A consultant gynaecologist and obstetrician at the University of Ilorin Teaching Hospital, Dr Adegboyega Fawole, talks about vaginal yeast infection and its treatments with DOLAPO AKITOYE
What is vaginal yeast infection?
Vaginal yeast infection is an affectation of the vaginal lining and it is caused by the candida fungus. The most common yeast is the organism called candida albicans.
How does one contract it?
Most times, the organism is present in the anus and the anus is close to the vagina. Sometimes, it escapes and goes into the vagina. One of the ways in which it can escape into the vagina is when people use the toilet.
When some people use the toilet, they wipe forward instead of backwards. When cleaning the vagina or vulva, it is important to wipe backwards as there is more bacteria at the back than at the front. If one wipes forward, one can carry the bacteria from the back to the front. Another way of coming in contact with it is when people use antibiotics for longer than they need to. This could alter the normal bacterial level there and allow candida to grow faster in the vagina. The normal vagina environment has a bacterial balance; there is a little of each bacterium so that they disturb each other’s growth and none of them become a majority. However, when one uses anti-bacterial drugs like antibiotics for a long time, it can kill off some of the bacteria that are normally protective and that allows candida to thrive and it overgrows the other bacteria and cause a yeast infection.
What are its symptoms?
The most common sign is in the vaginal discharge. When one has a yeast infection, the discharge is very thick and cheesy — like the Fulani cheese. The discharge comes with a fishy odour and it itches. The itchiness can also cause pain because in the process of scratching the vulva — the external part of the vagina — can create bruises which can make the vulva peppery and if it is large, it can be painful.
What complications can arise from vaginal yeast infection?
It is usually a superficial infection. It does not usually go deeper but if it is not well treated, it can re-occur at frequent intervals and disturb a person’s quality of life. It has no consequence on future reproduction. However, due to its presence, it makes the vagina less protective than it would have been. If there is a presence of other organisms like the gonorrhoea organism, it might be able to penetrate into the body faster and cause more problems.
It is the permissive environment that it creates for other harmful bacteria to enter the body. But on its own, it does not affect reproduction in the future or menstruation.
Can it spread from one person to the other?
Yes. If one uses the towel of somebody that has it, one can contract it. This is because it stays in a moist environment.
Can it be contracted through sex?
That has not been proven but when a person is being treated and the infection stays, the doctor can also try to treat the partner of the person. However, there is nothing that shows that it can be spread through sex.
How is it diagnosed?
One way in which it is diagnosed is based on the visual symptoms that a patient has. When a patient complains of a white discharge — that may have a yellow or green coloration — and associated itching, the patient will be checked by the physician. Then, a wet swab can be done and taken to the laboratory to be tested and if it is a yeast infection, the fungi will be found floating around.
What are the risk factors?
The risk factors include unnecessary and indiscriminate use of antibiotics, wiping forwards when using the toilet, making use of unclean or unsanitary toilets and using the clothing of a person that has the infection.
How can it be treated?
The treatment is usually done by using an ointment or a vagina pessary on it directly or with oral tablets. The vagina pessary is inserted into the vagina. It dissolves slowly throughout the day, washes it out and ensures that the vagina environment is restored. The vaginal pessary can come in form of the clotrimazole group of drugs. It is used for one week. The pessary takes care of the discharge inside the vagina. Then, a cream is also used to rub on the vulva two times a day to control the itching. Then, oral capsules or anti-fungal tablets can also be used. However, if the woman is pregnant, she might not be administered the oral component of the drugs; she would only be administered the cream to control the itching and the pessary to take care of the infection inside the vagina.
Can vaginal yeast infection be prevented?
Yes, it can be prevented by avoiding the risk factors that can make one prone to getting it. One should use antibiotics only under prescription. Also, as mentioned earlier, one should wipe backwards instead of forwards. One should also use a public toilet that is clean and if one has to use an unclean toilet, one should make sure that one uses clean water to wash one’s private areas as soon as one is able to. Then, one should avoid using other people’s clothing or towels.
Is it more dangerous for a pregnant woman to have vaginal yeast infection?
There is not much danger about it as the irritation is the same. The only thing is that if the infection is much and the woman is going to have a vaginal delivery, the baby might be susceptible to having discharge from the eye. However, this can be treated.
Is it an infection that can continue recurring in a woman’s life?
The risk of recurrence is based on how much one keeps away from the risk factors. These risk factors cannot be completely eliminated but they can be controlled. Some people may not have it at all for several years, some might not have it at all and some people have it every other month.
What ages of women are prone to the infection?
It is common with women in the reproductive age group; those are the ones that have started with their menstruation. The age range is between the ages of 16 and 45.
Are there any myths or misconceptions about the infection?
I am not aware of any. People normally get treatment quickly and can be okay for a very long time.
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