Chronic Recurrent Yeast Vaginitis - What Can Be Done?
Frederick R. Jelovsek MD
\"How do you get rid of recurrences of yeast infections? This is a constant thing every month. I need help. I don\'t have sugar. I have been tested for that as well as thyroid. I am 39 years old and I have been to several doctors and so far I haven\'t been able to shake this infection completely. What other doctor should I go to besides a Gyn physician? \". T.J.
Chronic yeast infections can be very annoying. The symptoms are vaginal discharge with vulvar itching and burning which occurs 4 or more times a year. These symptoms can also be a sign of irritant vulvitis so it is important to confirm the diagnosis of recurrent yeast infection.
The diagnosis can be confirmed by seeing yeast on a wet prep of the vagina, or by growing candida yeast species on culture. This should be performed for several recurrences in a row, otherwise the condition can easily be an irritant vaginitis which will not respond to anti-yeast treatment. Remember that most episodes of vaginal burning that are assumed to be recurrent yeast infections are really irritant vulvitis due to
- propylene glycol
- butylated hydroxyanisol (BHA)
- cetyl alcohol
- sodium lauryl sulfate
- methyl benzethonium chloride
which are present in creams, lubricants, spermicides, scented sanitary products, douches, soaps, bubble baths and condom lubricants (1). There are also many other vulvar dermatoses that can present with vulvar burning (2).
If the vaginitis always occurs around the time of menses and if you get irritation high up on the mons pubis, the area of skin and fat above the clitoris, and you use sanitary pads, then you should strongly suspect that your symptoms are due to an allergic or sensitivity reaction to the pads themselves rather than a yeast vulvitis (3).
Common Questions About Chronic Yeast Infections
What are risk factors for chronic recurrent yeast infections?
Diabetes and abnormal glucose tolerance or insulin resistance are major risk factors for recurrent yeast infections but fortunately you have stated that your testing was negative for this. Oral contraceptives are also a risk factor (4). Patients infected with HIV are only at risk if their CD4 counts are less than 100 (5). Chronic antibiotic therapy can also be a risk factor for recurrent yeast infections. As long as you do not have any of these conditions, you should be able to get cleared up of the chronic recurrences of yeast.