7 minute read
yeast is a fungus that lives in your body normally without causing any problems, but a yeast overgrowth can lead to infection. a vaginal yeast infection affects up to three out of every four women at some point, according to the mayo clinic , causing the irritation, discharge and intense itchiness of the vagina and the tissues at the vaginal opening.
healthing spoke with dr. vanessa poliquin , an obgyn and infectious disease expert at the university of manitoba and co-chair of the society of gynecologists of canada’s infectious diseases committee. her research is investigating how bacteria and immune function can impact the vagina and the female reproductive system.
dr. poliquin : yeast infections are one of the most common causes of vaginal discharge and itching. it’s a fungal infection. in north america, the most common species of fungus that causes these infections is candida albicans. that’s not necessarily the same throughout the world. basically, candida albicans lives in our gut. so, if there’s contamination into the vagina, it’s usually from the rectum. and truthfully, if you swabbed and looked for candida in many women’s vaginas you’d probably find it in low quantities. in low levels it’s not a problem — it’s called a colonizer at that point in time. but the problem of a yeast infection occurs when there’s a relative increase in the proportion of micro-organisms in our vagina that is candida and it out-competes the optimal bacterial makeup.
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dr. p.: some women might become symptomatic at a very low level of candida and some have a different kind of environment within their vagina that would require a lot more of a shift to become symptomatic. the whole concept of where the candida goes from colonizer to a problem is different for each person. but it becomes a problem when somebody develops symptoms — typically itching inside the vagina and vaginal discharge. many women describe the vaginal discharge as being white and clumpy, although some women have also described green discharge that is still consistent with a yeast infection. also, women can have pain when they urinate or pain when they’re having intercourse. some women even can have a candida fungal infection on the outside of their labia, like a red rash that kind of looks like a diaper rash. i see that more in women with diabetes, for instance, where they have high levels of sugar in their urine. so, if there’s a spill of that urine onto the skin around the vagina, i see more of the external skin affected rather than just an infection inside the vagina.
dr. p.: about three out of four women at some point in time in their life, typically in their reproductive years, would have a yeast infection. and many of those women would have had two yeast infections. it’s particularly common in a few situations. the first is antibiotics. many women will experience their first yeast infection sometime after taking a course of antibiotics. and that kind of gets back to that concept that yeast being there isn’t the problem. it’s their relative abundance compared to the rest of the normal flora. when you take antibiotics, even though you might be trying to treat strep throat, that antibiotic has the potential to really knock down some of your good bacteria inside your vagina. that’s what allows the imbalance and the movement as a colonizer to a problem. so, women who are taking antibiotics more often are susceptible.
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dr. p.: a lot of women come to my clinic and they’ve read about dietary changes, like avoiding bread and flour. and truthfully, the evidence for dietary avoidance as a way of preventing a yeast infection is not really robust. so, it’s really a lifestyle choice — if you want to stay away from gluten, then do that. but don’t do that only because this is what you think is going to control a yeast infection. i don’t have the right evidence to suggest that’s a good idea.
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dr. p.: there’s over-the-counter options and then there’s prescribed options. the vast majority of the yeast infections that we see can be treated with over-the-counter preparations in two varieties. there’s either the variety that comes as a gel or cream that goes inside the vagina, and depending on different concentrations is dosed for one night or up to seven nights, or there’s an oral pill that you can take. we like to try to direct the antifungal, so the first line is always the topical or intravaginal. but if someone doesn’t like putting a medicine in their vagina, we do have the antifungal pill.
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dr. p.: if you’re struggling, the big thing is really not to self-diagnose. see your doctor and see your nurse if it’s either not getting better or if it just keeps coming back because it might be something different.
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dr. p: when i see someone in clinic and they feel they can finally talk about something or finally get an answer to something that has really not felt appropriate to talk about. that’s the space that i like to create in my clinic. and i feel like i’m succeeding, creating a safe space. coming to our clinic is value-added because it’s that space where we can uniquely and openly talk about things.
for more information about yeast infections, visit healthlinkbc and the cleveland clinic .
