InfectionpicWomen don’t like to talk about it but vaginal infections are a common cause of discomfort. Yeast infections are a typical cause of vaginitis. The other common cause of vaginitis is bacterial vaginosis; less common is Trichomonas and other Sexually Transmitted Infections (STIs).

Yeast infections are caused by Candida fungus. Most women will have one yeast infection at some point in their life. Some unfortunate women will get them recurrently. The common symptoms with a yeast infection are a white curd-like or watery discharge from the vagina, redness, swelling, itching and burning in the vaginal area and sometimes around the anus, and pain in the vagina after intercourse. It is important for a woman to have their first yeast infection diagnosed with a doctor or other qualified health care provider like a nurse practitioner, midwife or physician’s assistant to make sure it really is yeast and that it is not something worse, like an STD. Yeast grows due to an imbalance in the woman’s system that can be caused by antibiotics which kill off healthy protective bacteria, hormones of pregnancy or birth control, high sugar levels in diet or diabetes. Yeast LOVE sugar (I’m sure you can empathize!). Men can get a yeast infection from their partner, but it is not as likely.

Common over the counter non-prescription treatments are Gyne-Lotrimin, Gynezol and Monistat. They are anti-fungal creams or suppositories that are used in the vagina from 1-7 days at bedtime. They are a little messy but usually very effective against yeast. There are prescription medications for yeast that are a lot stronger than but they are not usually necessary. Monistat 7 is the CDC recommendation for yeast infections in pregnancy.

As many as two-thirds of women who treat themselves with OTC products don’t actually have a yeast infection, but another kind of vaginal infection or problem. That’s why getting professional help is important if self care measures do not resolve the problem.

Bacterial vaginosis (BV) is the other common vaginal infection. According to the CDC, BV is the most common vaginal infection in women between 15-44 years of age. Symptoms of BV are a grey or yellow vaginal discharge with a fishy odor, sometimes along with itching or burning. Several STDs can also cause similar symptoms so it is important to get a first case of BV checked by a healthcare professional.  One really bad thing about BV is that it can provide ideal conditions for other STDs to get started.

BV is caused by an overgrowth of normally occurring bacteria. It is not believed to be sexually transmitted, but the result of an imbalance in the vaginal ecosystem. Having a new male partner or multiple partners can increase the chance of getting BV. When the healthy bacteria are not present the pH of the vagina is wrong and the BV germs can grow. BV often recurs after treatment if the underlying causes are not resolved, and is seen more in women who smoke, use spermicides and douche. 

The usual medications used to treat BV are prescription Metronidazole or Clindamycin. Sadly, these medications can make yeast infections bloom and then some women find themselves in a cycle of yeast and BV, but it is not known how sex contributes to BV. 

Since the body’s ecology is key in both yeast and BV, dealing with any imbalances will help prevent recurrences. Here are some tools that can help:

Diet: The health of the whole body and intestines affects the ecosystem of the vagina. Eat a diet rich in whole foods with little to no sugar or refined carbohydrates and minimal use of alcohol. Have a diet rich in fresh colorful vegetables & fruits.  Have some of your vegetables and fruits raw. Increase your intake of live yogurt. Garlic daily may be helpful.

Vitamin D: Bacterial vaginosis is associated with vitamin D deficiency. This is especially significant in women of dark skin. Vitamin D is the sunshine vitamin and there is limited vitamin D available in foods. Supplementing with 2,000 IU of vitamin D per day is a must for most people, especially those who spend most of their time indoors. A lab test can also be done to determine vitamin D levels. To get vitamin in the best form spend time 10 minutes per day naked or in a bikini in the sun in the brightest time of the day! Ten minutes will not cause sunburn and will provide enough exposure to have an ideal vitamin D source.

Probiotics: Taking one oral lactobacillus supplement daily for 2-6 months will help restore normal vaginal ecology. Try Femdophillus by Yarrow or Integrated Therapeutics Pro Flora Women’s Formula (both available at Peoples Rx). You can also buy lactobacillus vaginal suppositories or use your fingers to apply live active plain yogurt to the side walls of the vagina as deep inside as you can. Use vaginal yogurt or suppositories for a couple of weeks at least to help recover from yeast or BV.

Yeast Arrest vaginal suppositories by Vitanica: These are good for yeast, as well as for BV.  Insert one morning and evening for 3-14 days. For chronic infections insert one suppository daily for 2-4 weeks. Use with a panty liner. This should not be used in pregnancy. These are available at Peoples Rx.

Tea Tree oil suppositories 10%/200mg in the vagina for six nights. From Tea Tree Therapy (6 suppositories per box). Tea tree has broad spectrum effect against fungal and bacterial infections. These, however, should not be used in pregnancy. 

Boric acid suppositories: If the infections are recurrent, insert one 600 mg suppository daily for two weeks. Another option is to use daily with the menstrual period for 3 months. These are prescription suppositories and can be obtained from a compounding pharmacy like Peoples Rx.

Be well, and don’t let infections rule your life!

MaryBarnettMary Barnett, Certified Nurse Midwife and Advanced Practice Registered Nurse, has a Masters in Nursing and Midwifery from Emory University and engages in ongoing studies with the Institute of Women’s Health and Integrative Medicine. Mary is experienced in gynecology and primary care for women with a focus on integrative care, emphasizing nutrition and combining western medicine with holistic therapies.


 

Yeast Infection Treatments: Over-the-Counter Vaginal Creams, Dr. Todd Niven, 2015

Bacterial Vaginosis (BV) Statistics , Centers for Disease Control and Prevention, 2007.

Women’s Encyclopedia of Natural Medicine, Tori Hudson, M.D., 2008