Vaginal yeast infection

The likelihood of developing a vaginal yeast infection increases in women who:

• Are pregnant
• Use hormonal contraceptives
• Have poorly controlled diabetes
• Are currently or have recently been on antibiotics or immunosuppressive drugs
• Have a compromised immune system due to conditions like HIV infection

Diagnosing a vaginal yeast infection generally involves the following steps:

Review of Medical History

The healthcare provider will begin by discussing the patient’s current symptoms, how long they’ve persisted, and their severity. A complete medical history will also be documented to identify any predisposing conditions.

Physical Examination

The doctor will check for visible signs like rashes in the vaginal area or redness of the skin. A thick, white, clumpy discharge may be present, but on its own, it’s not enough for a diagnosis. Further testing is needed to confirm the presence of yeast.

Laboratory Testing

Testing methods may vary depending on where the symptoms are located:

• A sample of vaginal discharge may be examined under a microscope to identify the specific type of yeast, which helps in selecting the most effective treatment, especially for recurrent cases.
• Microscopic evaluation may detect "clue cells," which are vaginal cells coated with bacteria.
• Gram staining helps distinguish between beneficial and harmful bacteria, offering insight into the vaginal flora's balance.
• A pelvic exam assesses the severity of the infection.
• Vaginal pH testing evaluates acidity levels. A healthy pH is between 3.8 and 4.0. If the pH level rises to 4.5–5.0, it may create favorable conditions for yeast overgrowth, often accompanied by symptoms like itching and burning.

Advanced Testing

• Nucleic Acid Amplification Test (NAAT): Although more commonly used for detecting sexually transmitted infections, this test can detect minute quantities of DNA or RNA from pathogens in urine samples.
• Culture Testing: A sample is collected using a swab from the vaginal area. If yeast is present, it will grow in the culture medium, confirming the diagnosis.

Use of Breathable Fabrics

• Opt for cotton underwear as it doesn’t trap heat or moisture, reducing the risk of fungal growth.

Avoid Tight Clothing

• Garments like tight jeans, leggings, or undergarments can raise body temperature and moisture around the genitals, promoting yeast development.

Do Not Use Douches

• The vagina maintains its own protective acidic environment. Products like douches can disrupt this balance by removing helpful bacteria, increasing susceptibility to infections.

Change Wet Clothes Quickly

• Remaining in damp swimwear or workout clothes can increase the risk of yeast infections due to prolonged exposure to moisture.

Minimize Antibiotic Use

• Overuse of antibiotics can destroy healthy bacteria, giving yeast an opportunity to grow unchecked.

Practice Proper Hygiene

• During menstruation, change sanitary products regularly and maintain personal cleanliness to prevent yeast overgrowth.

Control Blood Sugar and Blood Pressure

• Blood sugar levels consistently above 250 mg/dL can foster yeast growth. Managing diabetes and reducing salt intake to control blood pressure can help.

Consume Probiotics and Yogurt

• Foods rich in beneficial bacteria, such as yogurt and other probiotic sources, support healthy flora and may prevent yeast overgrowth. Supplements containing Lactobacillus acidophilus are also helpful.

Specialists to Consult

• Primary Care Physician: Can assess symptoms and begin treatment.
• Gynecologist: Specializes in diagnosing and treating vaginal conditions such as itching and abnormal discharge.
• Candida Specialist: A functional medicine practitioner who investigates recurring infections to determine underlying causes.

Treatment plans depend on the patient’s age, health status, and the extent and recurrence of the infection. Infections may be classified as either simple or complicated.

• Simple Infections: Usually clear within a week using over-the-counter or prescription antifungal treatments, available as oral pills, topical creams, or suppositories.
• Complicated Infections: Require longer treatment under medical supervision. A combination of oral and topical antifungal therapies is generally recommended for 7 to 14 days.

Goals of treatment include restoring a healthy internal environment, eliminating overgrowth of Candida, and promoting healing.

Candida Diet

This diet limits sugar and carbs while focusing on anti-inflammatory foods to encourage gut health.

• Protein Sources: Essential component of the diet includes lean meats and eggs.
• Foods to Avoid: Sugar, refined flour, yeast, and alcohol can stimulate yeast growth and should be avoided. Gluten-free options like brown rice and millet are preferable.
• Fruits with Low Sugar Content: When infection is active, restrict fruit intake. Safe options include berries, lemon, lime, green apples, and avocados.
• Vegetables: Fresh, raw green vegetables like spinach, asparagus, cucumbers, and bell peppers are encouraged.
• Fermented Foods: Help improve digestion and gut flora. Yogurt is an excellent option.
• Hydration: Drink only water. Avoid sugary drinks, juices, milk-based beverages, and limit caffeine, which may elevate blood sugar levels.

Anti-Candida Supplements

• Probiotics: Rebalance gut flora to prevent yeast overgrowth. Examples include kefir (which is often tolerated by lactose-intolerant individuals), buttermilk, and certain cheeses high in calcium, protein, and Vitamin B12.
• Antifungal Supplements: Natural and herbal products like tea tree oil, oregano oil, and coconut oil may help fight fungal infections. Immune-supportive herbs like echinacea and astragalus also possess antifungal properties.

Medications

For Mild to Moderate Cases:

• Short-term therapy (3 to 7 days) using topical or oral antifungals such as miconazole or terconazole can effectively clear infections. Fluconazole may be taken as a single oral dose or through a brief intravaginal regimen, some of which are available over-the-counter.

For Severe or Recurrent Cases:

• Extended treatment for up to two weeks followed by maintenance doses weekly for several months may be needed. First-line treatments include intravaginal azole therapies. Oral antifungals like fluconazole, ketoconazole, and itraconazole are effective for systemic infections. For more resistant cases, fluconazole may be administered in three separate 150 mg doses, spaced three days apart.

In cases where the infection doesn’t respond to standard antifungals, boric acid capsules inserted vaginally may be prescribed. These are strictly for local use and can be toxic if ingested orally.

Several complications can arise if a yeast infection is left untreated or recurs frequently:

Spread to Internal Organs

• A severe complication involves the yeast entering the bloodstream and affecting organs such as the liver, lungs, brain, and heart, possibly causing conditions like meningitis, arthritis, and endocarditis.

Pregnancy-Related Issues

• Yeast infections during pregnancy can sometimes result in early labor or premature rupture of membranes.

Urinary Tract Infections Due to Candida

• The infection can extend to the urinary tract, potentially leading to renal candidiasis—a rare but serious condition caused by candida entering the kidneys through the bloodstream.

Recurrent Infections

• Improperly treated infections can return and become frequent, negatively impacting quality of life and potentially straining intimate relationships.

Some alternative therapies aim to target the underlying causes rather than the yeast itself.

Aromatherapy

Using essential oils derived from various plant parts, aromatherapy can help soothe symptoms like rashes and itching.

Tea tree oil is especially effective, along with clove, lavender, and oregano oils.

Tip: Mix 5–8 drops of essential oil in a liter of water for use as a vaginal rinse.

Traditional Chinese Medicine

Techniques like acupuncture, dietary adjustments, and herbal remedies aim to balance the body's energy and support detoxification through liver and kidney function.

Herbal Medicine

Some herbs help eliminate excess fungi, while others strengthen the immune system. Goldenseal is popular for its immune-enhancing effects and may help stabilize fungal overgrowth.

Herbs such as thyme, rosemary, chamomile, calendula, and ginger can be consumed in teas, capsules, or extracts.

Mind-Body Approaches

Since stress can contribute to yeast overgrowth, mental relaxation is essential. Meditation, social engagement, and stress-reducing activities may help manage and prevent recurring infections.

Vaginal yeast infections are often treatable at home using readily available products or alternative therapies.

Boric Acid

Known for its antiseptic and mild antifungal effects, boric acid can help manage yeast infections that don't respond to standard treatments.

Tip: Mix boric acid with water, apply to the infected area, and rinse off. Continue this routine for two weeks for effective relief.

Apple Cider Vinegar

A vinegar bath is a common home treatment due to vinegar’s acidic nature, which helps eliminate harmful microorganisms like yeast.

Tip: Add apple cider vinegar to a warm bath and soak for about an hour. This may ease itching and irritation.

Tea Tree Oil

This essential oil is renowned for its antifungal, antibacterial, and antiviral properties and may support the treatment of yeast infections.

Tip: Mix a few drops of tea tree oil with water or olive oil and gently apply to the infected area several times dail

Coconut Oil

With its natural antifungal compounds, coconut oil is a beneficial topical remedy for fungal infections.

Tip: Combine coconut oil with an equal amount of cinnamon oil and apply to the affected region to suppress yeast growth.

Calendula

A medicinal herb with notable anti-inflammatory and antifungal effects, calendula can aid in healing yeast infections.

Tip: Crush two to three calendula leaves and apply the paste to the infected area 2–3 times per week.

Cranberries

Their antifungal and antibacterial properties can assist in fighting yeast overgrowth.

Tip: Drink unsweetened cranberry juice several times a day to help accelerate healing.

Yogurt

Containing Lactobacillus acidophilus, a beneficial bacteria, yogurt may inhibit the growth of yeast.

Tip: Incorporate plain, unsweetened yogurt into your diet to promote a healthy microbiome and help control yeast levels.

If you’re dealing with frequent infections, a discussion with your healthcare provider is essential. Prompt diagnosis can ensure effective treatment with antifungals and prevent complications.

Make sure you understand the condition and its potential health impacts. Routine checkups can determine if treatment is working and help monitor progress.

Blood sugar testing is advised since elevated glucose levels can promote yeast growth.

It’s also important to assess any hormonal shifts from menopause, pregnancy, or hormone therapies, as these can increase susceptibility to Candida overgrowth.

If infections are frequent, an HIV/AIDS test may be necessary to check for underlying immunodeficiency.