Girl To Girl: Vol. 2

How To Recognize and Treat a Yeast Infection

Concerned you may have a yeast infection? You're far from alone. Yeast infections (also known as thrush, monilia, vaginal candidiasis, vulvovaginal candidiasis, and candidal vaginitis) affect 70 percent of us at some point in our lives — and an unlucky eight percent deal with recurrent infections. In the US alone, yeast infections are responsible for some 1.4 million outpatient visits every year, making them the second most common type of vaginal infection. Because many people never visit the doctor when they have a yeast infection, the true incidence is probably much higher.

All that said, knowing the statistics doesn't help much when it's you who's dealing with the symptoms. No matter how common they are, yeast infections can be a frustrating (and itchy!) experience, and there's a lot of misinformation out there about the best way to clear them up. Here's how you can identify a yeast infection and stop it in its tracks.

What Are Yeast Infections?

Yeast infections are caused by a tiny fungus called candida, which normally lives in the body undetected. If you looked at the body under a microscope, you might find small amounts of candida in the mouth, throat, and gut, and on the skin. And when it comes to vaginas, as many as 20 percent of people have candida there that's not causing symptoms.

While our body normally has ways of keeping this fungus in check, sometimes our lines of defense break down, and candida starts to multiply out of control. The result is an infection: candidiasis.

Vaginal candidiasis is unpleasant, itchy, and sometimes painful, and it can certainly be a buzzkill in the bedroom. The good news is that it isn't dangerous, and in most cases, it can be easily treated.

What Are The Symptoms?

Most commonly, you may notice itching, burning sensations around the vulva and vagina. You might experience pain during sex or while peeing, and there may be a thick, usually odorless white or yellow-tinged discharge that looks a bit like cottage cheese.

These symptoms can range from subtle to severe, and they won't all be present every time. In severe cases, there may be some swelling and redness and fissures (small cracks) that feel like paper cuts in and around the vulva and vagina. Needless to say, by the time the infection reaches this stage, you're likely to be pretty miserable.

What Are The Risk Factors?

Because the growth of candida is linked to higher estrogen levels, it's most common in younger people, as well as those taking some types of hormonal birth control (any type that throws off your natural balance of estrogen and progesterone). It's also commonly seen during pregnancy and among postmenopausal people on hormone replacement therapy whose estrogen levels are being artificially raised. Another risk factor is antibiotics. While antibiotics are great for clearing up bacterial infections caused by bad bacteria, they can also disrupt the natural balance of good bacteria that prevents candida fungus from overgrowing.

You are more likely to get a yeast infection if your immune system has taken a dip (for instance if you're very stressed or run down), or if you have diabetes that isn't well-managed. Yeast may be present in your sex partner's mouth (you've heard of thrush in babies), and receiving oral sex could set up yeast overgrowth in your vagina. If that happens consult with your health care professional about ways to prevent this.

There are other factors that are more in our control, like clothing choices! You may love your tight, synthetic underwear, but unfortunately so does candida. Sweaty gym clothes is another culprit — it creates the kind of warm, moist environment candida thrives in — so make sure to get out of those wet clothes as soon as you can after exercising.

That's not to say that a yeast infection means you've been unhygienic. In fact, you may have been too clean, in the sense that certain soaps and shower gels can aggravate the problem. Because the vagina is self-cleaning, you don't need to douche — or really to put any scented products near that area. And although yeast infections are not considered STIs, some people do find sex to be a trigger, particularly if you have used spermicides or received oral sex.

What Should You Do If You Have Symptoms?

Because there are over-the-counter medications available for yeast infections, it can be tempting to stock up and hope for the best. It's best to hold off on doing this unless you're really sure it's a yeast infection (and have had one before), as many other conditions present with similar symptoms.

In one small study from the journal Obstetrics & Gynecology, only a third of study subjects who purchased these medications had actually self-diagnosed correctly — which means a lot of people are taking anti-fungal drugs when they shouldn't be. That's why it's best to visit a medical professional, so they can do an examination and swab test. Pelvic exams aren't anyone's idea of a good time, but they are the best way to get the right diagnosis and get started on the path to a full recovery.

How Are Yeast Infections Treated?

Forget the old wives' tales — yoghurt, garlic, and other home remedies haven't been shown to help. Anecdotally, some people swear by inserting a garlic clove into their vagina or adding vinegar to their bathtub. However, there's no scientific evidence to support this, and (unless your alternative remedy of choice is simply to eat a lot of yoghurt) you may end up doing more harm than good.

Antifungal medications, on the other hand, have been shown to reliably clear up yeast infections. You might be prescribed a cream, pills, or suppository, either as a short course of medication or a one-time thing. You may also need a topical ointment to help with the swelling, itching and pain. Ointments are more soothing than creams which will often burn irritated, raw skin.

If you're generally healthy and the infection is uncomplicated, all these forms of treatment should work equally well. Your doctor may also recommend a different course of action if the problem is severe or keeps coming back.

What Else Could It Be?

If you've recently been on antibiotics, chances are that your clumpy discharge, itching and burning is a yeast infection, but if you have symptoms and you don't have a classic cause you should see your health care professional for a definite diagnosis.

There are other conditions that cause similar symptoms:

- Vulval Dermatitis — caused by an allergic reaction or an irritant, symptoms include chronic itching and a rash

- Genital Herpes — a sexually transmitted infection, it can cause blistering and ulceration of the skin and be itchy and painful

- Bacterial Vaginosis — this is the most common vaginal infection, and it's caused by a bacterium rather than a fungus. The main symptom is a strong-smelling grayish, thin vaginal discharge.

- Lichen Sclerosis — most common in postmenopausal people, this is a skin condition, not an infection, that can cause itching, redness, and pain.

- Urinary Tract Infections — symptoms include pelvic pain and a frequent need to urinate. The burning sensation with urination may be similar to a yeast infection.

- Vestibulitis — This causes a severe stinging, burning pain at the entrance to the vagina during sex and sometimes during everyday activities.

All of these conditions can and should be treated — so whether it's a yeast infection or something else, you owe it to yourself to get the right diagnosis and medication.

A word of warning: Failing to treat a yeast infection properly can just make it worse, increasing the irritation and inflammation. This can take weeks to fully heal, so it's best to nip the problem in the bud. Although yeast infections can be a miserable experience, they should be temporary and they are not dangerous. So seek advice from your doctor and wave goodbye to that itch for good.