Vaginal yeast infection

The symptoms can range from mild to moderate. Some common symptoms of a yeast infection include:

• Itching and irritation
• Redness and swelling
• Rash
• White, thick discharge resembling cottage cheese

The severity of symptoms depends on the duration of the untreated infection. If left untreated for an extended period, it may lead to more serious health problems, such as:

• Abnormal vaginal discharge (thick, white, odor-free discharge with a cottage cheese appearance)
• Itching or soreness of the vagina
• Vaginal rash
• Pain during sexual intercourse
• Watery vaginal discharge
• Pain or burning when urinating

If left untreated or if there are any risk factors, it can lead to a complicated yeast infection with symptoms such as:

• Persistent or multiple yeast infections per year
• Swollen or irritated vaginal tissue
• Itching leading to cracks, tears, or sores

In many people, Candida fungus is harmless. However, certain conditions may trigger the yeast to cause an infection. Here are some of the most common causes of yeast infections:

• Hormonal changes: Hormonal imbalance, especially in sex hormones like estrogen and progesterone, may affect the balance of fungus and other bacteria in the vagina, causing a yeast infection. This can also occur during pregnancy, breastfeeding, and menopause (if you are on hormone replacement therapy or HRT).
• Diabetes: In women with uncontrolled diabetes, there is a higher risk of vaginal yeast infection because excess glucose can serve as a food medium for yeast. Fungi can also grow in any warm, moist fold of skin, such as between fingers and toes, under breasts, and in or around sex organs.
• Poor hygiene: Poor hygiene and infrequent bathing can allow yeast to build up in the crevices of the skin, leading to growth in sweaty and moist areas, which can result in an infection.
• Tight clothing: Clothes, including undergarments that are too tight or made of non-breathable fabric, can contribute to the growth of yeast.
• A weakened immune system: An immune system compromised by disorders like HIV or medications that suppress the immune system, such as steroids and chemotherapy, can create opportunities for yeast and fungus to grow unchecked, causing a yeast infection.
• Medications: Taking antibiotics for infections like urinary tract infections can kill beneficial bacteria, allowing space for yeast to grow. Certain medications, while necessary, can weaken the immune system and increase the risk of yeast infections. Specifically, corticosteroids are used in treating arthritis, asthma, autoimmune diseases, and allergic reactions, increasing the chance of candidiasis. Tumor necrosis factor (TNF) inhibitors, used in the treatment of autoimmune diseases such as rheumatoid arthritis and psoriasis, can also increase the risk of histoplasmosis, an infection caused by the fungus Histoplasma, which thrives in soil containing large amounts of bird or bat droppings.
• Sexual intercourse: Although not common, a person with an active yeast infection can transmit the infection to sexual partners through unprotected genital or oral contact. Engaging in sexual activity during a yeast infection can exacerbate symptoms and delay the healing process.
• Stress: Ongoing stress can lead to elevated levels of cortisol, impairing the immune system's ability to fight infections and prolonging a yeast infection. Both chronic stress and reduced antioxidant capacity are risk factors for recurrent vaginal yeast infections.

• Pregnant
• Using hormonal contraceptives such as birth control pills
• Having uncontrolled diabetes
• Taking or having recently taken antibiotics or immunosuppressive medications, including steroids or those used during chemotherapy
• Having a weakened immune system due to HIV infection

To diagnose vaginal yeast infection, the common diagnostic steps include:

1. Medical history
   A doctor will discuss all the obvious symptoms, the level of severity, the duration of time a person has been experiencing the symptoms, and also note down the complete medical history to date.
2. Physical examination
   Appearances of rashes on the vaginal folds and reddened skin rashes from the body are indicative of a yeast infection. In some cases, vaginal yeast infection can cause a clumpy white discharge. However, the discharge alone is not enough to diagnose a vaginal yeast infection. The doctor must also conduct a few lab tests to determine whether yeast is present in the vaginal secretions.
3. Lab tests
   The type of test depends on the location of your symptoms:
   • The standard test is to diagnose a sample of vaginal fluid to determine the type of fungus causing the yeast infection. Identifying the fungus can help the doctor prescribe a more effective treatment for recurrent yeast infections. The microscopic examination looks for clue cells (vaginal cells studded with bacteria). Gram staining is usually performed to differentiate good bacteria from bad bacteria; this lab test checks for imbalances in the vaginal flora.
   • A pelvic examination is done to check the extent of the yeast infection.
   • A pH test is done to check for vaginal acidity. It measures how acidic or alkaline your vagina is on the pH scale. A healthy vaginal pH range is between 3.8 to 4 and is moderately acidic so that it can actively fight bacteria. When your vaginal pH is above 4, it is less acidic, making it easier for bacteria and yeast to thrive. If you are experiencing itching, burning, and discomfort and your vagina has a pH of 4.5-5.0, you may be experiencing a yeast infection.
4. Molecular tests
   Nucleic acid amplification test (NAAT) can be used to identify small amounts of DNA or RNA in test samples. This test can be used to identify bacteria, viruses, and other pathogens even when present in very small amounts. The urine sample is collected for NAAT testing. This test is less useful for diagnosing a yeast infection than it is widely used for identifying sexually transmitted infections.
5. Culture test
   A culture test can definitively diagnose a yeast infection. This is done by extracting cells from the vagina with the help of a swab and providing a proper sterile medium for the growth of yeast. If the infection is present, yeast will grow; if not, no growth will be found in the medium.

1. Wearing breathable undergarments: Cotton is the best choice of fabric as it doesn’t hold onto heat or moisture. It helps in keeping you dry and can prevent vaginal or genital yeast infections.
2. Wear loose clothes: Wearing tight-fitted clothes like jeans, skirts, underwear, yoga pants, and tights can boost body temperature and increase the amount of moisture around the private parts, raising the chances of yeast infection.
3. Avoid douching: The acidic environment protects the vagina from infections or irritation. Feminine hygiene products like douches can disrupt the balance of bacteria in the vagina by removing some of the beneficial bacteria that help fight infections.
4. Changing wet clothes immediately: Sitting in a wet bathing suit after swimming or damp workout clothes after the gym is not advised, as moist and wet clothes have a high potential for causing yeast infections.
5. Limiting the use of antibiotics: Taking antibiotics for infections like colds and flu can kill off beneficial bacteria, allowing yeast to grow.
6. Maintaining good personal hygiene: During the menstrual cycle, the risk of yeast infection increases. Changing sanitary napkins, tampons, and undergarments frequently can help prevent recurrent infections.
7. Managing diabetes and high blood pressure: Higher blood pressure levels can contribute to yeast infections; it can be controlled by limiting salt intake and managing stress. Diabetes can be managed by monitoring sugar intake.
8. Drinking probiotics and eating yogurt: These contain active live cultures of beneficial bacteria and yeast that help replenish the body’s flora and maintain a healthy balance, potentially preventing yeast infections. Taking supplements with Lactobacillus acidophilus may also be beneficial.

Vaginal infections are the most common type of yeast infection. Here are a few more tips to manage them better.

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The treatment for yeast infection depends on age, overall health, the extent of the infection, and other factors. It also varies based on whether the infection is simple or complicated. Simple infections are typically resolved within a week using readily available oral or vaginal antifungal medications, while complicated yeast infections require assistance from a general practitioner. A course of antifungal cream and medications is generally needed for 7 to 14 days. The treatment aims at:

• Creating a natural environment in the body where Candida cannot overgrow
• Providing the body with the key nutrients needed to repair the damage caused by the infection

1. Candida Diet

The Candida diet is essentially a low-carbohydrate, low-sugar, anti-inflammatory diet that promotes good gut health. The following foods should be added or avoided to maintain a healthy lifestyle without yeast infections:

• Protein: Lean cuts of protein and eggs are essential sources.
• Remove Problem Foods: Eliminate foods that feed Candida and encourage its growth, such as sugar, white flour, yeast, and alcohol. The diet should focus on vegetables and gluten-free foods like brown rice and millet.
• Low Sugar Fruits Only: During peak infection, it may be necessary to avoid fruits, as they convert to sugar and can trigger yeast growth. Selective fruits like berries, lime, lemon, green apples, and avocados are acceptable.
• Include Green Veggies: Green vegetables such as cucumber, spinach, asparagus, and capsicum should be consumed fresh and raw.
• Fermented Foods: Fermentation converts carbohydrates into organic acids. Yogurt is an excellent example of fermented food beneficial for digestion.
• Replacing All Drinks with Water: It is advisable to replace all beverages with fresh water and avoid sugary drinks, fizzy drinks, fruit juices, milkshakes, and caffeinated beverages.

2. Anti-Candida Supplements

• Probiotics: Yeast infections often result from imbalances in gut flora. Probiotic supplements help restore these imbalances by populating the intestine with beneficial organisms. Examples include yogurt and kefir, which is a better source of probiotics than yogurt.
• Antifungal Supplements: These contain ingredients that can directly or indirectly kill Candida and yeast in the body. Examples include tea tree oil, oregano oil, and coconut oil, along with natural extracts like echinacea and astragalus that have immune-boosting and antifungal properties.

3. Medications

The treatment for vaginal yeast infections depends on the severity and frequency of infections. For mild to moderate symptoms and infrequent episodes, a doctor might recommend:

• Short-term vaginal therapy for three to seven days, which usually clears up the infection. Medications are available in ointments, creams, tablets, and suppositories, with common examples including miconazole and terconazole.
• Oral antifungals such as a single dose of fluconazole or intravaginal treatments available over-the-counter (OTC) for one day or a three-day regimen.

For severe symptoms and frequent yeast infections, a doctor may recommend:

• Long-course vaginal therapy taken for two weeks, followed by once a week for six months. This includes intravaginal azole therapy, often administered for weeks to months. Oral azole drugs like ketoconazole, fluconazole, and itraconazole represent significant advances in systemic antifungal therapy.
• In complicated cases, the dose of fluconazole 150 mg may be increased to be taken orally once every three days for three doses.
• In cases of azole-resistant infections, a doctor might recommend a boric acid capsule inserted into the vagina, which is only used to treat Candida fungus resistant to standard antifungal agents.

In many cases, yeast infections can be easily and successfully treated at home. This is done with either over-the-counter products or alternative therapies.

1. Boric acid: It is a powerful antiseptic with mild antifungal properties useful for treating yeast infections that are resistant to other remedies.
   Tip: Dilute some boric acid with water, apply the diluted solution to the affected area, and rinse it. This can be done for two weeks to eliminate the yeast infection.
2. Apple cider vinegar: One of the most popular remedies for yeast infection is an apple cider vinegar bath. The acidic component of vinegar can eliminate harmful microorganisms, including yeast.
   Tip: Prepare a hot bath by adding some vinegar. Soak your body in this bath for about an hour to help lessen skin irritation and itching.
3. Tea tree oil: This essential oil is used to kill fungi, bacteria, and viruses. It has powerful natural antifungal properties that can aid in the treatment of yeast infections.
   Tip: Dilute organic tea tree oil with water or one teaspoon of olive oil and rub the diluted oil over the affected skin area several times a day.
4. Coconut oil: It possesses effective antifungal properties that can kill the fungi responsible for yeast infections. Pure coconut oil can be applied directly to the affected area.
   Tip: Make a mixture of equal amounts of coconut oil and cinnamon oil. Apply it to the affected skin area to control the growth of the infection.
5. Calendula: This herb has potent antifungal and anti-inflammatory properties that can help treat yeast infections.
   Tip: Crush two to three calendula leaves and apply them topically onto the infected area two to three times a week.
6. Cranberries: They contain both antibacterial and antifungal properties and can be used to combat the fungi responsible for yeast infections.
   Tip: Drinking unsweetened cranberry juice several times a day can help speed up the healing process and provide effective results within a short time.
7. Yogurt: Lactobacillus acidophilus, a friendly strain of bacteria present in yogurt, can control the growth of infections in the body.
   Tip: Incorporate plain, unsweetened yogurt into your daily diet to help increase the gut microbiome and reduce yeast levels in the body.

Some complications occurring due to yeast infection are:

• Spread to other organs: The most common complication of a yeast infection is the spreading of the infection to other organs. In some cases, the yeast cells enter the bloodstream and reach various organs, leading to serious complications such as endocarditis, meningitis, and arthritis. The organs commonly affected by Candida include the lungs, liver, heart, brain, joints, and intestines.
• Pregnancy complications: Vaginal yeast infections can sometimes cause problems during pregnancy. Pregnant women with yeast infections may experience preterm labor and preterm rupture of membranes.
• Urinary tract candidiasis: Candida infection can spread to the urinary tract. One rare complication of a yeast infection is renal candidiasis, which occurs due to the spread of infection through the bloodstream to renal cells.
• Recurrent infections: If the infection is not treated properly, there is a chance that it may recur. Recurrent yeast infections can be disruptive to a person's well-being and may cause difficulties in relationships if they disrupt normal sexual activity.

Several alternative therapies emphasize yeast infection treatment on the elimination of the causes, rather than eliminating the fungus.

Aromatherapy

• Aromatherapy is the practice of using natural oils extracted from flowers, bark, stems, leaves, roots, or other parts of a plant to alleviate the itching and rashes associated with yeast infection. Tea tree oil is widely used to treat various infections and is considered one of the more powerful infection-fighting oils. Other oils such as clove oil, oregano oil, and lavender oil can also be utilized. For vaginal infections, 5 to 8 drops of essential oil can be mixed with one liter of water. Use this mixture for vaginal douching.

Chinese Medicine for Yeast Infection

• Acupuncture, herbal therapy, and dietary and lifestyle changes offer methods to correct energy imbalances and enhance the body's defenses. Acupuncture and Chinese medicine can also assist in combating stress and correcting the body’s imbalances. Additionally, it helps the liver and kidneys eliminate toxins released by dead yeast.

Herbal Medicine

• Several herbs can eliminate excess fungus, while others are effective in strengthening the immune system. Goldenseal is one of the most commonly used herbs for its immune-boosting properties and is believed to stabilize the overgrowth of fungus. Other useful herbs for eliminating yeast infection include calendula, thyme, rosemary, chamomile, and ginger. These herbs can be taken in the form of capsules, extracts, or added to tea.

Mind/Body Medicine for Yeast Infection

• Chronic stress may lead to excessive yeast in the body. It is recommended to relax the mind and reduce stress through meditation. Joining social groups and communities and engaging in social activities can help modulate the mind and reduce stress.

If you frequently have yeast infections, you should discuss them with your healthcare provider. It is important to remember that an early diagnosis of a yeast infection can help clear up the infection with antifungal medication and can prevent further complications.

Make sure that the person understands the diagnosis and its health implications.

Regular checkups are required to evaluate the current infection and ensure the person is receiving the appropriate treatment to help reduce the infection.

Routine blood sugar level evaluations are necessary in cases of yeast infection, as yeast tends to overgrow in elevated sugar levels.

Discuss any possible hormonal changes due to menopause, pregnancy, and hormone replacement therapy. These changes can lead to hormonal imbalance and increase the risk of developing Candida yeast infections.

A test for HIV/AIDS is recommended if a person is experiencing frequent yeast infections.