Yeast infections: Diagnosis and treatment

Source: Best Health Magazine, November/December 2008

Up to 75 percent of women will have at least one vaginal yeast infection during their life. However, many women treat themselves when they don’t actually have one, according to a 2008 study from the Saint Louis University School of Medicine.

‘When a woman feels itchy or ‘burny’, it could be bacterial vaginosis, which requires antibiotics, or simply irritation from a common irritant such as a scented bath gel,’ says Susan Hoffstetter, a women’s health nurse practitioner and faculty member at the university.

What should you do if you suspect you have a yeast infection? If you have never been diagnosed with one, are pregnant or have recurring vaginal irritation, get checked by your healthcare provider. But if you’ve been diagnosed in the past and recognize the symptoms, it’s fine to use an over-the-counter kit containing an antifungal agent, which comes as a suppository or cream in one-, three- and seven-day formulations. The active ingredient is either miconazole or clotrimazole.

‘I usually recommend the three-day regimen,’ says Shelley Woloshyn, a Saskatoon pharmacist. ‘Women often don’t use the seven-day kits for the entire time, which compromises the effectiveness.’

Some women prefer a more convenient prescription medication called Diflucan (fluconazole), a single-dose capsule taken by mouth. It isn’t suitable for women who are pregnant or who have liver problems. The oral and the vaginal treatments for yeast infections work equally well, according to a 2007 survey by researchers at the Ottawa Health Research Institute of 19 clinical trials.

Talk to your doctor if you have diabetes (predisposing you to yeast infections caused by a yeast strain that does not respond to ‘azole’ medications) or are not responding to treatments.

While many websites and a number of studies say that eating yogurt or taking probiotic supplements are also cures, some experts aren’t convinced. Says Dr. Cherie LeFevre, an associate professor of women’s health at Saint Louis University School of Medicine who co-directs a vulvar and vaginal disease clinic, ‘They haven’t been definitively proven to have an impact.’ But, she says, they certainly can’t hurt.

Signs of a yeast infection

Symptoms include burning, redness and swelling, pain during urination or sex, and a thick white odourless discharge. The infection is caused by an overgrowth of vaginal yeast (typically Candida albicans) that occurs when the pH balance of the vagina changes’often due to shifting hormones (from pregnancy, birth control pills or an oncoming period) or antibiotics.

Preventing yeast infections

Maintain a healthy vulvar and vaginal environment, advises LeFevre. Limit the chemicals that come into contact with your vagina:

• Consider skipping scented feminine hygiene products, soaps and dryer sheets, and using laundry detergent without fragrance.
• Don’t douche.
• To allow your vagina to ‘breathe,’ wear cotton undies, and don’t use a panty liner if you’re not menstruating.
• Cancel your Brazilian wax, too. ‘Hair is good!’ LeFevre says. ‘It’s a protective barrier for the skin and keeps it healthy.’

This article was originally titled "The Truth About Yeast Infections," in the November/December 2008 issue of Best Health. Subscribe today and never miss an issue!