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
     
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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