Vaginal Yeast Infection
It's an itchy feeling your wife (or daughter) may notice at first.
Maybe, it's that her jeans are too tight, or clitoral/labial adhesions, or a change in menstrual hygiene or vaginal hygiene habits.... even maybe changing a bath soap or laundry detergent may cause your wife's (or daughter's) vulvovaginal area to begin itching. Any of these may have something to do with vulvovaginal itch and/or irritation. But if the itch keeps getting itchier, even when her tight-fitting jeans have been off for awhile, then there's something else involved.
That something else could very well be a fungus whose technical name is Candida, and which causes what is often called a "yeast" infection. Such infections are most common in teenage girls and women aged 16 to 35, although they can occur in girls as young as 10 or 11 and in older women (and less often, in men and boys as well). You do not have to be sexually active to get a yeast infection.
The Food and Drug Administrationnow allows medicines that used to be prescription-only to be sold without aprescription to treat vaginal yeast infections that keep coming back. But beforeyou run out and buy one, if you've never been treated for a yeast infection youshould see a doctor. Your doctor may advise you to use one of theover-the-counter products or may prescribe a drug called Diflucan (fluconazole).FDA recently approved the drug, a tablet taken by mouth, for clearing up yeastinfections with just one dose.
Though itchiness is a main symptomof yeast infections, if you've never had one before, it's hard to be sure justwhat's causing your discomfort. After a doctor makes a diagnosis of vaginalyeast infection, if you should have one again, you can more easily recognize thesymptoms that make it different from similar problems. If you have any doubts,though, you should contact your doctor.
In addition to intense itching,another symptom of a vaginal yeast infection is a white curdy or thick dischargethat is mostly odorless. Although some women have discharges midway betweentheir menstrual periods, these are usually not yeast infections, especially ifthere's no itching.
Other symptoms of a vaginal yeastinfection include:
Candida is a fungus often presentin the human body. It only causes problems when there's too much of it. Theninfections can occur not only in the vagina but in other parts of the body aswell--and in both sexes. Though there are four different types of Candida thatcan cause these infections, nearly 80 percent are caused by a variety calledCandida albicans.
Many Causes
The biggest cause of Candidainfections is lowered immunity. This can happen when you get run down from doingtoo much and not getting enough rest. Or it can happen as a result of illness.
Though not usual, repeated yeastinfections, especially if they don't clear up with proper treatment, maysometimes be the first sign that a woman is infected with HIV, the virus thatcauses AIDS.
FDA requires that over-the-counter(OTC) products to treat yeast infections carry the following warning:
"If you experience vaginalyeast infections frequently (they recur within a two-month period) or if youhave vaginal yeast infections that do not clear up easily with proper treatment,you should see your doctor promptly to determine the cause and receive propermedical care."
Repeated yeast infections can alsobe caused by other, less serious, illnesses or physical and mental stress. Othercauses include:
Sometimes hot, humid weather canmake it easier for yeast infections to develop. And wearing layers of clothingin the winter that make you too warm indoors can also increase the likelihood ofinfection.
"Candida infections are notusually thought of as sexually transmitted diseases," says Renata Albrecht,M.D., of FDA's division of anti-infective drug products. But, she adds, they canbe transmitted during sex.
The best way not to have to worryabout getting yeast infections this way is not to have sex. But if you do havesex, using a condom will help prevent transmission of yeast infections, just asit helps prevent transmission of more commonly sexually transmitted diseases,including HIV infection, and helps prevent pregnancy. Teens should always use alatex condom if they have sex, even if they are also using other forms of birthcontrol. (See "On the Teen Scene: Preventing STDs" in the June 1993FDA Consumer.)
If one partner has a yeastinfection, the other partner should also be treated for it. A man is less likelythan a woman to be aware of having a yeast infection because he may not have anysymptoms. When symptoms do occur, they may include a moist, white, scaling rashon the penis, and itchiness or redness under the foreskin. As with females,lowered immunity, rather than sexual transmission, is the most frequent cause ofgenital yeast infections in males.
OTC Products
The OTC products for vaginal yeastinfections have one of four active ingredients: butoconazole nitrate (Femstat3), clotrimazole (Gyne-Lotrimin and others), miconazole (Monistat 7 and others),and tioconazole (Vagistat). These drugs are in the same anti-fungal family andwork in similar ways to break down the cell wall of the Candida organism untilit dissolves. FDA approved the switch of Femstat 3 from prescription to OTCstatus December 1996 and a similar switch for Vagistat in February 1997. Theothers have been available OTC for a few years.
When you visit the doctor the firsttime you have a yeast infection, you can ask which product may be best for youand discuss the advantages of the different forms the products come in: vaginalsuppositories (inserts) and creams with special applicators. Remember to readthe warnings on the product's labeling carefully and follow the directions.
Symptoms usually improve within afew days, but it's important to continue using the medication for the number ofdays directed, even if you no longer have symptoms.
Contact your doctor if you have thefollowing:
Candida infections in the mouth areoften called "thrush." Symptoms include creamy white patches thatcover painful areas in the mouth, throat, or on the tongue. Because otherinfections cause similar symptoms, it's important to go to a doctor for anaccurate diagnosis.
Wearing artificial fingernailsincreases the chance of getting yeast infections under the natural fingernails.Fungal infections start in the space between the artificial and natural nails,which become discolored. Treatment for these types of infections--as well asthose that occur in other skin folds, such as underarms or between toes--requiredifferent products, most of which are available only with a doctor'sprescription.
Knowing the causes and symptoms ofyeast infections can help you take steps--such as giving those tight jeans arest--to greatly reduce the chances of getting an infection.
And, if sometimes prevention isn'tenough, help is easily at hand from your doctor and pharmacy.
Bacterialvaginosis, also called BV is the most common vaginal infection in women ofchildbearing age. It happens when the normal balance of bacteria in the vaginais disrupted and replaced by an overgrowth of certain bacteria. The vaginanormally contains mostly “good” bacteria, and fewer “harmful” bacteria.BV develops when there is an increase in “harmful” bacteria and fewer“good” bacteria.
Thecause of BV is not understood. It can develop when something, like sexualcontact, disrupts the balance between the good bacteria that protect the vaginafrom infection and the harmful bacteria that don't. It is not clear what rolesexual activity plays in the development of BV, but BV is more common amongwomen who have had vaginal sex. But BV is not always from sexual contact. We doknow that certain things can upset the normal balance of bacteria in the vaginaand put you more at risk for BV:
Having a new sex partner or multiple sex partners
Douching
Using an intrauterine device (IUD) for birth control
Not using a condom
Wealso know that you do not get BV from toilet seats, bedding, swimming pools, orfrom touching objects around you.
Womenwith BV may have an abnormal vaginal discharge with an unpleasant odor. Somewomen report a strong fish-like odor, especially after sexual intercourse. Thedischarge can be white (milky) or gray and thin. Other symptoms may includeburning when urinating, itching around the outside of the vagina and irritation.However, these could be symptoms of another infection too. Some women with BVhave no symptoms at all.
Thereis a test to find out if you have BV. Your doctor takes a sample of fluid fromyour vagina and has it tested. Your doctor may also be able to see signs of BV,like a grayish-white discharge, during an examination of the vagina.
BVis treated with antibiotics, which are medicines prescribed by your doctor. Yourdoctor may give you either metronidazole or clindamycin. Generally, male sexpartners of women with BV do not need to be treated. You can get BV again evenafter being treated.
Allpregnant women with symptoms of BV or who have had a premature delivery or lowbirth weight baby in the past should be tested for BV and treated if they haveit. The same antibiotics that are used to treat non-pregnant women can be usedsafely during pregnancy. However, the amount of antibiotic a woman takes duringpregnancy may be different from the amount taken if not pregnant.
Inmost cases, BV doesn't cause any problems. But some problems can happen if BV isuntreated.
Pregnancy problems. BV can cause premature delivery and low birth weight babies (less than five pounds).
PID. Pelvic inflammatory disease or PID is an infection that can affect a woman's uterus, ovaries, and fallopian tubes, which carry eggs from the ovaries to the uterus. Having BV increases the risk of getting PID after a surgical procedure, such as a hysterectomy or an abortion.
Higher risk of getting other STDs. Having BV can increase the chances of getting other STDs, such as chlamydia, gonorrhea, and HIV. Women with HIV who get BV increase the chances of passing HIV to a sexual partner.
BVis not well understood by scientists, and the best ways to prevent it areunknown. What is known is that BV is associated with having a new sex partner orhaving multiple sex partners. Follow these tips to lower your risk for gettingBV:
Don’t have sex. The best way to prevent any STD is to practice abstinence, or not having vaginal, oral, or anal sex.
Be faithful. Have a sexual relationship with one partner is another way to reduce your chances of getting infected. Be faithful to each other, meaning that you only have sex with each other and no one else.
Reprinted with permission from FDA
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