What is vaginitis?

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Alternative names :- Yeast infection - vagina; Vaginal candidiasis; Monilial vaginitis; candida;

Vaginal yeast infections are caused by a fungus called Candida albicans. Yeast are tiny organisms that normally live in small numbers on the skin and inside the vagina.

The acidic environment of the vagina helps keep yeast from growing. If the vagina becomes less acidic, too many yeast can grow and cause a vaginal infection.

The acidic balance of the vagina can be changed by your period (menstruation), pregnancy, diabetes, some antibiotics, birth control pills and steroids. Moisture and irritation of the vagina also seem to encourage yeast to grow.

Vaginitis is the most common gynecologic problem seen in primary care and gynecology settings. A vaginal yeast infection, also called vulvovaginal candidiasis, is one of three types of vaginitis. The other types are bacterial vaginosis and trichomoniasis.

Yeasts are always present in the vagina in small numbers; however, symptoms only appear when overgrowth occurs. As with the other forms of vaginitis, a yeast infection is triggered by changes in the vaginal ecosystem. It's estimated that 75% of all women will have a vaginal yeast infection at some point in their lives.

Signs & Symptoms

The most common complaint of women with yeast infections is vulval and vaginal itching. They may also experience irritation and inflammation.

Other symptoms may include:

• dyspareunia (painful intercourse)
• external dysuria as urine passes over the inflamed labia
• burning sensation during urination
• cottage cheese-like discharge.

Women may notice a worsening of symptoms during the week before the onset of menses, with relief during and after menses. due to the hormonal changes that occur during the menstrual cycle.

On physical examination, the clinician may note vulvovaginal edema and erythema. A thick, White, usually nonmalodorous discharge may be present. White flecks may be noted adhering to the vaginal wall. Excoriations may be observed due to scratching or irritation and the vagina may look and feel dry.

Types of vaginitis

To diagnose a yeast infection. the clinician must:

• assess the color and consistency of any discharge

• check the pH of vaginal fluid

• assess for the presence of amines by performing a whiff test • prepare wet mount slides with saline and potassium hydroxide (KOH). Vaginal pH is normal (greater than 4.5) in clients with yeast infection. A whiff test is performed by mixing the vaginal discharge with one or two drops of 10% to 20% KOH and assessing for odor. An odor shouldn't be present in patients with yeast infection; this is called a negative whiff test. A positive whiff test is associated with bacterial vaginosis. Microscopic evaluation of the saline slide and KOH wet mounts usually reveal budding yeast cells and pseudohyphae, although they aren't always seen.

Further testing with fungal cultures is indicated in patients with recurrent yeast infections or infections refractory to treatment.

What Causes vaginitis?

The most common cause (about 90%) of a vaginal yeast infection is a fungus called Candida albicans. Other fungi that may also be responsible include;

• C. glabrata
• C. parapsilosis
• C. tropicalis
• Saccharomyces cerevisiae.

It's unknown exactly why some women are more prone to yeast infections. Even so, some predisposing factors have been identified. including:

• antibiotic use
• hormonal contraceptives (oral and topical)
• corticosteroid therapy
• douching
• human immunodeficiency virus infection or other immunosuppressed states
• hormones
• increased frequency of sexual intercourse
• multiple sex partners
• oral or anal sexual intercourse
• obesity
• pregnancy
• sexually transmitted diseases
• stress
• tissue abrasion that allows yeast to infiltrate the vaginal epithelium
• uncontrolled diabetes mellitus
• vaginal medications.

Prevention:

Care of the patient with a yeast infection includes teaching about treatment and prevention. Self-diagnosis, treatment, and prevention must also be addressed.

• For the patient who is self-treating, if symptoms persist or if they recur within 2 months, medical care should be sought.
• Intercourse should be avoided until treatment is complete.
• Partner treatment isn't necessary unless symptoms appear, then topical treatment can be given.
• Patients who are pregnant should be treated for 7 days with a topical medication.
• Avoid brewer's yeast or foods rich in yeast.

Patients should be taught about vaginal hygiene, including the following:

• Avoid tight-fitting clothes.
• Wear cotton underwear.
• Dry the vaginal area well after bathing.
• Wipe from front to back after using the toilet.
• Change out of wet swimsuits or damp clothes promptly.
• Avoid deodorant sanitary pads, tampons, and toilet paper.
• Discourage douching or using feminine hygiene sprays.
• Decrease intake of sugar and yeast-containing foods and beverages.

When to seek Medical Advice:

Oral treatment is commonly preferred because it isn't as messy as topical treatments and patients are more likely to comply. However, the adverse effect of hepatotoxicity must be kept in mind. One oral dose of fluconazole (Diflucan) can be given.

For those with vulvar itching and burning, a topical anti fungal may be prescribed to relieve the discomfort when applied externally. Several over-the-counter treatments are available and can be recommended for clients with previously diagnosed yeast infections who have recurrence of the same symptoms.

Treatment/Therapy:

Yeast infections can be treated topically or orally. Topical treatments are generally more effective and may be given as creams, suppositories, or a combination of both.

Doses are given each night for 3 to 7 days, depending on the agent and concentration. Recurrent or refractory infections warrant longer therapy. Topical medications include:

• clotrimazole (Mycelex)
• miconazole (Monistat)
• butoconazole (Femstat)
• terconazole (Terazol).

Self Care strategies for Living with vaginitis

Natural Home remedies to cure vaginal yeast infection

• Peel a fresh clove of garlic and make a little tampon by wrapping it in cheesecloth and tying with unwaxed dental floss. You may leave a bit of floss to pull it out afterward. Insert it in vagina and leave there for several hours, say overnight, and remove it in the morning. For severe infection, try this in the morning and during night both. Repeat this until one day after the symptoms disappear.

• Drink at least two glasses of buttermilk a-day, whether infected or not. In fact making curds a part of the daily diet in take reduces the probability of vaginal yeast infection.

• Regularly daubing apple cider vinegar in the areas prone to this infection. Your can add some garlic to stop the itchy feeling; and water to dilute the vinegar concentration

• Dissolve 1 Tb sp of potassium sorbate in 1 cup water. Insert a tampon into the vagina and pour this solution inside to be absorbed by the tampon. Keep it there overnight. Repeat this for several nights. Helps to cure vaginal yeast infection.

• Pour a few drops of Tea tree oil (available from natural health stores) on a lubricated tampon & insert into the vagina. Helps to prevent vaginal yeast infection.

Diet change strategies:

human immunodeficiency virus infection or other immunosuppressed states can be dealt with by improving your nutrition and ensuring that your body is capable of absorbing this nutrition

You may want to read this article about: why is nutrition such an issue nowadays?

Vitamin & Nutrient Associations

Further reading through our articles on health issues will give you a body of information that will help you decide what options you have to deal with the underlying causes of your vaginitis problem through giving your body the nutrition products that will assist you body to heal from the inside out.

We wish you well in your search for solutions to this problem and your movement towards better health in all areas.

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