by Dr. Tena Kovacevic*

If you are a woman reading this article, it is very likely you have already had, you do have or you will have a vaginal yeast infection once in your life.

Vaginal yeast infections are a common problem in women and one of the most common causes of vulvovaginal itching and discharge. This type of infection is caused by a fungus called "Candida" therefore “vulvovaginal candidiasis” is the term we (doctors) use instead. Candida species are part of the normal vaginal flora of approximately 25 per cent of women.

What are the symptoms of a yeast infection?

Itching of the vulva is the most common symptom of a vulvovaginal yeast infection. However, women may also note pain during urination, soreness or irritation, pain during intercourse, or reddened and swollen vulvar and vaginal tissues. There is often little or no vaginal discharge. If present, discharge is typically white and clumpy (like cottage cheese) or thin and watery. Symptoms of a yeast infection are similar to a number of other conditions, thus a physical examination and laboratory testing are needed to determine the cause of symptoms.

How do you know if your symptoms are caused by a yeast infection?

Most women cannot tell whether they have a yeast infection or something else. Only about 10 per cent of women who have never had a yeast infection will accurately diagnose their infection. The symptoms of a yeast infection are a lot like the symptoms of many other conditions including bacterial vaginosis (a bacterial infection of the vagina), trichomoniasis (a sexually transmitted infection), and dermatitis (irritated skin), so it is hard to tell. The best way to find out if you have a yeast infection is to see your gynecologist who will examine your vulva and vagina. He or she will also swab the vagina to get a sample of discharge, which will be examined under a microscope in a lab.

I would advise you not to begin any kind of treatment at home until it has been confirmed that you have a yeast infection! Diagnosing and treating yourself (incorrectly) wastes money (on non-prescription treatment), wastes time as you will not feel better until you use the right treatment and can make you itchier and irritated. For these reasons, it’s important to see your gynecologist to confirm that you actually have a yeast infection before beginning the treatment.

How did I get a yeast infection?

In most women, there is no underlying health problem that leads to a yeast infection. The fungus that causes yeast infections (named Candida) lives in the gastrointestinal tract and sometimes the vagina. Normally, Candida causes no symptoms. However, when there are changes in the environment of the gastrointestinal tract and vagina, Candida can overgrow and cause the symptoms described above.

Here are several risk factors that may increase the chances of developing an infection.

Use of broad-spectrum antibiotics significantly increases the risk of developing vulvovaginal candidiasis. As many as one-quarter to one-third of women develop the disorder during or after taking these antibiotics because antibiotics kill a wide variety of bacteria, including those that normally live in the vagina and protect the vagina from the overgrowth of yeast.

Women with diabetes mellitus are at higher risk of yeast infections, especially if their blood sugar is not well controlled.

Vulvovaginal candidiasis appears to occur more often in the setting of increased estrogen levels, such as oral contraceptive use, estrogen therapy and pregnancy. (Vaginal discharge becomes more noticeable during pregnancy, although yeast infection is not always the cause!)

Candida infections are more common in immunosuppressed women, such as those taking glucocorticoids or other immunosuppressive drugs, or with human immunodeficiency virus (HIV) infection.

The role of various contraceptive devices and sexual behaviors on the risk of yeast infection is less clear.

There is no good evidence showing a link between vulvovaginal candidiasis and hygienic habits or wearing tight or synthetic clothing.

Vaginal yeast infections are not a sexually transmitted infection. They can occur in women who have never been sexually active, but are more common in women who are sexually active.

How are yeast infections treated?

Treatment is indicated for relief of symptoms. Ten to 20 per cent of reproductive-age women who harbor Candida species are asymptomatic (do not have any symptoms). These women do not require therapy! 

A variety of oral and topical preparations, like pills taken by mouth, vaginal tablets and creams are available for the treatment of yeast infections. Many of them are available over the counter.  Every patient should be approached and treated individually based on whether she has an uncomplicated or a complicated infection (i.e. pregnant women, women with more than 3 infections per year, etc.).There is no evidence that eating yogurt or other "probiotic" products containing live Lactobacillus acidophilus, or applying these products to the vagina, is of any benefit in women with recurrent vaginal yeast infections.

As I mentioned above, vaginal yeast infection is not a sexually transmitted infection, although the infection may rarely be passed from one partner to another thus I do not recommend treatment of a sexual partner.

When will you feel better?

Most yeast infections go away within a few days of starting treatment. However, you may continue to feel itchy and irritated, even after the infection is gone. If you do not get better within a few days after finishing treatment, you should call your doctor or nurse for advice.

What if you get yeast infections often?

Be sure to consult your doctor about it. That way you can find out for sure whether your symptoms are caused by a yeast infection and, if so, which type of yeast. There are a few different types of yeast, and they respond to different treatments. Plus, the same symptoms that you get with a yeast infection can sometimes be caused by other types of infections, an allergy, or other problems. Furthermore, if you get frequent infections, you might need a different treatment than you have tried in the past. – Family Medical Practice Vietnam

* Dr. Tena is board certified in Obstetrics and Gynecology. She came to us after 6 years of practicing in Croatia and after additional trainings in London and New York. She started seeing patients at Family Medical Practice Hanoi from the beginning of 2018. She is eager to meet her new patients in Hà Nội, and we are thrilled to have her on board.

FMP’s downtown Hồ Chí Minh location is: Diamond Plaza, 34 Lê Duẩn, District 1: 95 Thảo Điền Street, District 2. Tel: (028) 38227848. E:hcmc@vietnammedicalpractice.com

FMP Đà Nẵng is located at 96-98 Nguyễn Văn Linh Street, Hải Châu District, Đà Nẵng. Tel: (0236) 3582 699. E: danang@vietnammedicalpractice.com