Vaginal fungal infections occur when a fungus from the yeast family, most commonly Candida Albicans, which is initially harmless, has colonised too much of the vagina. They are very common, but not dangerous, affecting more than one in four women at least once in their lifetime. There is no risk of it spreading to the uterus or fallopian tubes, and there are no side-effects.
Only contagious in a third of cases, vaginal infections are much more bothersome for women due to the vast surface area of their mucous membranes! A fungal infection is not an STD as such. There is no need to treat sexual partners if they don’t have any symptoms. If they do have symptoms, these will be small red spots on the glands and itching.
When mycotic vaginitis is recurrent (episodes occurring at least four times a year), it becomes extremely disturbing and can turn into an obsession. This affects around 6 to 10% of women. The psychological impact can be considerable.
It is the result of an “attack” on the mucous membranes, which can cause an imbalance of the flora.
– Antibiotics, corticosteroids, roacutane, progestogen, chlorinated swimming pool water, acidic liquid soaps, antiseptics or other substances that affect the flora.
– Hormonal changes during pregnancy or before menstruation (but not pill or IUD, which have now been cleared of all blame).
– Contributing factors include: excess weight, excess sugar consumption and poorly-controlled diabetes; HIV and other diseases that reduce the body’s immune defenses; recurring stress.
The most obvious symptoms are intense itchiness of the vulva and vaginal opening (vulvovaginitis), a scant fairly thick white lumpy discharge, a burning sensation on the vagina itself and sometimes also when urinating, similar to cystitis. It is diagnosed by examining the patient: the outer and inner lips are bright red, oedematous, and the vaginal wall is covered with a thick white coating. A sample is only taken if the infection is thought to be mixed or if the condition is recurrent, in which case a fungal infection must be established and identified to make sure no other bacteria is present. Indeed, many women believe they have a fungal infection when they experience itching and thus self-medicate. But in 30% of cases they are wrong, either because another microbe is responsible or there is no infection!
Those who have a predisposition, should avoid anything that encourages heat, dampness, acidity and repeated friction, which includes wearing tights or tight trousers, synthetic materials, frequent swimming and wearing a wet swimsuit for extended periods of time.
Prolonged or very frequent sexual relations, especially after a period of abstinence, should also be avoided.
Treatment is local in the form of a pessary inserted for 1 to 3 consecutive evenings and the use of a cream for 7 days. It may take a while for all the symptoms to clear. With certain products, the signs can worsen on the first day. What’s more, patients must refrain from having penetrative sex for at least six days. To relieve itching, patients should use pH8 liquid intimate hygiene products with no chemical antiseptic and which have soothing properties to relieve the mucous membranes.
The cause is not always clear. Many women follow this advice and still suffer tiresome relapses.
– The fungal infection can be the result of a local immunological disorder or caused by an intestinal contamination, or an emotional or other factor. In this case it is not due to sexual transmission but to individual susceptibility or a more virulent Candida.
– Candida can also join forces with another bacteria and grow on a unbalanced flora.
Oral treatments and local treatments are effective for long periods, eventually combined with probiotics, specifically formulated for the intimate flora. Vaginal dryness also needs to be treated and the flora restored by all possible means.