Womens Health

Recurring Yeast Infections

The Pain of a Yeast Infection

There's nothing like a yeast infection to make you miserable. The itching and burning are uncomfortable and sometimes quite painful. About 75 percent of women will experience a yeast infection, called Candidiasis or yeast vaginitis, at least one time and of those women, five percent will have recurrent vaginitis. Recurring vaginitis is when you have four or more yeast infections in a year. It's bad enough having it once - but when it keeps coming back over and over again, the condition demands investigation to find a reason why. The most common symptoms of vaginal yeast infection include:

· itching or irritation of the vulva and the vaginal opening

· pain when urinating and vulvar soreness or irritation

· pain during intercourse

· swollen and inflamed vulva and vaginal tissue

· if there is a discharge, it is usually thick and clumpy like cottage cheese

The symptoms of vaginitis are very similar to bacterial vaginosis as well as the sexually transmitted diseases trichomoniasis and gonorrhea. Dermatitis can cause itching and irritation as well.

Be Sure It's Yeast

The most important thing you can do if you believe you have been having recurrent vaginitis is to be sure that it really is yeast you are dealing with and not some other type of infection. Sometimes what we think is a yeast infection may, in fact, be something else - which is why it doesn't respond to treatment and may be the reason it keeps coming back. As it turns out, the most common type of vaginal irritation is not yeast vaginitis, but rather nonspecific bacterial vaginosis, which affects 75 percent of women. Yeast as a source of vaginitis occurs only 15 to 30 percent of the time. Bacterial vaginosis accounts for 50 percent of the cases of acute vaginitis.


Some Possible Reasons It Keeps Coming Back

In order to be sure the infection is due to yeast visit your gynecologist or health care provider to have the discharge evaluated. Yeast can cause cracks in the skin of the area around the vulva and the discharge is usually the consistency of cottage cheese. If the infection is yeast, the pH in your vagina won't change. These symptoms are characteristic of yeast, but a microscopic analysis of the discharge will confirm the infection. Once you have a clear diagnosis, then proper treatment can be administered. However, if the infections keep recurring, your doctor will look for underlying causes. Some possibilities are:

· Pregnancy

· Constant use of broad-spectrum antibiotics (tetracycline, ampicillin, and cephaposporins) which destroy the good bacteria called lactobacilli and allow yeast to propagate.

· Immunosuppression, often caused by taking corticosteroids or present in people with HIV.

· Increase in glycogen production in the lining of the vagina during the luteal phase of menses.

· Diabetes mellitus that isn't kept under control.

· Increase in estrogen levels that can be caused by high-dose oral contraceptives.

· IUDs, vaginal sponges and diaphragms

· Anything that affects the balance of vaginal flora, like perfumed bubble bath, Jacuzzis, scented sprays and sanitary napkins.

· Sexual behaviors, even though yeast vaginitis is not classified as an STD. Nevertheless, it can be transmitted through sexual relations and may be linked to orogenital and anogenital sex.

· The infection may not be Candidiasis, which is caused by Candida albicans. It may be a less common type of yeast called Candida glabrata or Candida krusei, which shows up in about 15 percent of women with repeated infections. These strains of Candida do not respond to standard treatments.

It is important the infection is properly diagnosed, especially if it is caused by one of the less common strains of Candida because the medications to treat them are different from the standard treatments for Candidiasis.

Treating Recurrent Vaginitis

Women who experience recurrent infections are usually put on a course of treatment that is longer than usual and will likely be multipronged. A topical cream may be used for one or two weeks along with an oral medication (often fluconazole 150mg) that is repeated with a second dose three days later and a third dose six days later. Vaginal yeast infections are not STDs; however, they can be passed to your sexual partner. Most experts do not recommend treating the partner.

To learn more about the specific medicines used to treat recurring vaginitis, see the article on chronic infections in the section.

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