Vaginal infections are most commonly caused by yeast, bacterial vaginosis or Trichomonas vaginalis, a urethral parasite.
If you’ve had the unpleasant experience of having a vaginal yeast infection you’ll understand when I say that any sharp corner can look appealing!
Yeast infection (vulvovaginal candidiasis) is the most common cause of vulvar irritation and vaginal discharge. Yeast infections are associated with a whitish-coloured, often clumpy discharge, intense itching, inflammation and pain during urination as urine comes in contact with inflamed vulvar tissues. The culprit for most cases of vaginal yeast infections is Candida albicans, although other species of Candida can also cause infection.
Candida albicans is an opportunistic pathogen that responds to opportunities provided to them: antibiotic-treatment, compromised immune systems, birth-control, and vaginal irritation predispose to vaginal infection. Yeast cells are commonly present in low numbers in the vagina: when antibiotics reduce the numbers of bacteria normally residing in the vagina, yeast cells may take the opportunity to attach themselves to vaginal epithelial cells rich in glycogen: yeast love glycogen. Given the opportunity, yeast cells flourish in the glycogen-rich epithelial cells, bud and reproduce resulting in more yeast cells to attach to more vaginal epithelial cells. The symptoms of yeast infection – burning, itching, discharge – are actually an immune response to the metabolic by-products of yeast reproduction. The discharge associated with vaginal yeast infection is not usually outwardly offensive; whereas, bacterial vaginosis is often associated with a fishy odor, and Trichomonas infection is often outright offensive!
How is yeast infection diagnosed? Women who have had previous yeast infections have become experts on recognizing a current infection. Unless you have a new sexual partner or have not shared a sexual partner with anyone else (always a possibility), you will likely self-diagnose and purchase an over-the-counter treatment for yeast infection. If, however, you are experiencing symptoms that are new to you or are different in some way than symptoms you have experienced in the past, you should consult your physician. Bacterial vaginosis and Trichomonas vaginalis are also common causes of symptoms of vaginal infection and may present with similar symptoms.
Vulvovaginal candidiasis is diagnosed by the symptoms described above and the presence of yeast cells and pseudohyphae seen microscopically in vaginal discharge, a test often performed in the physician’s office. Alternatively, a sample of vaginal discharge collected from the vagina with a swab is smeared directly onto a glass slide for examination in the laboratory, or placed in a transport media and cultured in the laboratory. The finding of yeast in vaginal smears or cultures without symptoms is not suggestive of infection, as small numbers of yeast may reside normally in the vagina.
Vulvovaginal candidiasis is treated with short-term topical agents such as Clotrimazole, Miconazole or Nystatin inserted intravaginally. Preparations may be preloaded in a tampon-like device increasing ease of use and reducing the mess associated with vaginal creams; however, if you choose one of the tampon yeast treatments, you may also want to have some cream on hand to apply to external vulvar tissues to reduce itching, swelling and discomfort.
Numerous natural remedies promise to prevent yeast infections by maintaining or boosting numbers of Lactobacillus, the predominant flora found in the normally acidic environment of the vagina (pH < 4.5): yoghurt and probiotics are two of these. Do probiotics work? There are those who say they do, and those who say they don’t. However, they are generally not harmful, so if they work for you, then they work!
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