Vaginal Yeast Infection
Most women will experience that itchy, irritating feeling around the vaginal opening, symptoms of a yeast infection, at least once in a lifetime. Vaginal yeast infections are one of the more common reasons why women seek care from their OB/GYN. Most women harbor yeast, a fungal organism, somewhere in their vaginal canal. While usually in small amounts, certain situations allow for overgrowth. The body’s main defense against yeast infections occurring in the vagina is pH balance. The pH balance is maintained by normal bacteria referred to as lactobacillus, also known as acidophilus. This variety of bacteria creates an acid pH, which prevents the healthy vagina from harboring fungal organisms such as yeast and also odorous bacteria. Many factors influence the vaginal pH balance, for example, antibiotics tend to reduce the population of acidophilus resulting in a higher pH in the vagina and an environment that can harbor unfriendly organisms. Dietary habits such as high intake of sugar or carbohydrates result in higher than average levels of blood sugar causing fungal organisms to thrive. Pregnancy encourages the growth of yeast because of alterations that estrogen causes in the vagina. Other conditions that encourage yeast growth include diabetes, a depressed immune system and heredity also play somewhat of a part.
The symptoms of yeast infections can start out very subtly. Often a woman will notice only intermittent itching. This is more notable around her period at which time her vaginal pH is elevated. Usually the symptoms wax and wane and may resolve spontaneously, but in the majority of patients that are seen in the physician’s office, the most common complaint is itching. Often a discharge is present, but not always. Usually there is no significant odor. There are many medications now available over the counter to treat yeast infections. Usually these treatments will reduce the symptoms of itching and significantly reduce the population of yeast in the vagina. Occasionally a resistant strain of yeast is present and must require prescription medication for good results.
Prevention of recurrent yeast infections is the most important approach to avoid them. This can be done by several measures, one of which is dietary. Women who are prone toward yeast infections should be very careful about avoiding sugar or diets high in carbohydrates such as the “white stuff”: white potatoes, white rice, white pasta, and white bread. Soft drinks are a common cause of elevation of blood sugar. We, in the business of gynecology, often see more yeast infections around holiday times such as Christmas and Easter when candy, fudge, etc., are in abundance. Another approach is to increase dietary intake of products high in acidophilus such as cultured yogurt, particularly plain yogurt, acidophilus milk and capsules or powders available in most health food stores. I usually recommend the refrigerated varieties, as they tend to have more live cultures.
Women who are prone toward yeast infections should be cautious about antibiotic use, using them only when necessary and remembering to increase dietary intake of acidophilus food products when taking antibiotics. Other approaches should include efforts to reduce irritation of the vagina or vulva. I suggest patients wear only 100% cotton underwear, not just cotton crotch. Pantyhose should be vented to allow for good air circulation or try thigh high pantyhose as an alternative. Most pairs of pantyhose can be vented easily with a small slit inside the seams of the crotch. Wet athletic wear and bathing suits should be removed as soon as exercise or swimming is finished, changing into dry cotton underwear. The use of vaginal douches is not recommended as this may actually water down the acid pH. Yeast infections are not sexually transmitted diseases, but on occasion partners will both have inflammation of their genital areas. In men “jock itch” is one such condition and again is not sexually transmitted, but may be treated with antifungals available over the counter. Women who have symptoms of yeast infections should be seen by a physician or health care professional for an accurate diagnosis. Recurrent yeast infections may require blood work to assess whether there are other risk factors such as diabetes. While yeast infections are a great annoyance to most patients, research has not revealed any overall negative health effects from long term mild infections, other than discomfort.
In summary, vaginal yeast infections are extremely common, usually treatable and may be entirely preventable with dietary changes and other healthy habits.