What is yeast?
Yeast is a fungus scientifically referred to as Candida. The
specific type of fungus most commonly responsible for vaginitis is
Candida albicans. Yeast is commonly present on normal human skin
and in areas of moisture, such as the mouth and vagina. In fact,
it is estimated that between 20%-50% of healthy women normally
carry yeast in the vaginal area.
What causes vaginal yeast infections?
Vaginal yeast infections occur when new yeast is introduced into
the vaginal area, or when there is an increase in the quantity of
yeast already present in the vagina relative to the quantity of
normal bacteria. For example, when the normal, protective bacteria
are eradicated by antibiotics (taken to treat a urinary tract,
respiratory, or other types of infection) or by immunosuppressive
drugs, the yeast can multiply, invade tissues, and cause
irritation of the lining of the vagina (vaginitis).
Vaginal yeast infections can also occur as a result of injury to
the inner vagina, such as after chemotherapy. Also, women with
suppressed immune systems (for example, those taking
cortisone-related medications such as prednisone) develop vaginal
yeast infections more frequently than women with normal immunity.
Other conditions that may predispose women to developing vaginal
yeast infections include diabetes mellitus, pregnancy, and taking
oral contraceptives. The use of douches or perfumed vaginal
hygiene sprays may also increase a woman's risk of developing a
vaginal yeast infection.
A vaginal yeast infection is not considered to be a sexually
transmitted infection (STD), since Candida may be present in the
normal vagina, and the condition does occur in celibate women.
However, it is possible for men to develop symptoms of skin
irritation of the penis from a yeast infection after sexual
intercourse with an infected partner.
What are the symptoms of vaginal yeast
infection and vulvitis?
Vaginal yeast infection and vulvitis cause symptoms that are
nonspecific, which means that aside from the yeast infection,
other conditions can cause the identical symptoms. The most common
symptom of a vaginal yeast infection is itching in the vaginal
and/or vulvar area. Other symptoms of vaginal yeast infection and
vulvitis include:
burning,
soreness,
pain during intercourse and/or urination, and
vaginal discharge. (Vaginal discharge is not always present, but
when it occurs, the discharge is odorless and typically has a
whitish, thick appearance and texture, like cottage cheese.)
Vulvitis can also cause local pain in addition to the above
symptoms. Pain in the vulvar area is referred to as vulvodynia.
In up to 5% of women, yeast vulvovaginitis may cause a recurrent
problem. A recurrent yeast infection occurs when a woman has four
or more infections in one year that are not related to antibiotic
use. Recurrent yeast infections may be related to an underlying
medical condition and may require more aggressive treatment.
what
treatment can be done? Vaginal yeast infection and vulvitis may
be treated with antifungal medications that are applied topically
in and around the vagina or with antifungal medications taken by
mouth. Sometimes, mixed infections with more than one microbe can
require combinations of treatments.
Topically applied antifungal creams include:
* butoconazole (Femstat 3),
* clotrimazole (Lotrimin),
* miconazole (Monistat), and
* terconazole (Terazol 3).
The over-the-counter topical treatments are an option for some
women when yeast is the cause of the infection. However, it should
be noted that infection other than yeast can cause similar
symptoms. These include bacterial vaginosis, chlamydia, and
gonorrhea. If symptoms are not eliminated by over-the-counter
products, patients should see their doctor for evaluation.
Antifungal medications that are also
available as vaginal tablets include:
* clotrimazole (Lotrimin, Mycelex),
* miconazole (Monistat; Micatin),
* terconazole (Terazol), and
* nystatin (Mycostatin)
Oral medications for yeast vaginitis and vulvitis include
fluconazole (Diflucan).
Most doctors prefer to treat vaginal yeast infections with vaginal
tablets or suppositories rather than oral medications. Oral
antifungal medication can cause side effects such as headache,
nausea, and abdominal pain , while vaginal treatment is unlikely
to cause these side effects. Oral antifungal medications are also
not recommended for use during pregnancy.
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