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Yeast Infection
(vaginal)
Introduction
Yeast are tiny microscopic single cell fungi.
They are common in the environment and on our skin. Yeast like to grow in
warm, moist, dark environments. They survive by breaking down organic (formerly
living) matter generally.
Women are prone to yeast infections.
They typically occur in the vagina, which is a suitable warm, moist, dark
place with plenty of organic material to live on. Normally, the vagina has an entire
host of many different bacteria living in this environment. Just like animals live
in harmony with one another, so do bacteria live in harmony with one another.
Now, once in awhile this "harmony" gets disturbed. The most common
reason it gets disturbed would be the use of antibiotics that kill off certain types of
bacteria. The hosts of bacteria then grow "out of balance". When
this happens, it is possible for yeast to begin growing in great numbers. You then have a
yeast infection.
Some yeast infections come on for no apparent
reason.
Diagnosis
Yeast infections are marked by intense
itching, a white discharge sometimes described as being "curd-like" as in
cottage cheese, and sometimes there is visible red irritation of the vagina opening (the
lips or labia). The only way to be sure you have a yeast infection is to come in and
take a sample of the vaginal liquid to look at under a microscope. Many people are
electing to self treat their vaginal itching first. This is okay, but if it doesn't
clear up, you should be checked in the office.
Treatment
There are now many medicines used to treat
yeast infections, many are over-the-counter preparations.
Treatment for Vaginal
Yeast Infection
(for non-pregnant women only, if you are pregnant consult your obstetrician) |
| Over the Counter Preparations |
Dosing |
Brands |
| Butoconazole (cream) |
applicator full at bedtime for 3-6 days |
Femstat |
| Clotrimazole (tablets,cream or vaginal inserts) |
applicator full, tablet or insert at bedtime for 3-7 days |
Generic, Mycelex, Gyne-Lotrimin, Sweet'n Fresh |
| Miconazole (cream or vaginal suppository) |
applicator full or suppository at bedtime for 3-7 days |
Generic, Monistat, Femizol |
| Tioconazole (ointment) |
applicator full at bedtime |
Vagistat |
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|
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| By Prescription |
Dosing |
Brands |
| Fluconazole (pills) |
150 mg tablet, single dose |
Diflucan |
| Itraconazole (pills) |
200 mg tablet twice on one day |
Sporanox |
| Nystatin (vaginal tablets) |
one tablet in vagina at night for 2 weeks |
Generic, Mycostatin |
| Terconazole (cream or vaginal suppository) |
applicator full at bedtime for 3 days |
Terazol |
There are a few old treatments for yeast infections
including:
- Painting the inside of the vagina with gentian violet,
messy, but rapidly effective, stains clothing, may need to be repeated.
- Boric acid filled capsules or solution for use in the vagina, very cheap,you
usually have to make your own capsules these days.
- Douching with real yogurt, messy, variably effective.
Prevention
If you seem prone to frequent recurrences (more than 4 times in
a year), then you may want to consider the following:
Be sure to wear cotton underwear; polyester
or nylon holds in the heat and moisture making you more susceptible to re-infection.
Could you be diabetic ? Consider being tested,
especially if you have frequent urination during the day or night, frequent thirst, dry
mouth, crave sugar, had a history of pregnancy related diabetes in your earlier days, are
markedly overweight, or have a history of diabetes in your parents or brothers and
sisters.
Consider having both you and your sexual partner treated with
Diflucan®, Sporanox®, or Ketoconazole. A male partner may need to use an antifugal cream
on the head of the penis routinely.
If you have had recent yeast (candida) in your mouth consider
a course of pills to try and remove any resovoir of yeast from your gut or rectum.
Wash your underwear well with hot bleachy water, consider
microwaving your cotton underwear for five minutes in the microwave.
If you have any further questions feel free to contact me in the
office.
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