Yeast Infections

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Yeast Infections

Tame Vexing Vaginal Fungus

Sooner or later, most women get yeast infections, says Janet McCombs, Pharm.D., clinical assistant professor at the University of Georgia College of Pharmacy in Athens. And it's easy to see why, say other women doctors.

"The vaginal milieu is a delicate ecosystem that is easily unbalanced by insult," says May M. Wakamatsu, M.D., instructor of obstetrics and gynecology and reproductive biology at Harvard Medical School. A variety of microscopic organisms normally reside as peaceful neighbors in the vagina, among them the yeastlike fungus Candida albicans. But "insults" such as taking antibiotics for other conditions can kill off certain flora and leave Candida to go on a rampage. This results in Candida vaginitis, or a yeast infection, the second most common form of vaginitis experienced by women.

As any woman who has had a yeast infection--or several--can avow, the symptoms are the pits: itching in a place that's not polite to scratch, burning during urination and sometimes a thick, white discharge.

PROPER AT-HOME CARE

If your doctor has confirmed that what you have is a yeast infection and not some other form of vaginitis, antiyeast medications are usually necessary. But success depends on you. (For tips on soothing vaginitis in general, see page 564.)

When To See A Doctor If you've been visited by the Yeast Beast within the past two months and recognize the symptoms, women doctors say that it's okay to self-treat with an over-the-counter yeast medication such as Gyne-Lotrimin or Monistat 7. Otherwise, see your doctor for proper diagnosis and initial treatment if you experience: * A white vaginal discharge with a yeasty odor, similar to * cottage cheese in texture and appearance * Itching and irritation in the vulvar folds, in the area outside your vagina or both * Pain during urination * Pain during sexual intercourse Also, you should see your doctor if self-treatment doesn't work. You could be having a more serious episode of the infection or a different infection altogether. A Pap smear, visual exam and other simple tests can sort it out.

Take every last pill. Be sure to take your full course of whatever antibiotic that your doctor has prescribed, says Kathleen McIntyre-Seltman, M.D., professor of medicine in the Department of Obstetrics/Gynecology at the University of Pittsburgh School of Medicine. Cutting treatment short just because you feel better invites a recurrence, since you've only wiped out some of the fungus.

Use a nonprescription remedy. "For the average yeast infection, over-the-counter antiyeast suppositories and creams (such as Gyne-Lotrimin or Monistat 7) are very effective," says Dr. McIntyre-Seltman. "If you've had an infection before and recognize the symptoms, go ahead and use one."

Lean back and apply. To reduce leakage from your vagina, use suppositories and creams at bedtime, suggests Janet Engle, Pharm. D., clinical associate professor of pharmacy practice at the University of Illinois at Chicago. Place the applicator as far into your vagina as possible by inserting it while squatting slightly or, even better, while lying on your back with your knees bent and pulled toward your chest.

Wear a sanitary pad or panty liner during treatment to protect your clothing, suggests Dr. McCombs.

NONDRUG STRATEGIES FOR THE YEAST BEAST

Over and above proper use of at-home medications, women doctors say that there are quite a few other things that you can do to get more comfortable and deter a recurrence.

Try a vinegar douche. Flushing your vagina with a dilute solution of vinegar and water occasionally--no more than once a week--may help prevent yeast infection recurrences. "This makes the vagina a little more acidic, which is bad for yeast." Mix two tablespoons of white vinegar with one quart of water and use a standard douching bulb, available at drugstores.

Women doctors advise against using commercial douches--or douching any more often than once a week. Douching kills off "good" lactobacilli bacteria in the vagina, leaving Candida to run wild, says Dr. McIntyre-Seltman.

Apply yogurt. Some people believe that yogurt, which contains bacteria that are cousins to the "good" bacteria in the vagina, may help the good bacteria repopulate, says Dr. McIntyre-Seltman. If you are going to try this remedy, be sure to use plain, unsweetened yogurt containing live cultures and apply it to your vaginal opening at bedtime.

Eat yogurt. In one study, women with recurring yeast infections who ate yogurt every day had fewer yeast infections, says Vesna Skul, M.D., assistant professor of medicine at Rush Medical College of Rush University and medical director of Rush Center for Women's Medicine, both in Chicago, and infections that they did get retreated quickly. "Yogurt gives women a double benefit: It's a low-fat, high-protein, high-calcium food, and the lactobaccilus acidophilus bacteria it contains helps create a more normal bacterial environment." She tells the women she treats to eat a daily eight ounces of yogurt containing live yogurt cultures.

Crunch on carrots. According to doctors in the Department of Obstetrics and Gynecology at Albert Einstein College of Medicine of Yeshiva University in New York City, eating carrots and other foods rich in beta-carotene--a natural substance that's converted into vitamin A in the body--may offer protection against yeast infections. In one study, vaginal cells in women with yeast infections had significantly lower levels of beta-carotene than the vaginal cells in women who did not have yeast infections. The doctors theorize that benefit may be due to beta-carotene's ability to boost the immune system.

Besides carrots, spinach, broccoli, sweet potatoes and apricots all contain plentiful amounts of beta-carotene.

Clothe in cotton. "Candida likes moist, warm environments to grow in," says Dr. Skul. Keep dry and cool by wearing cotton underwear, loose clothing and panty hose with a cotton crotch, she suggests.

Add cornstarch. "Sprinkling a little cornstarch in your groin area helps absorb moisture," says Kimberly A. Workowski, M.D., assistant professor of medicine in the Division of Infectious Diseases at Emory University in Atlanta.

Exercise without restraint. Tight exercise clothes, says Dr. McKay, invite yeast infections on two counts: You're usually sweating in them, and their tightness interferes with cooling air circulation. "A pair of running shorts is better than running tights, because air can circulate in them," she says. And look for sportswear with an open, rather than tight, weave.

Ditch your wet swimsuit. Walking around in a clingy wet swimsuit is an invitation to yeast proliferation, says Kristene E. Whitmore, M.D., chief of urology and director of the Incontinence Center at Graduate Hospital in Philadelphia. "Buy two identical swimsuits," she suggests. "After a dip, rinse your suit in clear water and put on the dry suit. No one needs to know that you changed suits."

Lay off the sweets. "Woman who have diabetes and who eat too much sugar--which they shouldn't be doing anyway--will probably get more yeast infections," says Mary Lang Carney, M.D., medical director of the Center for Women's Health at St. Francis Hospital in Evanston, Illinois. "Their blood sugar levels rise, and all their tissues have more sugar in them. When there's more sugar anywhere, yeast have a great feast and multiply like mad."