Candida Infections in Women

Candida infections in the vagina are extremely common, with 75 per cent of women experiencing at least one bout during their childbearing years. Half of these can expect a second infection at a later date. The universal symptom of vaginal Candida is itch. This may or may not be accompanied by a vaginal discharge which, if present, is said to be white and creamy (a bit like cottage cheese) but which may also assume a watery appearance. Other symptoms include vaginal soreness, painful intercourse, and 'bladder pain' when passing water. The last is frequently mistaken for cystitis (a bladder infection), but this symptom arises from irritation of the bladder neck, rather than from a bladder infection per se. Treatment is usually very successful. Having said that, 5 per cent of adult females are plagued by recurrent or chronic infection. Some of these may be infected with a Candida species other than albicans, such as Candida tropicalis. The latter is rare but becoming more common, and is more resistant to treatment. However, and bearing in mind the fact that Candida is an opportunistic fellow, it is more likely that patients with recurrent infection are struggling with their internal ecological balance. Factors which alter the balance and predispose to vaginal infection include:

1. pregnancy
2. oral contraceptives, especially those with high doses of oestrogen
3. antibiotics, especially the broad-spectrum (blunderbuss) ones
4. steroids
5. allergy in the vagina, to perfumed toilet paper, for example
6. certain diseases, such as diabetes mellitus

Other factors which may be important include:
1. tight clothing, especially nylons, which prevent adequate ventilation
2. eating lots of sugary foods
3. vaginal douches
4. swimming in chlorinated pools
5. intrauterine contraceptive devices (IUCDs)
6. frequency of sexual intercourse
7. reinfection from an untreated sexual partner
8. reinfection from a reservoir of Candida in the bowel

Bacterial and other vaginal infections are twice as common as vaginal thrush. The only way to make sure that you are, in fact, dealing with thrush, and not some other infective agent, is by having a vaginal swab test. Also, the symptoms of allergic vaginal inflammation are very similar to the symptoms of infective inflammation. For this reason allergy is often overlooked, and mistaken for infection. The transient relief which Candida-allergic women enjoy from anti-Candida treatments only adds to the confusion. They feel they must have infection because their symptoms clear up with treatment. The real reason for their relief, however, is the reduction of vaginal Candida as allergen rather than as infective agent. The clue is the disparity between symptoms and the presence of yeast. Allergic symptoms may be severe in the absence of a significant vaginal discharge, and in the presence of only a small amount of Candida. Patients with recurrent vaginal infections should have a skin-prick test to exclude Candida allergy.

Source: Chronic Candidiasis by Michael T. Murray