It’s been itchy down there. But I am too shy to ask.

That may be a “vulvovaginal yeast infection”. Most women just call it a yeast infection. The cause of this problem is a fungus named “candida”. The infection can cause a variety of symptoms which include:

  • Itchiness of and around the vulva
  • Redness, irritation of even pain at the vulva or in the vagina
  • Pain during sexual intercourse
  • Pain during urination

Apart from the above-mentioned symptoms, there may be discharge from the vagina which is typically white and in clumps, much like cottage cheese. It may also be thin and watery. The discharge does not emit any particular odour. This is called vagina candidiasis, which may occur with vulvovaginal yeast infection or by itself. If the discharge is not white, or emits any odour, it may be caused by some other infection. Refer to our infographics on the different colours of vagina discharge and what they mean here.

 

Ewww… How did I get infected by yeast?

Candida is part of the normal flora of the vulva and vagina. Normal flora are micro-organisms such as bacterial and fungus that naturally live in or on the human body such as skin, gut and the vulva/vagina area. Usually, normal flora do not cause any problems or symptoms and they keep themselves in a delicate check and balance. Problems occur when the balance is disrupted, and one species of micro-organism overgrows. In the case of yeast infection, candida is getting the upper hand. Many factors may disrupt this balance causing overgrowth of candida such as

  • Stress
  • Medicines, especially antibiotics
  • Poor hygiene

This condition is extremely common. About 55% of women up to the age of 25 years have at least one episode of vagina candidiasis.

Itchiness, redness and pain are common symptoms of vagina candidiasis

 

Is there any treatment for this?

Mild yeast infections are usually treated by inserting an anti-fungal vagina pessary (a pill for the vagina) or anti-fungal cream. The cream may be inserted and/or applied to the vulva.

Pessaries and creams are available from pharmacies and come in different strengths. Depending on the situation, your pharmacist may recommend a different strength of treatment for you. It usually takes a few days for the treatment to take effect. If the problem persists a few days after completing the treatment, you should see a doctor for further evaluation and he/she may prescribe antifungal pills to be swallowed by mouth. It is also advisable to visit a doctor if you repeatedly get a yeast infection over a short period of time. Sometimes, the infection may be due to a different species of fungus or may be due to some other conditions.

 

I am pregnant, is it safe for me to use these treatments?

For pregnant women, it is safe to use vagina pessaries and creams containing -azoles antifungals. Examples are clotrimazole, tioconazole and miconazole.

Safe to use pessaries and creams during pregnancy

 

I am not too sure how to use the pessary, can you help me?

Sure. Click on the link here to learn how to use/insert a vagina pessary.

 

You’re welcome 😊

 

 

References

  1. Kasper D, Fauci A, Hauser S, Longo D, Jameson J, Loscalzo J. Harrison’s principles of internal medicine.
  2. Maxine A Papadakis; Stephen J McPhee; Michael W Rabow. Current medical diagnosis & treatment 2018. New York, N.Y: McGraw Hill Medical; 2017.
  3. Candida vulvovaginitis: Clinical manifestations and diagnosis [Internet]. Uptodate.com. 2017 [cited 20 December 2017]. Available from: https://www.uptodate.com/contents/candida-vulvovaginitis-clinical-manifestations-and-diagnosis

 

 

Pou Wee Gan
Pou Wee Gan

M.Pharm, MBBS, BCPS, R.Ph

A pharmacist first, then a medical doctor. An avid tea drinker and an occasional poet.

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