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The Battle Of The Bacteria In Women: What Happens When ‘Candida’ Wins

June 26, 2017

If you’re a woman, you’ve probably experienced the unfortunate itch and occasional pain of a yeast infection.

Ob-gyn Dr. Pamela Griswold from the Hartford HealthCare Medical Group answers your questions about this common and easily-treated health-care issue.

Q: What is a yeast infection?
A: What most women mean by a yeast infection is an infection of the vagina and the vulva with a fungal yeast organism called Candida, the usual species is Candida albicans.  This organism appears in healthy vaginas, but in some circumstances can overwhelm the other bacteria there (lactobacilli, commonly found in probiotics and yogurt), thereby presenting overabundant amounts.

Q: How common are yeast infections?
A: Candida vulvovaginitis is the second most common cause of vaginitis symptoms, and accounts for about a third of vaginitis cases.  We are not actually sure of how common it is, because many people do not come to the doctor and get diagnosed for sure. Some estimate that at least a third of women will have a yeast infection at some time in their life.

Q: Who is most likely to get a yeast infection? Why?
A: One of the most common situations to acquire a yeast infection is during or immediately after a course of antibiotics. This is due to changes in the normal bacteria that live in the vagina. Other factors for developing a yeast infection include pregnancy, oral contraceptives or hormone replacement use. In these situations, there is increased estrogen in the body that influences the microbiologic array in the vagina.  It will also appear more commonly in women who have diminished immune systems from the use of steroids (glucocorticoids), or having been diagnosed with diabetes or HIV.

Q: What are the symptoms of a yeast infection?
A: The overgrowth of the Candida albicans causes an inflammatory reaction, including redness, swelling-edema and a vaginal discharge often described as curd-like because it is white and thick. The infection is most often itchy. Some people experience painful urination. This occurs when urine hits the external skin, causing small cracks, or fissures,  in the skin.

Q: Do men ever get yeast infections?
A: Yes, men can get a yeast infection on the penis. It is called balanitis. Men with yeast balanitis are commonly diabetic. It should be noted that a yeast infection is not usually sexually transmitted.

Q: What is the treatment for yeast infections?
A: Treatment for a yeast infection is with an anti-fungal compound applied to the affected areas. There are options for applying the anti-fungal compound in the form of topical creams and ointments; creams that are placed into the vagina; or suppositories placed into the vagina.  There is also an oral anti-fungal tablet available.  No single option is preferred over the other.  Each have similar success rates in the typical, uncomplicated patient.

Q: Are there any preventative measures people can put in place with regard to yeast infections?
A: If a woman is using an oral contraceptive or taking hormone replacement, she should speak with her health-care provider about the possibility of a lower estrogen dose. Avoiding or controlling diabetes can also help prevent yeast infections. A few other common simple methods that are often suggested but not proven include: avoiding the use of panty liners, pantyhose, sexual lubricants, and douching.

Q: Are over-the-counter methods of treatment (like anti-fungal creams available in the drug store) safe and effective?
A: Yes

Q: Should people be diagnosed by a medical professional prior to treatment?
A: I feel it probably is best if women come to the doctor for a diagnosis, especially for the first case or if over-the-counter treatment does not work. There are studies that show only 11 percent of women who have self-diagnosed themselves with yeast infection are correct.  That improves a bit, to about 35 percent, if they have had a yeast infection before.  So I think it is best to have it diagnosed at the doctors at least for the first few times that a patient has the symptoms to be sure that they are actually dealing with yeast before self-diagnoses and self-medication.

The Hartford HealthCare Medical Group provides primary and specialty care services – including obstetrics and gynecology. Learn more here.