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Yeast Infections

Yeast infections of the vagina are what most women think of when they hear the term "vaginitis", used to describe infection or inflammation of the vagina. They are, in fact, one type of vaginal infection, which nearly every female experiences at least once in her lifetime.

Yeast infectious are caused by one of the many species of fungus called Candida. These fungi normally live in small numbers in the vagina as well as in the mouth and digestive tract of both men and women.

Yeast infections produce a thick, white vaginal discharge with the consistency of cottage cheese. Although the discharge can be somewhat watery, it is odorless. Yeast infections usually cause the vagina and the vulva (the external area around the vagina) to be very itchy and red.

What Causes Yeast Infections?

Since yeast is normal in a women's vagina, what makes it cause an infection? Usually this happens when a change in the delicate balance in a woman's system occurs. For example, a woman may take an antibiotic to treat a urinary tract infection and the antibiotic kills her "friendly" bacteria that normally keep the yeast in balance; as a result the yeast overgrows and causes the infection.

Pregnancy, which changes hormone levels, and diabetes, which allows too much sugar in the urine and vagina, can also upset the delicate balance. Other common risk factors for yeast infections include high estrogen contraceptives, immunosuppression, thyroid or endocrine disorders, and corticosteroid therapy.

Can you prevent yeast infections? Researchers have found that taking the following steps can help reduce your chances of getting yeast infections:

1. Avoid wearing garments that hold in heat and moisture, such as nylon panties, pantyhose without a cotton panel, and tight jeans.

2. Practice good hygiene and have a gynecological exam every 1-2 years.

3. Eat yogurt that contains active cultures (read the label).

How Are Yeast Infections Diagnosed?

Like other forms of vaginitis, yeast infections are diagnosed after examining the symptoms, such as burning or itching in or around the vagina, and the consistency of the woman's discharge. (Many forms of discharge are normal or might indicate another type of vaginal infection.)

By noting exactly which symptoms you have and when they occur, along with a description of the color, consistency, amount, and smell of any abnormal discharge, you can help your practitioner make an accurate diagnosis.

Also, do not douche before your office or clinic visit; it will make accurate testing difficult or impossible. It is wise to see your health care practitioner again if:

- All of the symptoms do not go away completely.

- The symptoms return immediately or shortly after you finish treatment.

- You have any other medical conditions that might be related, such as diabetes.

- You might be pregnant.

A qualified clinician can make the diagnosis after a physical exam of the affected area (in this case, the vagina and vulva) and through a microscopic exam of the secretion, or discharge.

It is important to realize, however, that as many as 4 out of every 10 women with vaginitis may not have typical symptoms. Frequently, a routine gynecologic exam will confirm vaginitis even if symptoms are not present. This is one reason why it is important to have a gynecologic exam at least every 2 years, according to the National Institutes of Health.

How Are Yeast Infections Treated?

Keep in mind that symptoms of yeast infections might be similar to those of other forms of vaginitis, but treatment must be specific for yeast infection in order to be effective.

When a woman has had a yeast infection diagnosed by her practitioner, she is usually treated with a prescribed vaginal cream or suppositories.

Some vaginal creams and suppositories can now be purchased without a prescription. Keep in mind that this medication may only cure the most common types of Candida associated with vaginal yeast infections and will not cure other yeast infections or any other type of vaginitis. If you are not absolutely sure, see your provider. You may save the expense of buying the wrong medication and avoid delay in treating your type of vaginitis.

Commonly used medications include

- Three-day treatments: butoconazole cream, clotrimazone vaginal tablet, terconazole cream & suppository, or miconazole suppository;

- Seven-day treatments: miconazole cream or suppository;

- Single dose treatments: clotrimazole tablet, tioconazole ointment, or fluconazole oral tablet.

Ketoconazole, taken once daily by mouth for up to six months, is considered effective in preventing recurring yeast infections.

As with any medication, be sure that you fully understand all the costs, benefits, and risks associated with it so that you can make informed decisions about your health and well-being. Also, it is important to continue medications for yeast infections as directed, even if your symptoms have gone away.

Infections that do not respond to treatment or that recur frequently could be signs of other medical conditions. If you have these experiences, it is advisable to see a health care practitioner.