Fungal infection of the vagina caused by Candida is referred to as vaginal yeast infection. It is estimated that around 75% of women suffer from Candidiasis or yeast infection once in their lifetime. Thick, foul-smelling discharge from vagina with cottage cheese appearance is a sign of vaginitis.
Practices such as douching can disturb the natural flora of vagina leading to unchecked candida growth. Pregnancy, high carbohydrate diet, diabetes, improper moisture retention are all precipitating factors for vaginitis.
Including probiotics in diet, maintaining adequate intimate hygiene, practicing safe sex can help prevent the occurrence of vaginal infection. Let us understand in detail about vaginal yeast infection, the signs and symptoms of vaginitis and how to avoid it.
What is vaginitis?
Candida is a yeast (fungus) leading to most fungal infections pertaining to the human body. Around 20 different species of the yeast is found out of which Candida albicans is the most common.
Candida is present in conjunction with the human body. The skin provides a barrier that prevents the entry of this fungus inside our body. A healthy vagina has a flora of various strains of bacteria and fungus that stays in synergism with the body.
Lactobacillus bacteria keeps the levels of Candida albicans in check. Since Candida is an opportunistic infection, an imbalance in the bacteria and fungus groups leads to the aggressive growth of the Candida fungus.
The offending yeast, in this case, is the strain of Candida Albicans which proliferates leading to candidiasis.
What are the types of a vaginal yeast infection?
Infection of the vagina can be of many types.
- Bacterial vaginosis
- Yeast infection
- Sexually transmitted diseases like Chlamydia,
- Gonorrhea Trichomoniasis
- Reactions or allergies also cause vaginitis.
Amongst this, the yeast infection of the vagina is the most common (1). Candidiasis of the vagina or vaginal thrush can also involve the vulva leading to vulvovaginal candidiasis.
Chronic vulvar pain known as vulvodynia gets aggravated by the yeast infection. Candida albicans responds well to antifungal medication.
But around 55 of the cases become recurrent and resistant to common antifungals. These frequent and recurrent cases of thrush are caused by other strains of Candida like Candida glabrata (2).
What are the signs of vaginal thrush?
- Vaginal and vulval itching and vaginal discharge (Cottage cheese like appearance)
- Redness and swelling can also occur.
- Slight bleeding is observed along with pain during vaginal sexual intercourse. During urination pain and burning sensation occurs.
- Aggravated vulvodynia or pain in vulva is seen (3).
- Rash around Vagina and vulva.
- Foul smell from the thick lumpy discharge. A constant urge to urinate.
What causes a vaginal yeast infection?
There are numerous precipitating factors or trigger factors work in unison to cause a vaginal yeast infection.
Disturbance in the ph of the vagina
Vagina has an optimal ph of 5.4; this ph keeps the balance of bacteria and fungus in check. Any disruption in the ph will lead to the proliferation of fungus. Practice such as douching leads to disturbance in the natural flora and hence the ph of the vagina.
Improper moisture retention
Fungi are most commonly found in moist environments. The moist environment provides a breeding ground for Candida albicans increasing their number. Hence the incidence of vaginal candidiasis increases during the rainy season.
In pregnancy, if proper care and hygiene are not maintained, candida overgrowth can lead to vulvovaginal candidiasis (4).
Uncontrolled diabetes leads to increase the level of blood sugar levels and also makes the individual immunocompromised. Candida naturally occurs in the gut and an increase in the blood sugar level fuels the overgrowth of candida (5).
HIV infection leads to immunosuppression that gives leeway to systemic candidiasis. Candida is an opportunistic fungus, the immunosuppression leads to its unchecked growth.
Tight underwear or pantyhose
Candida resides on the skin in and around vagina and vulva. Wearing tight underwear and pantyhose will lead to irritation of the skin leading to abrasion or laceration (6). The Candida albicans then enter the body through this abused skin causing the yeast infection.
High sugar diet
Females consuming high sugar diet give the opportunistic infection carbs to feed on and proliferate. Candidiasis overgrowth is directly related to intake of sugar in your diet.
Hormone replacement therapy, contraceptive pills and corticosteroid medication cause imbalance in the natural flora of the vagina (7). Women with intrauterine tubes are also more prone to develop vaginitis.
Prolonged antibiotic use will decrease the number of harmful bacteria as well as the number of useful bacteria from the body. Lactobacillus bacteria prevents the overgrowth of candida albicans keeping its level in check. Antibiotic abuse will decrease the number of lactobacillus bacteria, which will cause an uninterrupted growth of candida (8).
Infant and mother
During childbirth, Candida albicans can migrate from mothers vagina to the child. This can lead to pseudomembranous oral thrush development in infants.
Since the immunity is not yet developed in the child the only source of receiving immunity for the child is through mother’s milk. The infection then passes back and forth between the mother’s breasts and the baby’s mouth.
Conventional vaginal yeast infection treatments
Most Candidiasis can be treated with either topical or oral antifungal medication. Vaginal pessaries can also be used under the supervision of doctors. Candidiasis is treated by following antifungal medications.
These include, Clotrimazole, Nystatin, Fluconazole, Voriconazole, Amphotericin B.Intravenous fluconazole or echinocandin such as caspofungin are commonly used to treat immunocompromised patients.
In pregnant women, oral antifungal medication is strictly contraindicated. It can lead to a toxic effect on the baby and instead vaginal pessaries or cream should be used.
The infection can last for up few weeks but if it extends beyond that a longer course of treatment is recommended under the guidance of the doctor.
How to prevent a vaginal yeast infection?
The best way to deal with Candidiasis is to prevent its occurrence. Following a few simple rules will help maintain a healthy vagina –
As discussed, the lactobacillus bacteria keeps the growth of candida in check. Lactobacillus is an essential bacteria and to keep the lactobacillus count to optimum try and include a healthy amount of probiotics in the diet.
Lactobacilli count is high in probiotics like yogurt, kimchi, pickles, and shalotta. Including this food in the diet will help maintain the natural flora a pH of the vagina, preventing any infection.
Long-term antibiotic abuse greatly affects the lactobacillus count. Antibiotics should only be taken on prescription and should be accompanied with probiotics. One should try and avoid food high in carbohydrates and sugar.
Douching is the process of washing the inside of the vagina. This practice can cause some serious complications. Bacteria like lactobacillus are necessary to keep the level of other bacteria and fungi in check.
Douching can eliminate these lactobacilli leading to the unchecked growth of other bacteria and fungi (9). The vagina is self-cleaning, so washing the inside of the vagina is not required.
Try and keep baths to a minimum and prefer showers. The bath water can enter vagina during cleansing. Swimming pools should also be avoided during an episode of vaginitis.
While having a shower or bath, try and incorporate essential oils like tea tree oil. Tea tree oil has natural antibacterial and antifungal properties owing to the active ingredient terpene-4-ol.
Practice intimate hygiene
Use protection during intercourse to avoid contraction of disease sexually. Avoid soap and sprays in and around the vagina. Pads and especially tampons should be changed a minimum of 3 times a days.
The scented variant pads and tampon should be avoided. Alternately panty liners can also be used for a shorter duration and towards the end of the cycle.
Replace feminine products often to reduce the chances of candida overgrowth. Avoid use of scented perfumes around the vagina, also scented tampons and pads should be avoided (10).
Avoid vaginal irritants
The skin in and around the vagina is very sensitive. The vagina is self-cleaning and has an acidic ph that keeps the growth of fungi in check. Using harsh alkaline soaps will disturb the pH of the vagina which can lead to irritation of the skin around the vagina.
Shaving, using perfumes, deodorants around vagina will further lead to irritation. Washing the underwear with a harsh detergent can also affect the ph. Wear new underwear made up of natural fibers.
Try and avoid tight and synthetic clothes. Wash underwear in hot water to clean it optimally. Use an intimate wash to maintain the pH of the vagina. Avoid wearing wet clothes like bathing suits for a more extended amount of time.
Exercise improves the circulation throughout the body and minimizes stress. Kegel exercise, the exercise of the pelvic floor will help strengthen the vagina and improve the blood flow around the area.
- Suggested read: Yoga During Pregnancy – An Expert’s Guide
Final words on vaginal yeast infection
Prevention is the best method when it comes to vaginal yeast infection. Avoid any form of irritation in and around the area. Women with diabetes should be regular with their gynecologist. Optimal control of blood sugar level is key to a healthy vagina.
Also, manage stress levels and have a well-balanced diet. Include probiotics in your diet and avoid high sugar and carbohydrate diet. Give attention to intimate hygiene. Use protection during sex and be regular for routine checkups.