What are the common symptoms of candidiasis. How is candidiasis diagnosed and treated. Who is at risk for developing candidiasis. What are the long-term effects of recurrent candidiasis. How can candidiasis be prevented.

Understanding Candidiasis: A Common Fungal Infection

Candidiasis, often referred to as a yeast infection, is a prevalent fungal disease that affects millions of women worldwide. This condition, caused by an overgrowth of Candida species, primarily Candida albicans, can lead to significant discomfort and health concerns if left untreated.

Candidal vulvovaginitis, a specific form of candidiasis affecting the vulva and vagina, is responsible for approximately one-third of vulvovaginitis cases in reproductive-aged women. The impact of this condition is substantial, with an estimated 70% of women experiencing at least one episode of candidal vulvovaginitis in their lifetime.

Key Facts About Candidiasis

• Caused primarily by Candida albicans (90% of cases)
• Affects up to 70% of women at least once in their lifetime
• Responsible for about one-third of vulvovaginitis cases
• Can be recurrent in approximately 8% of women

Symptoms and Presentation of Candidal Vulvovaginitis

The symptoms of candidal vulvovaginitis can vary in intensity but often cause significant discomfort. Women experiencing this condition may report a range of symptoms that can impact their daily lives and intimate relationships.

Is there a specific set of symptoms that characterizes candidal vulvovaginitis? The most common symptoms include:

• Vaginal itching and irritation
• Burning sensation, especially during urination
• Thick, white, adherent discharge
• Redness and swelling of the vulva and vagina
• Pain or discomfort during sexual intercourse (dyspareunia)

It’s important to note that symptoms may intensify just before menstruation. While these symptoms are indicative of candidal vulvovaginitis, they can also be present in other vaginal infections, necessitating proper diagnosis by a healthcare professional.

Risk Factors and Predisposing Conditions for Candidiasis

Understanding the risk factors associated with candidiasis is crucial for prevention and management. Various conditions and lifestyle factors can increase a woman’s susceptibility to yeast infections.

What conditions or factors increase the risk of developing candidiasis? The following are recognized risk factors:

• Estrogen use or elevated endogenous estrogen levels (e.g., during pregnancy or due to obesity)
• Diabetes mellitus
• Immunosuppression (e.g., HIV infection, chemotherapy, or use of immunosuppressive medications)
• Broad-spectrum antibiotic use
• Genetic predisposition (particularly for recurrent infections)

It’s worth noting that while sexual activity is associated with a higher incidence of candidal vulvovaginitis, there is no conclusive evidence that the infection is sexually transmitted. The relationship between sexual activity and candidiasis is likely due to other factors, such as changes in the vaginal microbiome or increased irritation.

Diagnosis and Evaluation of Candidal Vulvovaginitis

Accurate diagnosis of candidal vulvovaginitis is essential for appropriate treatment and management. Healthcare providers employ a combination of clinical assessment and laboratory tests to confirm the presence of a Candida infection.

How is candidal vulvovaginitis diagnosed? The diagnostic process typically involves:

1. Clinical history and symptom assessment
2. Physical examination of the vulva and vagina
3. Microscopic examination of vaginal secretions (wet mount)
4. pH testing of vaginal secretions
5. Whiff test (potassium hydroxide [KOH] test)
6. Fungal culture in certain cases

During the physical examination, healthcare providers look for signs such as vulvar and vaginal erythema, excoriations, thick white discharge, and swelling. It’s important to note that the absence of discharge does not rule out candidiasis, as some patients may have minimal or no visible discharge.

The wet mount microscopy can reveal the presence of yeast cells or hyphae, confirming the diagnosis. A normal vaginal pH (4.0-4.5) is typically observed in candidal infections, which can help differentiate it from other types of vaginitis.

Treatment Approaches for Candidal Vulvovaginitis

Effective treatment of candidal vulvovaginitis aims to alleviate symptoms and eradicate the fungal infection. The choice of treatment depends on the severity of symptoms, frequency of recurrence, and patient preferences.

What are the primary treatment options for candidal vulvovaginitis? Treatment typically involves:

• Topical antifungal medications (e.g., miconazole, clotrimazole)
• Oral antifungal medications (e.g., fluconazole)
• Combination therapy for severe or recurrent cases
• Maintenance therapy for prevention of recurrence

For uncomplicated cases, over-the-counter topical antifungal creams or suppositories are often effective. These treatments usually resolve symptoms within a few days to a week. Oral antifungal medications, such as fluconazole, may be prescribed for more severe or recurrent cases.

In cases of recurrent candidal vulvovaginitis, defined as four or more episodes in a year, a longer course of treatment followed by maintenance therapy may be necessary. This approach helps prevent future infections and provides long-term symptom relief.

Prevention Strategies and Lifestyle Modifications

While candidal vulvovaginitis is common, there are several preventive measures women can take to reduce their risk of infection or recurrence. These strategies focus on maintaining a healthy vaginal environment and avoiding factors that disrupt the natural balance of microorganisms.

How can women reduce their risk of developing candidal vulvovaginitis? Consider the following preventive measures:

• Avoid unnecessary antibiotic use
• Wear breathable, cotton underwear
• Avoid tight-fitting clothing
• Practice good hygiene, but avoid douching or using scented products in the genital area
• Manage underlying conditions such as diabetes effectively
• Consider probiotic supplements or foods to support vaginal health
• Avoid hot tubs and very hot baths
• Change out of wet swimwear or exercise clothes promptly

For women prone to recurrent infections, additional preventive strategies may be recommended by healthcare providers. These may include prophylactic use of antifungal medications or lifestyle modifications tailored to individual risk factors.

The Impact of Recurrent Candidiasis on Women’s Health

Recurrent candidal vulvovaginitis, affecting approximately 8% of women, can have significant physical and psychological impacts. The frequent or persistent nature of symptoms can lead to frustration, anxiety, and a reduced quality of life.

What are the long-term effects of recurrent candidiasis on women’s health? Consider the following impacts:

• Chronic discomfort and pain
• Interference with sexual relationships and intimacy
• Psychological distress and reduced self-esteem
• Increased healthcare utilization and costs
• Potential development of antifungal resistance
• Impact on work or daily activities due to symptoms

Women experiencing recurrent infections may benefit from a comprehensive management approach that addresses both the physical symptoms and the psychological impact of the condition. This may involve collaboration between gynecologists, primary care providers, and mental health professionals to provide holistic care.

Emerging Research and Future Directions in Candidiasis Management

As our understanding of candidal vulvovaginitis evolves, researchers are exploring new approaches to diagnosis, treatment, and prevention. These advancements hold promise for improving outcomes and quality of life for women affected by this common condition.

What are some areas of ongoing research in candidiasis management? Current research directions include:

• Development of rapid diagnostic tests for point-of-care use
• Investigation of novel antifungal agents with improved efficacy and reduced resistance potential
• Exploration of the role of the vaginal microbiome in candidiasis susceptibility and prevention
• Studies on immunomodulatory therapies for recurrent infections
• Research into genetic factors influencing susceptibility to candidal infections
• Evaluation of alternative and complementary therapies for symptom management

These research efforts aim to enhance our ability to prevent, diagnose, and treat candidal vulvovaginitis more effectively. As new findings emerge, clinical guidelines and treatment protocols may be updated to incorporate the latest evidence-based recommendations.

In conclusion, candidiasis, particularly candidal vulvovaginitis, remains a significant health concern for women worldwide. By understanding the risk factors, symptoms, and available treatment options, women can take proactive steps to manage their health and seek appropriate care when needed. As research continues to advance our knowledge of this condition, we can look forward to improved strategies for prevention and management, ultimately enhancing the quality of life for those affected by candidal infections.

Vaginal Candidiasis – StatPearls – NCBI Bookshelf

Continuing Education Activity

Vulvovaginitis, or inflammation of the vulva and vagina, most commonly occurs in reproductive-aged women and is usually secondary to infection. Candidal vulvovaginitis is responsible for about one-third of cases. This activity reviews the evaluation and management of candidal vulvovaginitis and highlights the role of interprofessional team members in collaborating to provide well-coordinated care and enhance outcomes for affected patients.

Objectives:

• Describe the epidemiology of vulvovaginitis.

• Review the presentation of vulvovaginitis

• Summarize the treatment options for vulvovaginitis.

• Outline interprofessional team strategies for improving care coordination and communication to advance care and outcomes in patients with vulvovaginitis.

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Introduction

Vaginal complaints are common. Vulvovaginitis, or inflammation of the vulva and vagina, is most commonly secondary to infectious agents in reproductive-aged women. Candidal vulvovaginitis is responsible for about one-third of cases.[1][2][3][4]

Etiology

Candidal vulvovaginitis is caused by inflammatory changes in the vaginal and vulvar epithelium secondary to infection with Candida species, most commonly Candida albicans. Candida is part of the normal flora in many women and is often asymptomatic. Therefore, candidal vulvovaginitis requires both the presence of candida in the vagina/vulva as well as the symptoms of irritation, itching, dysuria, or inflammation.[5]

Epidemiology

Candidal vulvovaginitis is common. It is responsible for a third of all cases of vulvovaginitis in reproductive-aged women, and 70% of women report having had candidal vulvovaginitis at some point in their lifetimes. About 8% of women suffer recurrent candidal vulvovaginitis. The most common responsible pathogen is C. albicans (in about 90% of cases), with most of the remaining cases caused by Candida glabrata. It is important to recognize that detailed epidemiological data is not available for this disease process. Because of the wide availability of over-the-counter treatments, many patients with candidal vulvovaginitis likely do not present for care. Furthermore, diagnosis is based on both clinical and ancillary evaluation, and therefore, epidemiologic reports based on culture alone overestimate disease, as 10% of women are asymptomatic with positive candidal cultures. Finally, studies demonstrate that self-diagnosis is not accurate, so data derived from a patient query are likely somewhat inaccurate.

Recognized risk factors for acute candidal vulvovaginitis include estrogen use, elevated endogenous estrogens (from pregnancy or obesity), diabetes mellitus, immunosuppression (i.e., patients with chemotherapy or antimetabolite medications, HIV infection, or transplant patients), and broad-spectrum antibiotic use. Although candidal vulvovaginitis is more common in women who are sexually active, there is no evidence that candidal infection is sexually transmitted. Patients with recurrent candidal vulvovaginitis (defined as four or more episodes of culture-proven candidal vulvovaginitis) have predisposing genetic factors that cause them to be susceptible to recurrent fungal infections. These factors may also predispose to a hypersensitivity to Candida.

Pathophysiology

Candidal vulvovaginitis occurs when Candida species superficially penetrate the mucosal lining of the vagina and cause an inflammatory response. The dominant inflammatory cells are typically polymorphonuclear cells and macrophages. Patients may present with discharge, which is typically thick and adherent, or with excoriations, “external” dysuria, vaginal itching, vaginal burning, dyspareunia, or swelling.

History and Physical

Patients typically complain of irritation, itching, and burning. Symptoms are often prominent just before the patient’s menstrual period. Many patients will have a history of similar symptoms, and some will have attempted over the counter treatment with topical agents or alternative therapies. On exam, the clinician will often encounter vulvar and vaginal erythema, excoriations, thick white adherent discharge, and swelling. Some patients will have little to no discharge. The provider should not encounter ulcers, asymmetric swelling/masses, or foreign bodies. The degree of irritation is typically severe in patients with acute vulvovaginal candidiasis. Patients with infection with Candida glabrata usually have less severe symptoms. There is much overlap in the presentation of patients with vulvovaginal candidiasis versus other forms of vaginitis or cervicitis, and therefore ancillary testing, including wet mount, whiff testing, and pH testing, should be performed to make this diagnosis.

Evaluation

To diagnose this condition, the provider should perform a pelvic exam, a vaginal wet prep, pH testing, and testing to exclude other etiologies of vaginal discharge and infection (specifically gonococcal and chlamydial disease). In patients with candidal vulvovaginitis, inflammation is evident during a pelvic exam. However, the cervix is typically normal and not inflamed. The patient should not have cervical motion tenderness, and there should be no abnormal discharge from the cervical os. In patients with vulvovaginal candidiasis, the vaginal pH is typically less than 5. On wet prep, the provider should see lactobacillus as the prominent bacteria present, and will also likely see inflammatory cells. The patient should have a negative Whiff test (a fishy odor when potassium hydroxide is applied to the discharge on a slide). After potassium hydroxide application, the provider may see budding yeast, hyphae, or pseudohyphae on microscopy.[6][7][8][9][10]

Vaginitis may be secondary to more than one etiology, and therefore the provider should be vigilant to the presence of clue cells (representative of bacterial vaginosis) or trichomonads (representative of trichomoniasis) on wet prep.

Most infections are secondary to Candida albicans, and if the provider sees budding yeast in the clinical setting of a reproductive age woman presenting with vulvovaginitis, there is no need to perform confirmatory cultures for Candida (although a DNA probe for sexually transmitted infections is often still appropriate). Since Candida species are part of normal vaginal flora in many women, routine cultures in asymptomatic women are also discouraged. In women with repeated episodes of candidal vulvovaginitis, culture should be obtained to identify the fungal species that may be resistant to typical empiric therapy or to identify alternative causes of vaginitis.

Treatment / Management

Acute candidal vulvovaginitis is treated with antifungal agents. Since most cases of candidal vulvovaginitis are secondary to C. albicans species, and since C. albicans does not have significant resistance to azole antifungals, these are the agents of choice for this disease. Antifungals may be taken orally as a single dose (fluconazole 150 mg) or can be applied intravaginally in a single day or 3-day regimens that are available over the counter. In patients with uncomplicated disease (those without immunosuppression or pregnancy who do not have recurrent candidal vulvovaginitis) either therapy is equally efficacious. Therefore, treatment decision may be made based on cost, patient preference, and drug interactions. If patients do not respond to standard therapy, cultures may be warranted to look for other species of candida, which are often resistant to azoles.

Patients with complicated candidal vulvovaginitis, for example those patients who are .immunosuppressed, require longer therapy. Typically, therapy includes intravaginal azole therapy for at least 1 week, or oral treatment with fluconazole 150 mg (renally adjusted for CrCl <50 ml/min) once every 3 days for three doses. Patients with recurrent candidal vulvovaginitis may benefit from suppressive therapy with weekly oral fluconazole for 6 months. Pregnant patients should not be given oral antifungals. In these patients, a 7-day course of intravaginal therapy is appropriate. Fluconazole is considered safe in breastfeeding women.

There is inadequate evidence to recommend intravaginal or oral yogurt therapy, intravaginal garlic, or douching.

Differential Diagnosis

• Allergic reaction

• Atopic dermatitis

• Lichen sclerosis

• Neoplasm

• Paget disease

• Psoriasis

• Sexual abuse

• Vulvodynia

Pearls and Other Issues

Although vaginitis is not a dangerous disease, it can be disabling and upsetting to patients. It is important to address social issues and sexual dysfunction in addition to the infection itself.

It is also important to maintain a broad differential diagnosis. Trauma, abuse, foreign body, malignancy, immune diseases, inflammatory bowel disease, and sexually transmitted infections can all present with vaginal discomfort. The provider should always perform a careful and complete physical exam, appropriate ancillary testing as described above, and further testing if treatment failure occurs.

Enhancing Healthcare Team Outcomes

Candida vulvovaginitis is usually managed by the gynecologist, nurse practitioner, primary care provider or an internist. The condition is clinically diagnosed and management is with antifungal medications. Most simple cases resolve within days. Patients with complicated candidal vulvovaginitis require longer therapy. Pregnant patients should not be given oral antifungals. In these patients, a 7-day course of intravaginal therapy is appropriate. Fluconazole is considered safe in breastfeeding women. There is inadequate evidence to recommend intravaginal or oral yogurt therapy, intravaginal garlic, or douching.[11]

At the same time patient education is important. The condition is not life threatening but can be associated with embarrassment and withdrawal from sexual activities. It is also important to maintain a broad differential diagnosis. Trauma, abuse, foreign body, malignancy, immune diseases, inflammatory bowel disease, and sexually transmitted infections can all present with vaginal discomfort. The provider should always perform a careful and complete physical exam, appropriate ancillary testing as described above, and further testing if treatment failure occurs.

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References

1.

Buggio L, Somigliana E, Borghi A, Vercellini P. Probiotics and vaginal microecology: fact or fancy? BMC Womens Health. 2019 Jan 31;19(1):25. [PMC free article: PMC6357464] [PubMed: 30704451]

2.

Aguirre-Quiñonero A, Castillo-Sedano IS, Calvo-Muro F, Canut-Blasco A. Accuracy of the BD MAX™ vaginal panel in the diagnosis of infectious vaginitis. Eur J Clin Microbiol Infect Dis. 2019 May;38(5):877-882. [PubMed: 30685805]

3.

Ahangari F, Farshbaf-Khalili A, Javadzadeh Y, Adibpour M, Sadeghzadeh Oskouei B. Comparing the effectiveness of Salvia officinalis, clotrimazole and their combination on vulvovaginal candidiasis: A randomized, controlled clinical trial. J Obstet Gynaecol Res. 2019 Apr;45(4):897-907. [PubMed: 30663184]

4.

Swidsinski A, Guschin A, Tang Q, Dörffel Y, Verstraelen H, Tertychnyy A, Khayrullina G, Luo X, Sobel JD, Jiang X. Vulvovaginal candidiasis: histologic lesions are primarily polymicrobial and invasive and do not contain biofilms. Am J Obstet Gynecol. 2019 Jan;220(1):91.e1-91.e8. [PubMed: 30595144]

5.

Farhan MA, Moharram AM, Salah T, Shaaban OM. Types of yeasts that cause vulvovaginal candidiasis in chronic users of corticosteroids. Med Mycol. 2019 Aug 01;57(6):681-687. [PubMed: 30544194]

6.

Barnes P, Vieira R, Harwood J, Chauhan M. Self-taken vaginal swabs versus clinician-taken for detection of candida and bacterial vaginosis: a case-control study in primary care. Br J Gen Pract. 2017 Dec;67(665):e824-e829. [PMC free article: PMC5697552] [PubMed: 29158246]

7.

Donders GGG, Ravel J, Vitali B, Netea MG, Salumets A, Unemo M. Role of Molecular Biology in Diagnosis and Characterization of Vulvo-Vaginitis in Clinical Practice. Gynecol Obstet Invest. 2017;82(6):607-616. [PubMed: 29017160]

8.

van der Meijden WI, Boffa MJ, Ter Harmsel WA, Kirtschig G, Lewis FM, Moyal-Barracco M, Tiplica GS, Sherrard J. 2016 European guideline for the management of vulval conditions. J Eur Acad Dermatol Venereol. 2017 Jun;31(6):925-941. [PubMed: 28164373]

9.

van Schalkwyk J, Yudin MH., INFECTIOUS DISEASE COMMITTEE. Vulvovaginitis: screening for and management of trichomoniasis, vulvovaginal candidiasis, and bacterial vaginosis. J Obstet Gynaecol Can. 2015 Mar;37(3):266-274. [PubMed: 26001874]

10.

Mendling W, Brasch J, Cornely OA, Effendy I, Friese K, Ginter-Hanselmayer G, Hof H, Mayser P, Mylonas I, Ruhnke M, Schaller M, Weissenbacher ER. Guideline: vulvovaginal candidosis (AWMF 015/072), S2k (excluding chronic mucocutaneous candidosis). Mycoses. 2015 Mar;58 Suppl 1:1-15. [PubMed: 25711406]

11.

Crouss T, Sobel JD, Smith K, Nyirjesy P. Long-Term Outcomes of Women With Recurrent Vulvovaginal Candidiasis After a Course of Maintenance Antifungal Therapy. J Low Genit Tract Dis. 2018 Oct;22(4):382-386. [PubMed: 29975334]

Disclosure: Rebecca Jeanmonod declares no relevant financial relationships with ineligible companies.

Disclosure: Donald Jeanmonod declares no relevant financial relationships with ineligible companies.

Vaginal Yeast Infection Symptoms, Causes, Treatment, and More

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An overgrowth of yeast in the vagina can cause a vaginal yeast infection. Treatment may depend on the type of infection and whether the infection is recurring.

A vaginal yeast infection, also known as candidiasis, is a common condition. A healthy vagina contains bacteria and some yeast cells. But when the balance of bacteria and yeast changes, the yeast cells can multiply. This causes itching, swelling, and irritation.

Treating a vaginal yeast infection can relieve symptoms within a few days. In more severe cases, it may take longer.

Vaginal yeast infections aren’t considered a sexually transmitted infection (STI), commonly known as sexually transmitted disease (STD). Sexual contact can spread it, but women who aren’t sexually active can also get them.

Vaginal yeast infections have a common set of symptoms, such as:

• vaginal itching
• swelling around the vagina
• burning during urination or sex
• pain during sex
• soreness
• redness
• rash

Whitish-yellow and clumpy vaginal discharge is another symptom. Some people describe the discharge as looking like cottage cheese. Sometimes the discharge may also be watery.

The yeast Candida is a naturally occurring microorganism in the vaginal area. Lactobacillus bacteria keeps its growth in check.

But if there’s an imbalance in your system, these bacteria won’t work effectively. This leads to an overgrowth of yeast, which causes the symptoms of vaginal yeast infections.

Several factors can cause a yeast infection, including:

• antibiotics, which decrease the amount of Lactobacillus (“good bacteria”) in the vagina
• pregnancy
• uncontrolled diabetes
• weak immune system
• hormonal imbalance near your menstrual cycle
• stress

A specific kind of yeast called Candida albicans causes most yeast infections. These infections are easily treatable.

If you’re having recurring yeast infections or problems getting rid of a yeast infection with conventional treatment, a different version of Candida might be the cause. A lab test can identify what type of Candida you have.

Yeast infections are simple to diagnose. Your doctor will ask about your medical history. This includes whether you’ve had yeast infections before. They may also ask if you’ve ever had an STI.

The next step is a pelvic exam. Your doctor will examine your vaginal walls and cervix. They’ll also look at the surrounding area for external signs of infection.

Depending on what your doctor sees, the next step may be to collect cells from your vagina. These cells go to a lab for examination. Lab tests are usually ordered for women who have yeast infections on a regular basis or for infections that won’t go away.

If you don’t already have a obgyn, you can browse doctors in your area through the Healthline FindCare tool.

You can try to treat vaginal yeast infections with natural remedies if you’d like to avoid taking prescription medication, but these aren’t as effective or reliable as the indicated medications. Popular natural remedies include:

• coconut oil
• tea tree oil cream
• garlic
• boric acid vaginal suppositories
• plain yogurt taken orally or inserted into the vagina

Make sure your hands are clean before applying creams or oils to your vagina.

You may also want to talk to a doctor before trying natural remedies. This is important because, if your symptoms are due to something other than a simple yeast infection, your doctor can help diagnose your condition.

Talk to your doctor about herbal remedies if you take OTC or prescription drugs. Some herbs can interact with medications you may be taking or can cause other unintended side effects.

While vaginal yeast infections are more common in women, it’s possible for men to get yeast infections, too. When it affects the penis, this is known as a penile yeast infection.

All bodies have Candida — not just the female body. When there’s an overgrowth of this fungus, it can lead to a yeast infection. The groin area is especially prone to Candida overgrowth because of skin folds and moisture.

Still, penile yeast infections are most commonly caused by having unprotected vaginal intercourse with a woman who has the infection, too. You can help prevent a yeast infection by wearing condoms during sex. Regular bathing can also help.

The symptoms of a yeast infection in men may not be as prominent, though you might see redness and white patches along the penis as well as burning and itchy sensations. See your doctor for a proper diagnosis if you think you have a penile yeast infection.

Yeast infections are common in women. It’s estimated that up to 75 out of 100 women will get a vaginal yeast infection at least once in their lifetime. Despite their prevalence, it’s important to treat vaginal yeast infections early.

Recurring yeast infections are common, especially if you are pregnant, have diabetes, or have a weakened immune system. Talk to your doctor if you have more than four yeast infections per year.

While yeast infections are commonly associated with vaginal infections, babies can also get them.

The most common yeast infection in a baby is a diaper rash. However, not all diaper rashes are the result yeast overgrowth.

You can tell if the condition is more than just a diaper rash if your baby’s skin is extremely red and has spots in the diaper/groin area, despite using diaper rash cream. Yeast infections may also be presented in other folds of the skin, such as under the armpits.

Your child’s pediatrician will likely prescribe a topical antifungal cream to treat yeast infections of the skin. An oral medication may be needed if your baby has oral thrush (yeast infection of the mouth). While yeast infections in babies are usually harmless, they can lead to more serious infections when left untreated.

Yeast infections aren’t considered STIs. In rare cases, you can pass a yeast infection from one partner to another.

It’s also possible for a baby to get a fungal diaper rash at birth if the mother has a vaginal yeast infection during delivery. You may also pass on a yeast infection to your baby’s mouth during breastfeeding if Candida overgrowth is present in the breast area.

While you can pass a yeast infection to another person, it’s not contagious in the same way as other infections are. You won’t “catch” the infection by air or by using the same shower as someone with the infection, for example. If you’re concerned about transmission, talk to your doctor about situations in which a yeast infection could be contagious.

Yeast infections are common during pregnancy because of hormone fluctuations. See a doctor if you’re pregnant and suspect a yeast infection so you can get the right diagnosis.

A yeast infection during pregnancy isn’t always treated in the same way as nonpregnant women are treated. You won’t be able to take oral antifungal medications due to possible birth defects. Topical antifungals are safe to use during pregnancy, though.

While yeast infections won’t hurt your baby, it’s possible to pass the Candida fungus to them during delivery. This can lead to diaper rash and oral thrush in your baby. It’s important to treat yeast infection early, especially if you’re pregnant, so that you can prevent such complications.

Another common infection in women is a urinary tract infection (UTI). While it’s possible to have one or the other, or even both infections at the same time, UTIs and yeast infections are two different conditions.

A UTI is a bacterial infection that affects the urinary system. This complex system includes your urethra, as well as your bladder and kidneys. Sex, STIs, and failure to urinate regularly can all lead to UTIs.

The symptoms of a UTI are also different from a yeast infection. There’s no noticeable discharge, but you might see a small amount of blood in your urine. A UTI can also cause frequent urination along with pelvic and abdominal pain.

Without treatment, a UTI can lead to more serious complications of the kidneys. See a doctor to get antibiotics. Ask your doctor for more information regarding the differences between a yeast infection and a UTI.

If this is your first suspected yeast infection, you’ll want to get a proper diagnosis from a doctor. This ensures that your symptoms are related to Candida overgrowth and not a more serious condition.

Your doctor will first conduct a pelvic exam, noting any visible discharge, redness, and swelling. They will ask you about other symptoms such as burning and painful urination.

If needed, your doctor might order a vaginal fluid test. They will first collect a sample of vaginal discharge with a cotton swab, which will then be sent to a lab for study under a microscope. Once your doctor has determined it’s a fungal infection — or another type of infection — they will then be able to prescribe the correct treatment.

While it’s possible to develop a yeast infection after sex, a yeast infection itself is not an STI. Instead, there are other factors at play that can throw off Candida balance in the vaginal area. Vaginal intercourse, as well as penetration via sex toys and fingers, can introduce bacteria.

Another possibility is having vaginal intercourse with a man who has a penile yeast infection. The opposite can happen too, where a man might develop a penile yeast infection from a woman who has a vaginal yeast infection. Oral sex may also disrupt bacteria in the mouth, vagina, and penile areas.

It’s also possible that the yeast infection is purely coincidental. There are many underlying risk factors of a yeast infection, with sexual intercourse being just one of them.

Bacterial vaginosis (BV) is the most common type of vaginal infection in women between the ages of 15 and 44. Its primary causes are bacterial imbalances from douching and sex — it’s not a fungal infection like a typical yeast infection. BV is said to have a strong fishy odor, too.

BV has similar symptoms as a yeast infection, including discharge, burning, and itching. This can make distinguishing between the two infections difficult. But while a vaginal yeast infection doesn’t cause long-term complications, untreated BV can.

Among the complications include fertility issues and premature delivery (if you get infected while pregnant), and a higher risk of contracting STIs.

Unlike a yeast infection, you’ll need a prescription antibiotic to clear up BV. Your doctor will help you distinguish between a yeast infection and BV.

Chances are that you know exactly what led to your yeast infection. For example, some women experience these infections every time they take antibiotics. Whether you know the exact cause, here are tips to avoid recurring infections.

Try:

• eating a well-balanced diet
• eating yogurt or taking supplements with lactobacillus
• wearing natural fibers such as cotton, linen, or silk
• washing underwear in hot water
• replacing feminine products frequently

Avoid:

• wearing tight pants, pantyhose, tights, or leggings
• using feminine deodorant or scented tampons or pads
• wearing wet clothing, especially bathing suits
• sitting in hot tubs or taking frequent hot baths
• douching

Essential oils have gained attention in recent years as “natural” remedies to common medical ailments. These plant-based products can be powerful, but so far, no research has shown that essential oils work better for yeast infections than conventional methods.

One issue with essential oils is that some people might be allergic to them. Do a patch test on a small area of skin before applying them to larger areas of the body. This is especially important when considering sensitive areas such as the vagina.

It’s also important to dilute oils properly before use. Confirm with a doctor that your symptoms are indeed caused by a yeast infection before trying essential oils as treatment. You can also ask about safer oils, such as coconut oil, for your yeast infection.

Having both a yeast infection and your period can feel like a double whammy. However, this isn’t uncommon. Yeast infections are most likely to occur in women during the final days leading up to their period.

Fluctuations in hormones are thought to be a cause of yeast infections before your period, causing imbalances in healthy bacteria in the vagina.

If you experience white to yellow discharge in the week before your period, this isn’t automatically a yeast infection unless you have other hallmark symptoms, too, such as redness, burning, and itchiness.

While a nuisance, early treatment can help clear up your yeast infection before your period starts. See your doctor if your yeast infection symptoms don’t improve after your period ends. Also see a doctor if you continue to get yeast infections before your period every month.

Yeast infections are common occurrences, but prompt treatment can help reduce the uncomfortable symptoms within a few days. By recognizing your own risk factors, you can prevent future infections.

Talk to your doctor if you have recurring yeast infections that last longer than 2 months.

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Oral thrush in children – Holisal® gel for thrush in the mouth in infants

Content of the article

1. Causes of thrush in children in the mouth
2. Symptoms
3. Treatment of thrush in the mouth of a child

The disease is caused by a fungus of the genus Candida, so its other name is candidiasis. The article contains detailed information about the causes and symptoms of the disease. Medicines for thrush in the mouth in children are also considered. But first, children with complaints and if a fungal infection is suspected must be shown to the doctor.

Causes of thrush in children in the mouth

Candida can be found in a healthy person. But if the immune system weakens, the microorganism begins to multiply rapidly and causes inflammation. Candidiasis can ¹ :

• weakened children in the first weeks of life;
• healthy baby in violation of hygiene;
• newborns during passage through an infected mother’s birth canal;
• frequently ill children;
• babies who took medications: antibiotics, hormones, cytostatics.

Symptoms

Older children complain of burning, bad taste in the mouth. Babies become restless, eat and sleep poorly. In the mouth, you can see a film resembling curdled milk. On the inner surface of the cheeks, along the line of closing of the teeth, on the palate, lips, tongue, a plaque is formed that looks like white dots, which is easily removed. With a severe course of the disease, the plaque becomes continuous, takes the form of yellowish-gray films. Films are difficult to remove, swelling and redness remain under them, sometimes bleeding defects.

Of the common manifestations of oral candidiasis, fever is possible, lymph nodes under the lower jaw and on the neck may increase ¹ .

Treatment of thrush in the mouth of a child

How to treat thrush in the mouth of a child, the specialist decides after diagnosis. Both general and local treatment or a combination of them can be prescribed. General treatment can be aimed at correcting underlying diseases, replenishing vitamin deficiency, restoring immunity, etc. ¹

Local remedies for thrush in the mouth of a child should not only have an antifungal effect, but also reduce discomfort, relieve inflammation. Holisal ^® dental gel has such a complex action.

As part of the preparation Cholisal ^{® 2} :

• choline salicylate is an anti-inflammatory and analgesic component. The analgesic effect may appear within 2-3 minutes after application and last up to 8 hours;
• cetalkonium chloride – an antiseptic active against fungi, viruses, bacteria;
• gel adhesive base — keeps the active ingredients on the oral mucosa for a long time.

Gel Holisal ^® is indicated for use in oral candidiasis in children from one year old, in children under one year of age it is used with caution, under the supervision of a physician ² .

It may also be recommended to limit carbohydrates in the diet (sweets, baked goods), carefully handle bottles, nipples, underwear ¹ .

Do not self-diagnose or self-medicate. In any case, you should consult a doctor. Only a doctor can establish the correct diagnosis and select the optimal treatment.

References:

1. Leontiev VK Pediatric therapeutic dentistry / ed. Leontieva V.K., Kiselnikova L.P. – Moscow: GEOTAR-Media, 2021. – 952 p., p.V, ch.33.
2. Instructions for medical use of Cholisal ^®

ENG-STO-SAC-SAC-08-2022-3727

Women’s disease thrush – what kind of disease, symptoms, treatment

Contents

What is thrush? What is thrush?

Thrush is caused by the opportunistic yeast-like fungus Candida albicans. Hence the other name of the disease is candidiasis. Candida fungus always lives on the mucous membranes, it is part of the natural human microflora. But when exposed to adverse factors, the growth of the fungus can become excessive and cause manifestations of candidiasis. There are many such factors, and it is difficult to predict which of them can become a trigger.

Anatomical features, the proximity of the intestines contribute to the fact that thrush occurs more often in women.

Possible causes of thrush

Any or all of the above can cause thrush.

• Acute or exacerbation of a chronic disease, reduction of body resistance due to them;
• Taking antibiotics, oral contraceptives;
• Operations, therapeutic and diagnostic manipulations in the pelvic area;
• Abortion, miscarriage;
• Pregnancy;
• Hypothermia, including due to being in a wet bathing suit;
• Bad habits – smoking, alcohol abuse;
• Diseases of the endocrine system, including diabetes mellitus, obesity, hypothyroidism and others;
• Anemia – lack of iron in the blood;
• Non-compliance with personal hygiene;
• Bathing in dirty or excessively chlorinated water

Possible manifestations of thrush

It can take from 2 to 14 days from the moment that became the starting point to the appearance of signs of thrush. Thrush in women is often limited only to the external genitalia, which is why this form of the disease is called “vaginal candidiasis. ” Its probable signs:

• Inflammation, swelling of the mucosa of the large and small labia, vagina. This leads to a feeling of discomfort, pain during intercourse.
• Itching and burning, discomfort. These sensations in women can increase after urination, before going to bed, after a long walk, taking a bath or hot shower, during menstruation.
• White, flaky, odorless discharge. Sometimes they can acquire a greenish or gray tint.

Synthetic underwear, poor hygiene, change of sexual partner, inaccuracies in diet – spicy or salty foods, alcohol, clothes that are too warm and tight: these can also cause thrush symptoms in women.

Thrush: what is needed for diagnosis

In order to choose the right treatment, you need the right diagnosis. Since some of the symptoms of this disease may be similar to other urogenital infections, it is important for a woman to know what happened. Then, knowing the preliminary diagnosis, she will choose the time to visit the doctor and receive professional advice.

Diagnosis of thrush at home is possible using a modern tool for its detection – FRAUTEST candida. This test is specific – it determines the presence of thrush, and does not respond to pathogens of other infections: with an accuracy of 9A 5% test will show that it is thrush, and will allow you to visit a doctor in time and prescribe the right treatment.

During a visit to a doctor, diagnosis begins with an examination. According to its results, the following laboratory tests can be assigned.

• Microscopy swab to detect fungal colony. If it is thrush, then Candida mycelium will be found.
• Culture swab. The material is sown on a special nutrient medium, and then examined under a microscope and their number is determined. The size of the colony grown on the medium is important for clarifying the diagnosis: if the growth is insignificant, then this may be a variant of the norm, some fungi are always present in a small amount in the vagina of a healthy woman.
• Antibiotic susceptibility swab. The standard treatment regimen does not always help. This may be due to the fact that the fungus is not sensitive to the antifungal drugs used. If the treatment does not give the desired effect for a long time, this study is carried out. Many people prescribe it before treatment in order to immediately select the exact drug and its dose.
• Blood glucose test (blood for sugar). Thrush can occur with diabetes mellitus and other disorders of carbohydrate metabolism. If this is revealed by analysis, then for the successful cure of thrush, you need to consult an endocrinologist and fulfill his appointments.

The comparison table shows some of the symptoms that can occur with thrush, gardnerellosis (bacterial vaginosis), trichomoniasis, or a combination of these infections.

These are only individual symptoms, they may vary and cannot serve as a diagnostic guide. To make an accurate diagnosis, it is necessary to evaluate not only the quantity and quality of discharge, but also to conduct other studies, including laboratory ones.

Treatment of vaginal candidiasis

The main direction of treatment is the elimination of factors and causes, diseases. Perhaps the doctor will advise you to change the type of contraception; complete the course of medication, prescribe methods for correcting disturbed metabolic processes. If necessary, correction of immune disorders, other urinary tract infections in women is carried out.

Specific treatment consists of topical and systemic (i.e. whole body) antifungal drugs. The exception is thrush in pregnant women. In this case, only local preparations against a fungal infection are used.

Complications of thrush

Thrush should not be taken lightly as something of little importance. If it is not treated, then the process can become chronic, it will make itself felt at the slightest violation of the usual way of life. It is difficult to treat such a thrush.

Thrush is dangerous because it can spread to other parts of the urinary tract: uterus, fallopian tubes, ovaries, urethra. This can lead to adhesions, fibrosis, open the entry gate for the attachment of other microorganisms. Abdominal pain, menstrual disorders, inflammation, infertility, adnexitis, salpingo-oophoritis caused by Candida albicans are difficult to treat, make it long, financially costly, complicate the course of other diseases and even become their background process.

Preventive measures against thrush

1. Observe personal hygiene, including the genitals.
2. Timely change hygiene products, linen.
3. Avoid wearing underwear made of synthetic fabrics, and if necessary, wear them for a short time.
4. Avoid clothing that is out of season, too warm or cold, tight, constricting.
5. Do not self-medicate. This is especially true for antibiotics. Before starting treatment, consult a doctor about the possibility of complications from treatment in the form of thrush and, according to his appointment, take preventive measures.