In this interview, Occupational and public health physician, Dr Abayomi Folajimi, tells TEMITOPE ADETUNJI of The PUNCH (our source) the causes, treatment, and misconceptions about yeast infection
What causes yeast infection?
It is caused by microorganisms called fungi and occurs commonly in nature as mould, mushrooms, yeast, and mildew. Yeast, as a fungus, has a subtype called candida that naturally exists in the vagina with other healthy bacteria but when certain conditions cause them to overgrow, it results in a condition called candidiasis. This can happen when bad bacteria attack the good bacteria within the body and overwhelm it causing the yeast or candida to grow rapidly.
When yeast or candida invades and overgrows in the vagina, it is called vaginal candidiasis, this is a common infection seen in women aged 20 to 40 years and very worrisome. They normally occur after puberty and before menopause, though certain medical conditions can allow them to happen anytime.
When the yeast or candida invades and multiplies in the vagina and the vulva area, it is called a vulvovaginal candidiasis yeast infection. Yeast infection typically causes a burning sensation, itching, and redness in the area outside the vagina called the vulva. There is associated inflammation in these areas leading to painful sensations. It is worth noting that three out of four women may likely experience this in their lifetime. They can also affect men and manifest as a red rash that spreads across the penis to the groin, buttocks, and anus area. Even children are not spared.
Is thrush the same as yeast infection?
Thrush can be described as one of the symptoms of yeast infection and it is caused by the same fungus called candida albicans. It affects the lining of the mouth, tongue, and lips. Candida can affect the mouth (called oral thrush), diaper areas in children, and some other parts of the body but when the same candida affects the vagina, it is called vagina yeast infection or vaginal candidiasis.
So, in essence, people can have an oral thrush or a vagina thrush all caused by yeast infection depending on what body part it affects. Even though it is an irritable condition, it normally does not cause long-term health issues when treated early.
Does it have a connection with the common yeast?
Yeast co-exists with other bacteria peacefully within the body. They occur commonly in nature in the skin, digestive system, and vagina. The body contains yeast at a normal balance and typically does not cause any problems because they are part of the human body flora. It is when they are affected by certain conditions that they tend to overgrow and cause health issues
When and how can a woman get infected with yeast infection?
A yeast infection can happen at any time as long as the risk factors exist. Certain medical conditions can be responsible. This includes the use of drugs like antibiotics, hormonal therapy, and use of steroids, a weak immune system, uncontrolled blood sugar, and pregnancy.
Wearing tight-fitting clothes can cause dampness leading to irritation and yeast infection. Not showering after a workout session with sweaty or wet underwear is also a risk factor. Perfumed tampons and some vaginal deodorants have been known to cause vaginal candidiasis. Your soap and toilet paper may contain chemicals that are irritating and can predispose one to candida infection. Inserting soap into the vagina is also a causative factor. All these will alter the normal vaginal PH and make it susceptible to developing a yeast infection.
What is the place of hygiene in yeast infection?
Like any skin infection, poor hygiene is a major predisposing factor. However, it is just one of the causes as there are several other causes as itemised earlier. Yeast thrives and grows in humid, warm, and moist areas; therefore, good hygiene can help prevent it.
Is yeast infection a strong indicator of high sexual activity?
It cannot be sexually transmitted but can develop after intercourse from other causes, especially during intense itching which may cause other bacteria or organisms that cause sexually transmitted disease to enter the vagina. They can occur in people who have never had sex. Frequent sexual activity, especially with different partners, however, can introduce new bacteria that will compromise the good bacteria in the vagina by disturbing the PH. It is advisable to wait for yeast infection to clear before engaging in sexual activity; intercourse may worsen the irritation, burning sensation, and pain associated with candida. Having multiple sexual partners may result in HIV/AIDS which lowers the body’s immunity and allows yeast infection to multiply as an opportunistic infection.
Are there other signs of yeast infection?
One may experience skin cracking around the vulva area, depending on severity. The consistency of vaginal discharge is likely to change; a thick white vaginal discharge that looks like cheese is a strong sign of a yeast infection. A woman can also experience pain when urinating and during intercourse. Yeast infections can also be passed from a mother to an unborn child resulting in ‘nappy rashes’ and oral thrush. A thick whitish to yellowish, typically odourless discharge suggests an active yeast infection. It can also be watery.
Apart from poor hygiene, what other factors promote yeast infection?
Poorly treated diabetes, impaired immune system in HIV/AIDS, oral contraceptive usage, and chemotherapy for cancer all predispose one to yeast infections. Yeast feeds on sugar; high blood sugar is the perfect medium for it to grow. So, care should be taken to keep it well under control. Birth control pills, like oral contraceptives, will disrupt hormonal balance and help the yeast to multiply within the body. Some researchers have linked it to genetic predisposition
Some claim that the use of antibiotics to treat yeast infection only makes it worse. How true is that?
This is not exactly true. Antifungal drugs are the recommended drug of choice and work perfectly for yeast infections. However, other types of antibiotics may destroy healthy bacteria in the body and consequently cause yeast infections.
Because fungi and bacteria are all microorganisms, the drugs are targeted to attack them, and both the good and bad bacteria in the body will be affected. Once the good bacteria colony reduces, it leads to yeast multiplication.
What is the relationship between the menstrual cycle and yeast infection?
The menstrual cycle disrupts normal physiologic function bringing about high levels of hormones. One of the hormones that surge is called estrogen and has been associated with the likelihood of developing yeast infection during this period. It is believed that estrogen helps release more sugar in the body. Yeast typically feast and multiply in the presence of sugar. Physical and barrier forms of contraception can also cause yeast overgrowth. Spermicidal jellies and creams have been known to alter the balance of the bacteria residing in the vagina, which makes it easier for yeast to grow. The use of vagina jellies or creams can create a moist environment that allows candida to rapidly grow. Vaginal sponges, diaphragms, intrauterine devices (IUDs), and other devices that sit in the vagina may also promote the risk of growth and infection.
Also, vaginal douching can release chemicals in the vaginal that can kill healthy bacteria. In fact, this may cause an infection called bacterial vaginosis with a fishy odour, and it’s one of the most uncomfortable and embarrassing odors women experience. Cleaning from the anus to the vagina is said to increase the risk. It’s better to clean from the vagina to the anus. The anus contains various microorganisms that we cannot see and they are very active, using the same wipe to clean the anus and then onto the vagina will easily introduce these germs into the vagina which we know can predispose one to candida or yeast infection
How can women manage the severe itching caused by yeast infection?
Avoid touching the affected part as much as possible because you stand the chance of spreading the infection to other parts of the body if you don’t practice good hand washing. Itching is a very uncomfortable symptom and depends on the severity of the infection. Some may experience mild to moderate itching while some have intense itching that may even lead to bruising and bleeding.
Fortunately, there are many remedies to alleviate the intense itching associated with a yeast infection. Home remedies have been advocated in the past but a lot of them are controversial as research evidence does not support some of their uses. However, the use of vaginal antifungal topical creams applied directly to the vulva itchy areas will help suppress itching. Oral antifungal drugs have proven to be very effective too. Good hygiene, especially for women who sweat a lot, and during pregnancy is highly recommended.
How does yeast infection affect intercourse?
Sexual activities will delay the healing time because they can result in additional bruising.
Repeated penetration will definitively disrupt creams and ointments meant for treatment thereby making them less effective. Couples are advised to allow yeast infection to clear out before engaging in sexual activities.
Yeast infection becomes very complex to deal with when you are sexually active. In itself, it does not affect the consistency or natural makeup of condoms. However, it’s also true that some anti-fungal topical medications used contain some oily solutions, and contact with the condom during sexual intercourse can cause a condom to break. This leads to the risk and complications of unwanted pregnancy.
How can a yeast infection be treated?
All yeast infections should be identified and treated promptly. Some may resolve but usually do within a week. If they don’t, a medical consultation would be necessary to avoid complications as it can even spread to the bloodstream in severe cases if left untreated. According to experts, 11.8 per cent of Nigerians suffer from serious forms of fungal disease. Medical consultation is advisable even for those experiencing the infection for the first time. Your doctor will listen to your complaints; confirm the signs and symptoms and then may recommend a test for confirmation to rule out other probable causes that may mimic a yeast infection. Once this is done, over-the-counter medications will be prescribed
How early should treatment begin?
Treatment should start early as soon as symptoms are noticed or as soon as a doctor confirms the diagnosis. All symptoms should be identified as accurately as possible for proper diagnosis. Treatment will depend on the severity and how often the person has the infection. Some individuals may have it repeatedly in a year with very irritating symptoms while others may experience the mild form. In general, we have mild, moderate, and severe symptoms. Medications come in many forms, including oral therapy, vaginal pessaries, topical creams, and other suppositories. An applicator is used to introduce the creams and suppository so that they come in direct contact with the inflamed parts.
For mild to moderate symptoms, a short-course vaginal therapy involving an antifungal medication for three to seven days will usually clear a yeast infection. A single oral dose of anti-fungal also works wonders. For severe and frequent yeast infections, a long-course vaginal therapy is recommended with an anti-fungal medication taken for even up to six months. Multi-dose oral medication involves taking two or three doses of anti-fungal medication to be taken by mouth instead of vaginal therapy. The treatment goals are to reduce the itching, inflammation, and burning sensation and clear the infection. Please, note that oral medication isn’t recommended if you’re pregnant. However, vaginal therapy can be tolerated.
Does yeast infection affect the mental state of a woman?
Recurrent and chronic yeast infection is of particular concern; this may cause low libido, sexual dissatisfaction, and even infertility which all worsen the mental balance. In pregnancy, a vaginal infection can result in premature labour, premature birth, and even miscarriages. These are stressors that will affect anyone. A doctor should be consulted if anyone experiences depression.
No woman should feel intimidated or shy to discuss this subject to get the necessary help as it is a manageable infection. It should be well noted that it is not a sexually transmitted infection and should not be categorised as such. It can, however, be passed between partners on a few occasions.
If you have a recurrent or chronic yeast infection where there is a repeat of the infection twice within six months, please see your doctor for further treatment. You may require further examination, diagnosis, and more intense treatment, especially for chronic and recurrent vulva vaginal candidiasis. Further examination may reveal other concurrent or similar medical conditions that may need to be managed alongside the yeast infection.
Good personal hygiene cannot be overemphasised for prevention. Prevention, they say, is better than cure. Try to stay clean and dry as much as possible, remove wet or sweaty clothing on time when after using the gymnastics or swimming, reduce moisture by wearing loose-fitting underwear made of absorbent cotton or silk material which will allow air to circulate, avoid douching and use of other toiletries that can disrupt the normal flora and PH of the vagina, practice safe sex and take extra care during menstruation. Avoid non-breathable panty liners and sanitary pads.
