The recurrent infection will develop in case of four or more specific episodes occurring in one year, or at least three episodes unrelated to antibiotic therapy occurring within the year.
Over 50 percent of women of more than 25 years of age develop vaginal thrush at some time of their life. At the same time, fewer than 5 percent of these women experience recurrences. Since this is a common problem, there are also common treatment options available in a gynecologist’s office.
What is vulvovaginal candidiasis?
Vulvovaginal candidiasis or vaginal thrush is a yeast infection of the vulva and vagina. This yeast infection affects approximately 75 percent of women at some time in their lives, and many women suffer recurring attacks. Although easily treated, vaginal thrush can be very unpleasant and uncomfortable for a woman, affecting her sex life and her confidence.
Yeast or Candida is a fungus that occurs naturally in the vagina, mouth, digestive system and other parts of the body. Symptoms only appear in case of overgrowth of this fungus. Yeast growth is normally kept under control by the friendly bacteria in our body. However, if the balance of bacteria is upset and the yeast cells are able to overproduce, a yeast infection known as candidiasis can occur. Infections are most common in premature babies, in adults debilitated by general ill health, and in those with a suppressed immune system.
Vaginal thrush risk factors
Yeast infections affecting the vulva and vagina known as vulvovaginal candidiasis are a common cause of vaginal irritation. A particular type of yeast called Candida albicans is responsible for up to 80-92 percent of cases of vulvovaginal candidiasis or vaginal thrush. In many cases, a precipitating factor for the infection is not clear, but several factors have been associated.
Changes in a woman’s hormone levels are important. Vaginal candidiasis is rare in those who have not yet menstruated, and less common in post-menopausal women. In many women, the hormonal changes that take place during the week before their periods are the cause of vaginal thrush. It could also happen during pregnancy, particularly in the third trimester. High doses of oral contraceptive pills have also been associated with vulvovaginal candidiasis. While not considered a sexually transmitted disease, vaginal sexual intercourse and other forms of sexual activity can transmit this yeast infection. Some men whose partners have vulvovaginal candidiasis develop symptomatic yeast dermatitis, or inflammation of the skin on the penis.
- Diabetes makes patients susceptible to yeast infections if poorly controlled.
- Antibiotics kill off friendly bacteria as well as infectious strains, so they may cause an imbalance in the yeast environment, and indirectly provoke vulvovaginal candidiasis.
- Suppressed immune system in some women due to chemotherapy, HIV or immunosuppressive drugs, can make them more susceptible to vaginal yeast infections.
- The use of vaginal sponges and intrauterine devices has also been associated with candidiasis in a number of reported cases.
- Mechanical factors may also be important because perspiration associated with tightly fitted clothes or poorly ventilated underwear increases local temperature and moisture. Mechanical irritation of the vulvovaginal area by clothing or through sexual intercourse may also predispose already colonized areas to yeast infection. One study demonstrated a positive relationship between the monthly frequency of sexual intercourse and the incidence of recurrent vulvovaginal candidiasis in some women.
Studies have not established an association between douching and vulvovaginal candidiasis. As well, the use of sanitary towels or tampons does not increase the risk of vaginal thrush. Some studies claim that wearing tight clothing can also provoke vaginal infection, but this theory remains unproved for now.
What are the typical symptoms of vulvovaginal candidiasis?
In some cases, women did not report any symptom present in vaginal thrush. However, most commonly an infection will produce symptoms.
Typical symptoms are:
- itching of the vulva
- thick curd-like white vaginal discharge
- irritation in the region of the vulva and vagina
- burning on passing urine
- pain during sexual intercourse, or dyspareunia
If you think that you may have a vaginal yeast infection, it is extremely important to ask your doctor to confirm the diagnosis. Some of the symptoms associated with thrush can resemble other conditions, so get examined by your doctor first to confirm the diagnosis. Sexually transmitted diseases such as trichomonas, Chlamydia and gardnerella are commonly confused with vaginal thrush. That is why consulting your doctor will also rule out the possibility that the irritation is there because of a more serious infection. You should rule out the possibility it could be cancer of the vagina or cervix, or the presence of a foreign body.
To confirm a diagnosis, your doctor will undertake a history and examination. On examination, the white curd-like discharge should be visible and the vulva and vagina may look red and swollen. Your doctor will probably take a sample of the discharge and examine it for the presence of yeast under a microscope. If you suffer from recurrent bouts of thrush and are certain of the diagnosis, there are many over-the-counter treatments available from your local chemist.
Treatment of vaginal thrush
Anti-fungal medications are a common treatment option to target the yeast infection. The group of drugs commonly used are azoles, including Imidazole, Miconazole, Clotrimazole and Fluconazole. Over-the-counter treatments in the form of creams, pessaries, tablets, and suppositories are very effective in thrush treatment. Treatment duration varies according to the type of medication used for vaginal thrush. Fluconazole is available as a single dose tablet, but side effects are mild and include headache, rash and nausea. Pregnant women should not receive the oral azoles.
Dramatic relief after the first 24-48 hours should follow treatment, no matter what your doctor choose. However, you must be sure to follow the recommended instructions for your medication. If you are required to complete a week-long course and do not finish it, the infection will probably return. Try to avoid topical corticosteroid creams, because it frequently exacerbates the burning sensation.
Some studies have reported success in a limited number of women with recurrent infections who ate live or active yoghurt containing lactobacillus. However, there is a lack of positive studies in this area.
If you are one of the small percentage of women who suffer from antibiotic-induced candidiasis, your doctor may prescribe prophylactic anti-fungal therapy. The best treatment option is to use a anti-fungal therapy along with the antibiotics. Yeast-free diets do not have any benefit on vulvovaginal candidiasis treatment.
Ozone therapy and vaginal thrush
Vaginal insufflations of ozone is a treatment option for disorders of the female reproductive area, specifically vaginal, uterine, ovarian, or lower abdominal problems. The conditions it might help include thrush, for which it is outstandingly effective, often where all else has failed. Beside vaginal thrush, ozone therapy can treat endometriosis, pelvic inflammatory diseases, and fibroids as well.
Ozone therapy involves the patient, not the practitioner, inserting a small catheter as far into the area as is comfortable and guiding ozone into it at a low flow rate. This method is painless, not at all intrusive, and does not cause discomfort of any kind for the patient. In fact, the practitioner does not need to stay in the room while the insufflations take place. Ozone therapy is effective against female problems of all kinds, from endometriosis to thrush. The yeasts and microorganisms tend to be the basis of vaginal health problems, but are very sensitive to ozone. It’s interesting how healthy body cells are not affected by ozone at all. Rather, ozone therapy stimulates the antioxidant side of the body and leads to an increase in immune system functioning and health of the vagina.
Ozone treatment usually leads to a dramatic improvement in vagina symptoms, and it appears that the benefits continue for a considerable amount of time. It is a safe and non-toxic treatment, and can simply be repeated at appropriate time intervals. Women have an anatomical advantage over men here, because vaginal insufflations are very easy, require no preparation, and can be administered for very long periods. The gas will usually find its way into the uterus, out the fallopian tubes, and then into the abdominal cavity, wherever the problem might be. However, if you are diagnosed with vaginal thrush, your doctor is the best person to tell you which treatment is appropriate for you.