Infection Detection: Yeast Beast or Something More Serious?

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If it’s itchy down there, it must be a yeast infection, right? Wrong.

Before you run to the drugstore for an over-the-counter (OTC) anti-fungal treatment, you might want to re-evaluate your symptoms. An estimated 44 percent of women with a vaginal infection initially treat themselves with an OTC yeast infection medication when they actually have bacterial vaginosis (BV), a much more serious infection caused by an overgrowth of the bacteria that occur naturally in the vagina.

A yeast infection, on the other hand, is caused by an overgrowth of fungus that occur naturally in the vagina.

In fact, the outward symptoms of many forms of vaginal infection are similar. Here’s a quick chart to help you detect whether it’s the yeast beast — or something more serious.

If your discharge is a milky gray-white, or if it’s accompanied by a fishy or foul odor, see your doctor right away. OTC yeast-infection medications are not an effective treatment for bacterial vaginal infections and, in fact, may be harmful if they delay proper treatment.

Untreated BV can lead to significant health complications, including premature delivery, postpartum infections, clinically apparent and subclinical pelvic inflammatory disease (PID), postsurgical complications (after abortion, hysterectomy, cesarean section and other reproductive procedures), increased vulnerability to HIVinfection and, possibly, infertility.

Vaginal Yeast Infection Overview

A vaginal yeast infection, also known as vaginal candidiasis, genital candidiasis, or vulvovaginal candidiasis (VVC), is an infection involving a type of fungus, or yeast. The fungus most commonly associated with vaginal yeast infection is called Candida albicans, which account for up to 92% of all cases, with the remainder due to other species of Candida. These fungi can be found all over the body and are normally present in warm and moist areas of the body. Studies have shown that up to 20% to 50% of all women normally carry yeast in the vagina without the presence of symptoms. When C albicans in the vagina multiplies to the point of infection, this infection can cause vaginal inflammation, irritation, odor, discharge, and itching.

Certain types of bacteria that live naturally in the vagina usually keep C albicans from growing out of control. If the balance of these microorganisms becomes upset, C albicans may be allowed to grow uncontrollably and lead to symptoms. The use of certain medications including antibiotics, changes in hormone levels, or certain diseases are examples of factors that can allow a vaginal yeast infection to develop.

Vaginal yeast infections are extremely common. Seventy-five percent of all women develop a yeast infection at some point during their lives.

A vaginal yeast infection is not considered a sexually-transmitted infection (STD), but 12% to 15% of men develop symptoms such as itching and penile rash following sexual contact with an infected partner.

Under normal circumstances, a vaginal yeast infection is not serious and can be treated with medications. However, a vaginal yeast infection can be a sign an underlying, more serious condition or can lead to serious complications, especially if left untreated.

  • Many women who think they have a vaginal yeast infection actually have other types of vaginal infections. When these women attempt to treat their condition with over-the-counter medications intended to treat yeast infections, the symptoms do not improve. This may allow the infection to worsen. A study performed by the American Social Health Association found that 70% of women used over-the-counter medications designed to treat yeast infections before calling their doctor. Studies have shown that when women self-diagnose a vaginal yeast infection, in many cases, the symptoms are related to other conditions, such as bacterial vaginosis, which is a bacterial infection. Other causes of symptoms similar to those of a vaginal yeast infection include local irritation (for example, from intercourse or tampons); allergic reaction; or chemical irritation from soap, perfumes, deodorants, or powders.
  • Recurring yeast infections may be a sign of a serious disease such diabetesleukemia, or AIDS.
  • In very rare cases, a yeast infection can lead to systemic Candidal disease, which is fatal in 75% of people who develop this major complication. This occurs when the infection spreads throughout the body via the bloodstream. Women with weakened immune systems are most susceptible to this type of complication

Vaginal Yeast Infection Causes

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The vagina is an environment that maintains its own balance of microorganisms. When this balance is disrupted, such as when the fungus Candida albicans is allowed to multiply unchecked, a vaginal yeast infection can result. The following are examples of factors that can disrupt the natural balance of microorganisms that live in the vagina:

  • Antibiotic use:Antibiotics can destroy bacteria that protect the vagina or alter the balance of bacteria that are normally present. A vaginal yeast infection may develop during or after the use of antibiotics taken to treat other conditions such as strep throat.
  • Steroid use
  • Diabetes:This disease can lower the glycogen store in certain vaginal cells. Diabetes may also raise the sugar content (and pH) of the vagina, which increases the risk for developing a vaginal yeast infection.
  • Factors that can cause a weakened immune system(for example, HIV/AIDS, steroid use,pregnancy, cancer chemotherapy or other drugs that weaken the immune system)
  • Use of douchesor feminine hygiene sprays
  • Scratches or wounds in the vagina(for example, caused during insertion of tampons or other objects).
  • Underwear that is tightor made of a material other than cotton. (This can increase temperature, moisture, and local irritation.)
  • Hormonal changes
  • ovulation
  • menopause
  • pregnancy
  • birth controlpills

When to Seek Medical Care

Typically, a vaginal yeast infection is not a life-threatening condition. However, a woman with symptoms of a vaginal yeast infection should see her doctor to rule out other, more serious infections or diseases that may cause or be mistaken for a yeast infection. Anyone with a weakened immune system should contact a doctor upon experiencing any new symptoms. Vaginal yeast infections may cause unpleasant itching, but they should not cause pain. Women experiencing pain should contact their doctor. In addition, a woman with symptoms of a vaginal yeast infection should contact her doctor if she notices the following:

  • foul-smelling or yellow vaginal discharge;
  • vaginal discharge that lasts for more than a week;
  • bloody discharge;
  • increased urination;
  • stomach or back pain that accompanies vaginal discharge;
  • vomiting;
  • fever;
  • if symptoms diminish but return within two months; or
  • if symptoms are not fully relieved with therapy.

Vaginal Yeast Infection Diagnosis

To help determine the cause of vaginal infection or irritation, the doctor usually asks the woman about her symptoms and performs a physical and pelvic examination. The doctor usually also tests the woman’s urine and samples of vaginal discharge. Before the exam, sexual intercourse and douching should be avoided for one to two days if possible to avoid complicating the diagnosis.

The doctor may also ask the following questions:

  • When did this condition begin? Has the discharge changed during the condition?
  • What does the discharge look like? What is the color and consistency? Does it have an odor?
  • Do you have pain, itching, or burning?
  • Does your sexual partner, if you have one, have discharge from his penis?
  • Do you have many sexual partners?
  • Do you use condoms?
  • What helps relieve the discharge?
  • Do you take frequent baths?
  • Have you tried over-the-counter medications?
  • Have you used a douche product?
  • What other medications do you take?
  • Have you changed detergents or soaps recently?
  • Do you often wear tight underwear or pants/jeans?
  • Have you had similar symptoms in the past?

During the pelvic examination, the doctor inspects the woman’s vaginal canal and cervix for discharge, sores, and any local pain or tenderness. The doctor may insert a speculum into the vagina to examine the cervix. This may be uncomfortable because of pressure on the vaginal tissues.

Most Candidal infections can be diagnosed without laboratory tests. The following diagnostic tests the doctor may be administer at the time of examination.

  • The doctor may take culture swabs of any vaginal discharge to determine if the infection is fungal (yeast), protozoan (trichomoniasis), or bacterial (bacterial vaginosis). The doctor may also view a discharge sample under a microscope to look for organisms that cause vaginal yeast infections. Examination of the discharge under a microscope is the simplest and least costly method used for diagnosis of yeast infection, but this test may be negative in up to 50% of women who have a yeast infection.
  • In some cases, the doctor may administer a Pap testto rule out the possibility of cervical dysplasia or cancer. The test is then sent to a laboratory, and results typically take one week.
  • The doctor may recommend a colposcopyor biopsy if the woman’s cervix appears abnormal. Colposcopy involves a lighted microscope to examine the surface of the cervix. A biopsy involves taking a tissue sample for testing.
  • The doctor may use a special DNA tests to detect yeast or other organisms in the discharge.

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