotton innerwear which can breathe enough.
· Clothing Tight jeans, wet bathing suits, nylon underwear, and panty hose can contribute to yeast infections. Ideally, females should only wear dresses or skirts and no underwear so excess moisture does not collect, clothing does not irritate the delicate vulva tissues, and the ambient temperature does not increase.
· Antibiotic use Antibiotics often eliminate some of the normal bacteria of the vagina, allowing yeast to overgrow. Females taking long-term antibiotics for any reason may therefore suffer chronic yeast infections. If your body will likely eliminate an infection on its own given the time, females may discuss with the gynecologist for not using an antibiotic.
· Depressed immunity Recurrent yeast may be the result of a major systemic illness such as AIDS. Most females with recurrent yeast and decreased immunity, however, do not have AIDS. They may have a minor defect in their immune system that predisposes them to yeast.
· Reinfection from spouse sexual partner Even after a female is completely treated, her husband with oral or genital yeast can reinfect his wife. Couples may infect and reinfect one another as well.
· Infection with a resistant strain of Candida As mention, drug resistance is more common with certain species of Candida. A longer treatment course or use of a different antifungal may be needed. Cultures of the yeast may be helpful in deciding the best treatment in these unusual cases. Females may need to ensure that her gynecologist does not presume for a common type of Candida infection by requesting a copy of lab test report.
· Diabetes Females with diabetes are more likely to have recurrences.
How Can Yeast Recurrences Be Eliminated? Controlling recurrences of yeast can be accomplished in most patients with the following:
· General measures Wear COTTON underwear and loose-fitting clothes; reduce sweets and dairy products; improve control of diabetes.
· Longer treatment courses Use the treatment for ten or fourteen days instead of seven.
· Suppressive doses of medication before recurrences Use the antifungal for three nights before a menstrual period (if that’s when the yeast occurs) for six months. Consult with your gynecologist before trying this.
· Changing other medication use Use lower-dose birth control pills or change to a different method of contraception; use an antifungal cream while taking antibiotics; stop taking systemic steroids (under your gynecologist’s supervision).
· Examination and treatment of husband and wife every time together due to sexual partners--------------------------------------------------
Fungus n. (pl. fungi) a simple plant that lacks the green pigment chlorophyll. Fungi include the yeasts, rusts, molds, and mushrooms. The single-celled microscopic yeasts are a good source of vitamin B and many antibiotics are obtained from the molds.