Treatments for Vulvovaginal Candidiasis

Vulvovaginal Candidiasis, caused by the overgrowth of the fungus Candida, affects nearly 75% of all adult women at least once their lives. Candida is a relatively harmless yeast, normally found in the mouth, throat, intestines and genitourinary tract of most humans. In the yeast state, Candida is simply a non-invasive, sugar-fermenting organism, whose purpose is to destroy harmful gut flora (bacteria). In a normal environment, Candida is controlled by a properly functioning immune system and helpful “friendly” gut flora like Lactobacillus acidophilus, Bifidobacterium bifidum and Bacillus laterosporus, all of which suppress undesirable bacteria and yeasts and help maintain a balanced, healthy immune system. When the balance between the normal microorganisms of the vagina are disrupted, however, Vulvovaginal Candidiasis can result.

Commonly referred to simply as a vaginal yeast infection, vulvovaginal Candidiasis disorder occurs when the acidity of the vagina changes. This may be due to hormone imbalance, in conjunction with other illnesses (such as Diabetes), in those who are immunosuppressed (such with AIDS or HIV), in those who use oral contraceptives, and commonly, with antibiotic use (particularly tetracycline)[.1, 2] Pregnancy, prolonged use of steroid hormones, acid blockers and ulcer medications, immunosuppressants or anti-inflammatory drugs, excessive stress, and improper diet can also contribute to Vulvovaginal Candidiasis.[3]

Vulvovaginal Candidiasis is not a sexually transmitted disease, nor is it an airborne infection. It can, however, be transmitted from one partner to another through intercourse, deep kissing or oral sex.[4] Fortunately, if the other person is healthy, his or her immune system will destroy the cells and prevent infection. Still, an estimated 12%-15% of men develop symptoms such as itching and rash following sexual contact with an infected partner.[5] It is also possible for breastfeeding mothers to transmit the infection to their infants.

The National Institutes of Health[6] lists the following as the most common symptoms of Vulvovaginal Candidiasis:

Abnormal vaginal discharge (ranging from a slightly watery, white discharge to a thick, white, chunky discharge)
Vaginal and labial itching or burning
Redness and/or inflammation of the vulva
Pain with intercourse
Painful urination

Diagnosis is made through visual examination, symptom review and in some cases, laboratory tests. Once identified, Candida can be successfully treated through several measures. Remedies include the determination and elimination of any causative factors, application of antifungal medications, lifestyle changes (such as quitting smoking and reducing or avoiding alcohol consumption), removing (or reducing) pollution and toxins in your environment, and strengthening your immune system through the combined application of a healthy lifestyle plus proper nutrition and probiotic supplements.

Before undergoing any treatment – conventional or otherwise – be sure you are dealing with a true vaginal yeast infection. Self-treating a suspected vaginal yeast condition may delay diagnosis and effective treatment of a similar vaginal infection that will not respond to yeast treatments. In fact, one study by the American Social Health Association found that 70% of women self-treated vaginal infections before calling a health care provider. Most often, they incorrectly thought they had a yeast infection when, in fact, it was bacterial vaginosis.[7]

Common treatments include antifungal medicines in the form of tablets, creams, ointments or suppositories, including [8]:

Femstat: an antifungal type of antibiotic applied as a vaginal cream. Femstat is available as a 1-day or 3-day treatment. See http://www.drugdigest.org/DD/DVH/Uses/0,3915,92%7CFemstat,00.html for details.

Clotrimazole: Clotrimazole comes as a lozenge, topical cream or solution formula, as well as in over-the-counter vaginal creams and tablet forms. See http://www.aegis.com/factshts/network/access/drugs/clot.html for more information.

Monistat: these prefilled applicators come in 1, 3 or 7 day treatments. See http://www.monistat.com/index.jsp for details.

Nystatin (Mycostatin): comes in tablet or cream form. See http://www.nlm.nih.gov/medlineplus/druginfo/medmaster/a682758.html#combo-names for details.

GyneCure: comes as vaginal ointment and ovule. See http://www.rxmed.com/b.main/b2.pharmaceutical/b2.1.monographs/CPS-%20Monographs/CPS-%20(General%20Monographs-%20G)/GYNECURE.html for more information.

Diflucan: an oral suspension not recommended for use in pregnancy. See http://www.nlm.nih.gov/medlineplus/druginfo/medmaster/a690002.html for details.

Cranberry Juice: always helpful for bladder infections, cranberry lowers the ph of urine. Supporters say that the juice may also help prevent the occurrence of yeast infections and aid in their treatment.[9]

Lactobacillus acidophilus: yogurt! You can ingest it, or�as some braver folks do, insert it vaginally [see http://www.msu.edu/user/eisthen/yeast/yourself.htm]. You can also take acidophilus pills from your local health store.

Not so common remedies[10, 11] include:

Garlic: yes, garlic. Supporters of this tried and true method say that a fresh, peeled clove of garlic can cure a yeast infection in a matter of days. Wrap the peeled garlic clove in gauze, tie the ends with unwaxed, unflavored dental floss – but leave a bit of floss hanging for removal – and insert it vaginally. Leave it in for several hours or even overnight. Repeat as necessary until the infection has resolved. Others say you can also use the garlic capsules sold as dietary supplements in health food stores.
Tea tree oil: commonly used in Italy, tea tree oil has been shown to be effective against yeast. Widely available, this essential oil treatment may be just what helps you. Check with your local alternative health practitioner for proper methods of use.

Boric acid vaginal suppositories (600 mg/day for 10 days) are effective, even in cases of resistant infections.

Whichever treatment you try, vaginal yeast infections should be cleared up within two weeks or less of treatment; often even within a few days. If you suffer from recurrent or resistant infections, see your doctor.

[1] “Genital Candidiasis,” Centers for Disease Control Division of Bacterial and Mycotic Diseases. http://www.cdc.gov/ncidod/dbmd/diseaseinfo/candidiasis_gen_g.htm
[2, 5, 6] “Vaginal Yeast Infections,” National Institutes of Health. http://www.nlm.nih.gov/medlineplus/ency/article/001511.htm
[3] “The Candida Albicans Mystery,” by Stephen B. Edelson, M.D., F.A.A.F.P., F.A.A.E.M C.
[4] “Candida: Frequently Asked Questions,” by Aleksandar Ivanovic with input from Roberta Blaylock, Anne Mears, Charles Binder, Carrie Micko, [name removed upon request], Gail Brenner, Tina Guarasci, Beth Peacock and contributing members of YEAST-L.
[7] “Vaginal Infections,” by Arasi Thangavelu-Veluswamy, MD, FAAEM, Clinical Instructor of Emergency Medicine, Weill Medical School, Cornell University; Consulting Staff, Department of Emergency Medicine, Passaic General Hospital; Consulting Staff, City of New York Fire Department. http://www.emedicinehealth.com/vaginal_infections/article_em.htm
[8, 9 ] “Vaginal Yeast Infection,” Harvard Medical School Faculty. http://www.intelihealth.com/IH/ihtIH/WSIHW000/9339/10956.html
[10] http://www.msu.edu/user/eisthen/yeast/yourself.html
[11] “Candida yeast vaginitis ,” by Frederick Robert Jelovsek, M.D., M.S. http://www.wdxcyber.com/dxvag004.htm