Infections Of The Female Genital Tract
What is a "yeast infection"?
Yeast infection is an overgrowth of the yeast population in the vaginal area because of the different environmental factors in the vagina. So for example, if there's a lot of sugar in the body or if the competition is dying off because of too much antibiotic use, it causes yeast to overgrow.
How do I know if I have a yeast infection?
Yeast infections in general cause a certain discharge that is thick and flakey white. Not always. It's actually a very common mistake to diagnosis based on the discharge, but that's one sign. Also, itching and burning in the vulvar and the vaginal area. That's a usual yeast infection sign but it's not 100% reliable.
What is the difference between a yeast infection and bacterial vaginitis?
The difference between a yeast infection and bacterial vaginitis is the organism that is causing the infection. So, if the bacteria is growing out, whether it's a sexually transmitted disease or it's a bacteria that has come up to the vaginal area, and it's causing a discharge or smell or infection; that is a bacterial vaginitis--the overgrowth of a bacteria, either from the vagina or from an external environment. And a yeast infection is an overgrowth of the yeast population in the vaginal area.
How and why is a "wet smear" exam done?
We put a speculum inside, we get a Q-Tip, we get a sample of the discharge and fluid that's collected in the vaginal area, we smear it on a laboratory slide, and then we treat it with different chemicals. If we're looking for yeast, or if we're looking for a bacterial infection, we treat it with a very special agent, and we look at it under the microscope. And then we look for either yeast components or bacterial components, or inflammatory cells, because sometimes the discomfort may not even be an infection. It may be some kind of an irritation or allergic reaction. So this will help us differentiate between the different possibilities for the symptoms a patient is experiencing.
How did I get a vaginal yeast infection?
The causes of yeast infection are usually too much sugar in the body, too much starch intake, not enough water. So if a person eats a lot of sugar, a lot of starch, and not enough water, their chances of feeding these organisms in the vaginal area goes up, so do the chances of yeast infection. And of course, with everything that you feed, it grows. And yeast infection is as a result of that.
How did I get bacterial vaginitis?
Bacterial vaginitis can be sexually transmitted. A lot of women that wash a lot use Jacuzzis. They can get vaginal infections or contamination of the vaginal environment with bacteria from the rectum or the skin around it. So there are many different ways that the bacteria can be introduced into the vaginal area. Then what happens is that because of very little competition, these bacteria grow and they produce the discharges that cause the abnormal smell, color and so on.
Are vaginal yeast infections contagious?
Not really the way we think that it is. A woman can't really give it to another woman. But it can be transmitted to a man that has not been circumsised, especially. Because the yeast, or the bacteria really, can go under the prepuce, or the skin around the penis and can grow there. So if a woman's treated, and then she has intercourse with a man that has not cleaned under that skin, then she can get reinfected with that organism once again. So it's very important for male partners to pull the skin back every time they take a shower, and they clean well under the skin, and that should avoid any problems. Very rarely, male partners can become chronically colonized by these bacteria or yeast organisms. There's also no way to really detect that in a man, so if that so happens, then we would have to treat the man empirically if we've done everything else and the woman partner has done everything she can to avoid these infections to come but they keep coming back.
Is bacterial vaginitis contagious?
Bacterial vaginitis infections are contagious the same way as yeast infections are. Vaginitis infections collect under a man's prepuce or skin around the penis, and with the next intercourse vaginitis infections can be transmitted to the woman partner even though we've just treated her, the vaginitis infection can then return. So it's very important for male partners to clean under the skin every time they take a shower to avoid recurrent vaginitis bacterial infections in their female partners.
How will my doctor test for a vaginal infection?
A doctor's testing for vaginal infection is simply a wet smear in the office, which is a pelvic exam, using a speculum in the vaginal area. We insert a Q-tip into the fluid and a discharge is collected from the vaginal area. We smear that onto a little slide and then we apply the different agents that we need to identify that organism. We look at it under the microscope, and that usually tells us what is causing the problem and if there is a vaginal infection. If that doesn't give us all the information that we need, then we can do DNA cultures in the office or we can do sent-out cultures where they also can identify the type of yeast or the type of bacteria, and the ability of these organisms compared to different anti-microbial or anti-fungal agents.
What medicines are used to treat a vaginal yeast infection?
There are all kinds of different antifungal treatments for virginal yeast infections. There are oral tablets, many different types of vaginal inserts and suppositories. Those are the most commonly used. In the old days they used boric acids and other types of medication that is not quite commonly used as much as these days.
Are oral yeast medications as effective as vaginal suppositories?
Oral yeast medications are as effective as vaginal suppositories. I usually use the oral creams for women that have a lot of discharge, but not much inflammatory reactions like itching or burning. The creams work better because they have a small amount of steroids in them and they can increase the amount of inflammation in the tissues also. Therefore they work quite the same in defeating the infection; however, one works a little better in certain scenarios.
Are there any alternative treatments for bacterial vaginitis or yeast infections?
There are many different alternative treatments introduced for yeast and bacterial infections. Yeast infections and bacterial infections are as common as colds in women. And so, over the years, many alternatives have been suggested. For example, one alternative remedy for bacterial and yeast vaginal infections that a lot of people know about is yogurt in the vagina, and that simply does not work. Or, they recommend women to eat a lot of yogurt because somehow that bacteria in the yogurt changes the bacterial environment in the vagina as a remedy for bacterial vaginal infection. That also is not really true because the GI system or the mouth, there is no way it's connected to the vaginal area. And so the bacteria that are in the yogurt are not going to change the environment in the vagina. Also a lot of the carbohydrates in the yogurt can probably make the yeast or the bacteria grow even more. So those are the myths about treating bacterial or yeast vaginal infections we have out there.
Is treatment for a vaginal yeast infection different if I am pregnant?
Yes. We don't use the oral tablets as much in pregnancy. We use mainly local treatments. For example, if it's just an external irritation and itching, we use medication just locally for the outside. If it's an internal problem, we use suppositories for the inside. But we avoid the oral anti-fungals as much as possible.
How can I prevent getting a vaginal yeast infection?
Avoiding too much or too many antibiotics. If it's not necessary, don't take it because it kills the bacteria and the yeast will have no competition for the nutrition in the vaginal area and will grow. Avoid a lot of sugary foods because sugar content in the blood gets absorbed very slowly and so it feeds the yeast and the bacteria that live in the vaginal area. Or starch, because starch is also converted to sugar and that also increases the risk of vaginal yeast infections.
