Yeast Infections

Yeast infections are one of the most common vulvovaginal condidtions in women. Although most women experience at least one infection in their lifetime, only about 5% experience trouble with recurrent infection1. Recurrent yeast infections are defined as 4 infections in 12 months. Most experts agree that at least 2 infections should be documented by a practitioner. Research supports that women are only about 35% accurate when asked to self-diagnose a yeast infection.

Symptoms associated with a candidal infection include redness, itching, irritation, burning with urination and pain with intercourse. There may be a thick, clumpy, white discharge. Diagnosis is made by physical exam which includes inspection of the vulva and vagina, collection of wet mount and occasionally obtainment of a vaginal fungal culture. Treatment includes the use of oral (Diflucan) and over-the-counter intra-vaginal anti-fungal products2, 3. Boric acid is an alternative treatment that has been shown in research to be an effective and inexpensive alternative4.

Yeast infections are not caused by sexual activity and are not associated with carriage in the male partner. High sugar diets are also not associated with recurrent . Unfortunately, when the use of acidophilus products has been studied, it has not been shown to be helpful in preventing recurrent infections. Women who are immunocompromised or pregnant often require a longer treatment course and may have more difficulty with recurrence.

By far, albicans is the most common species associated with this type of infection. Less common Candida species are found and can be harder to treat. Examples include , Candida parapsillosis and Sacchromyceses. Using a vaginal culture can be helpful to correctly diagnose the organism and thus allows more directed treatment5.

Most yeast infections easily respond to the use of medications. More resistant cases are further investigated and almost always an effective and reasonable treatment plan is devised with your practitioner.

1. SPINILLO A, PIZZOLI G, COLONNA L, NICOLA S, DE SETA F, GUASCHINO S. Epidemiologic characteristics of women with idiopathic recurrent vulvovaginal candidiasis. Obstet Gynecol 1993;81:721-7. 2. SLAVIN MB, BENRUBI GI, PARKER R, GRIFFIN CR, MAGEE MJ. Single dose oral fluconazole vs intravaginal terconazole in treatment of Candida vaginitis. Comparison and pilot study. J Fla Med Assoc 1992;79:693-6.

The Program in Vulvar Health • OHSU Center for Women’s Health Last updated Nov 2007 • www.ohsuwomenshealth.com/vulva/

3. OSSER S, HAGLUND A, WESTROM L. Treatment of candidal vaginitis. A prospective randomized investigator-blind multicenter study comparing topically applied econazole with oral fluconazole. Acta Obstet Gynecol Scand 1991;70:73-8. 4. VAN SLYKE KK, MICHEL VP, REIN MF. Treatment of vulvovaginal candidiasis with boric acid powder. Am J Obstet Gynecol 1981;141:145-8. 5. NYIRJESY P, SEENEY SM, GRODY MH, JORDAN CA, BUCKLEY HR. Chronic fungal vaginitis: the value of cultures. Am J Obstet Gynecol 1995;173:820-3.

The Program in Vulvar Health • OHSU Center for Women’s Health Last updated Nov 2007 • www.ohsuwomenshealth.com/vulva/