VAGINAL
YEAST
Vaginal
yeast infections are the second most common cause of vaginal
discharge in the United States (the first is Bacterial
Vaginosis). Yeast infection is not considered
a sexually transmitted disease, but is included here because
it is such a common cause of vaginal discharge. Candida
yeast can be found in the vaginas of almost one in every
two woman of childbearing age though the majority of these
women have no symptoms unless something occurs to disrupt
the normal vaginal environment (see below). The vast
majority of yeast infections are caused by the Candida
albicans species.
Common
Signs & Symptoms
Vaginal
itchiness and a cottage cheese-like discharge are the most
common symptoms of a yeast infection. The vagina
and labia can be red, swollen, sore, and quite irritated.
Burning with urination and pain during intercourse (dyspareunia)
are also common complaints. Odor, if present, is minimal
(in contrast to the fishy odor of bacterial vaginosis).
How's
it Diagnosed?
Diagnosis is made on examination. A pelvic exam is
done and a sample of the discharge is obtained (pictured
is the curd-like discharge as seen through a speculum during
pelvic examination). A sample of the discharge is
often viewed under the microscope and reveals the yeast
organisms. Looking under a microscope also helps rule
out other causes of discharge (e.g., bacterial vaginosis,
trichomonas) that would require different treatment.
How's
it Treated?
Treatment is with an antifungal medication of which there
are many. Over-the-counter creams and vaginal suppository
medications are available without a doctor's prescription
and include clotrimazole (Gynelotrimin, Mycelex), butoconazole
(Femstat), and miconazole (Monistat). An oral antifungal,
fluconazole, is commonly prescribed by physicians as it
is a one time dose with minimal side effects (including
ease of administration; one pill and not a number of days
applying something onto or into one's vagina). Yeast
infections are not considered sexually transmitted, and
therefore sexually partners do not need treatment ( though
it is interesting to note that 1 in 5 men whose partners
had a yeast infection were found to have microscopic yeast
present in their urethras).
How
do I avoid Getting It (Prevention)?
Though not currently believed to be sexually transmitted,
yeast infections are associated with a number of medications
and personal states. Avoidance of these will decrease
your chance of getting a yeast infection. One of the
most common cause of yeast infections is the use of an antibiotic.
In addition to destroying bacteria that cause illness, antibiotics
kill off the "good" bacteria that normally live in the vagina.
Without the normal lactobacillus bacteria in the vagina,
yeast cells can take-over and grow out-of-control.
This is why some woman douche with yogurt. Unpasturized
yogurt contains the "good" bacteria that are normally found
in the vagina. It is unclear, however, if douching
with yogurt helps or hurts, and we do not recommend trying
this without first checking with your doctor. Vaginal
yeast infections are just one more reason why antibiotics
should be avoided except in the treatment of a bacterial
infection (e.g., and not for the treatment of colds and
flu - which are caused exclusively by viruses upon which
an antibiotic will have no effect). Also, douching
with vinegar or other chemicals has been shown to increase
the rate of vaginal yeast infections. This is likely
a result of the same process that occurs with antibiotics:
the "good" bacteria living in the vagina are destroyed by
the douche, leaving the yeast to grow and multiply.
Yeast
infections are quite common during pregnancy. It is
believed this is due to a chemical change in the vaginal
environment (essentially there is more sugar in the vaginal
juices on which the yeast feed). Similarly, people
with diabetes (a disease of sugar metabolism) also get yeast
infections more frequently.
It
has been shown than tight fitting, poorly ventilated clothing
and non-cotton undergarments result in an increase in groin
warmth and moisture (sweat), and can lead to yeast infections.
This is one reason yeast infections are more prominent in
the warmer tropical and sub-tropical climates.
Additional
Information
Get additional information on this and other diseases by
clicking here.
