Understanding Discharges

Good Dr. Carey, I have been following your column of lately in Your Style eZine and I must say I really like your unorthodox style of approaching women's health. I am an adult female with a problem for which I have seen a few doctors about, but I am still not clear on the issue. For the past 2 years I have be struggling with yeast infections about every 2 and a half to 3 months. While I do realize that I perspire a great deal and hence this may contribute to its occurrence. I have also tried to wear cotton clothing as often as I can, particularly during the very hot days but the yeast is still a problem. Do you have any suggestions for this? Really looking forward to your response, Thanks much.

Dear Reader,

Thank you for your question and I am very pleased that you are enjoying the column. I look forward to hearing from you again.

Yeast infections of the vulva and/or vagina (called vulvovaginal candidiasis), are a common problem for many women. Because of the discomfort (persistent itching, irritation, tenderness of irritated skin) and the associated clumpy discharge, it can be quite debilitating as well as embarrassing. Yeast is a common organism in the vagina, and due to changes in body chemistry, these organisms may multiply and become symptomatic. In the majority of cases, the reason for the overgrowth /yeast infection is physiological i.e. not due to disease. These changes can occur just prior to or after menstruation (“the period”), and many women become accustomed to these recurrent episodes. Yet some everyday strategies to reduce these occurrences include using only cotton underwear, the use of panty liners in women who perspire excessively (and even forgoing panties at night when sleeping), and an increased intake of yogurt.

It must be understood that just like the yeast that grows on old bread, yeast on the body also responds to the same conditions. Areas with high levels of moisture, a food source, and warmth are yeast’s favoured conditions. So without getting gross! The unstimulated vagina is already moist and warm, and there is a significant microscopic food source in the vagina of menstruating women; these all encourage yeast growth. So the lifestyle changes listed above should reduce their incidence.

In the women who rarely have yeast infections: the other normal bacteria within the vagina help to prevent yeast overgrowth. However, when this balance is disturbed then a yeast infection can occur. These imbalances occur with recent antibiotic usage, pregnancy, and immunosuppression due to illnesses like diabetes mellitus (“sugar”) and human immunodeficiency virus (HIV). So it is important that women who do not have “the physiological” form present to their physician for further evaluation and treatment. The mainstay for treatment for yeast infections is to treat any underlying causes and to give antifungals either orally, topically, or with intravaginal inserts and this will depend on the severity of the infection and the needs and compliance profile of the patient. Just like antibiotics, you must take the whole course of antifungal medication for it to be beneficial!!!

I hope this helps to shed some light on the problem that you have articulated above, however as with any medical concerns, please visit your doctor for a complete evaluation.

Let me know how you are doing.