You Are Feeling Itchy Down There?
The inflammation of the vagina caused by a fungus from the genus Candida is called vaginal candidiasis or vaginal yeast infections or vaginal thrush. The infection usually affects both the vagina and external genitals, in case of the vulvovaginal candidiasis. The presence of other protective microorganisms in the vagina, especially bacteria Lactobacillus, maintains low and harmless number of fungi on the mucous membranes of the vagina. When this ratio is disrupted and there is a significant multiplication or increase in the number of fungi, the infection occurs.
The genus Candida is a heterogeneous genus of fungi containing about 200 species. Only a few fungi from the genus cause inflammation of the genital organs. The most common cause (90%) is Candida Albicans or monilia.
Fungal vaginal infection is, beside bacterial vaginosis, the most common cause of inflammation of the female genital organs. Approximately 75% of sexually active women have had this infection at least once in their lives, and half of them have experienced problems caused by this infection more than once. In about 10% of women candidiasis is often repeated as recurrent infection.
Although candidiasis is not considered a sexually transmitted disease, the cause can be transmitted by vaginal, oral or anal intercourse with an infected person; 12-15% of men developed symptoms such as tingling, itching and rash (balanoposthitis) after sexual intercourse with an infected woman.
The most common and most prominent symptom in vulvovaginal candidiasis is itching, burning and vaginal discharge that may be very abundant, white, thick, cheesy, of a specific sweet smell. Lining of the vagina and of the small and large lips is red, swollen, and painful. The pain occurs during sexual intercourse, urination and when walking. Itching and scratching worsen the symptoms and lead to damage of the skin and mucous membranes. The symptoms can be mild and unnoticeable so that women often ignore them, and that is the most common reason for intensification of the infection, and the appointment with the gynecologist is scheduled when symptoms are already quite pronounced.
Candida Albicans is a microorganism that is normally present in healthy women. It lives on the lining of the vagina in 35% of healthy women, in the upper part of the respiratory system in 77% of healthy people, and in the digestive system in 85% of healthy people, and it is in fact harmless and does not cause any symptoms. The presence of other protective microorganisms in the vagina, especially bacteria Lactobacillus, maintains low and harmless number of fungi on the mucous membranes of the vagina. When this ratio is disrupted and there is a significant multiplication or increase in the number of fungi, the infection occurs. Sources of infection are most commonly the fungi that already exist in our body.
Change of the acidity of the vagina and reduction in the number of harmless bacteria caused by menstruation, menopause, pregnancy, ovarian dysfunction, stress, frequent sexual intercourse; drugs (corticosteroids, antibiotics, oral contraceptives, hormonal replacement, intrauterine devices, the use of spermicides, use of lubricants with glycerol); diseases (diabetes mellitus, hypothyroidism, hypoparathyroidism, Addison's disease (primary adrenal insufficiency and hypocortisolism), AIDS, hypogammaglobulinemia, cystic fibrosis, all types of cancer, malignant blood diseases, malnutrition); consuming large amounts of alcohol, nicotine, caffeine and sugar; excessive moisture and irritation of the vulva and vagina, wearing tight and synthetic laundry, using perfumed soaps, deodorants, sanitary pads.
After reviewing the history and after physical examination, the gynecologist takes the smear of mucous membrane for microscopic examination (to determine group of secretions). In the case of candida, vaginal discharge will be VI group of purity. Less commonly the smear is taken for seeding the surface on which after a few days will grow colonies of Candida Albicans or rarely some other species of Candida. Although symptoms may indicate that it is candidiasis, often a wrong diagnose is set only on the basis of symptoms, as other pathogens can cause identical symptoms of vulvovaginitis, and candidiasis itself can develop the atypical clinical picture. Bacterial vaginosis can occur together with candidiasis, so after a partial or complete treatment failure it is necessary to conduct re-examination and revision of therapy.
All women with vulvovaginal yeast infection must be treated regardless of the severity of the symptoms. Treatment is conducted by gynecologist who determines the type, method and regimen of therapy. There are several types of antimycotics, and most commonly used are vaginal ones which are administered for 3 to 7 or more days. Local therapy may include antimycotic ointments for skin and mucous membrane of the vulva. If gynecologist estimates necessary, s/he may prescribe an oral, systemic antifungal agent in a single dose. Find out more here.
In case of serious infections gynecologist recommends vaginal douching with prepared antiseptic and analgesic solutions or solutions of baking soda, sage, St. John's wort. Vaginal douching or showering should be done in the evening before applying new vaginal tablets. Oral probiotics can be administered during and after treatment for a few weeks, a local probiotics that contain lactobacillus are given as a continuation of antimycotic treatment to help recover the saprophyte flora. Gynecologists know that it is usually necessary to carry out the treatment in two phases. After a break of one week or after the upcoming menstruation antifungal therapy should be repeated, because improvement of symptoms most commonly does not completely cure but only calm the infection that may worsen after a few days.
Pregnant women often develop vulvovaginal candidiasis, and it is treated by taking local antimicotics. The treatment prevents not only the symptoms but also the inflammation of membranes and pregnancy complications. Vaginal candidiasis during childbirth can lead to infection of the newborn.
Candidiasis is likely to cause vaginal tearing during childbirth and problems with wound healing after the tear or episiotomy.
The treatment of candidiasis in pregnant women may take a little longer and needs to be repeated because of frequent recurrent infections. Oral antifungals are not administered because of teratogenic effects on the fetus.
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