4:01 pm - 08/06/2005

[FAQ #1] Yeast Infection Connection: A guide to one of our most frequently asked questions

What is this?
VP is initiating a new kind of FAQ called the Top 20 that will contain comprehensive answers to the questions that are most commonly asked in the community. We're kicking things off with an oldie but goodie: yeast. We will link this post from our side bar as well as the Archives (under "READ THIS BEFORE YOU POST ABOUT YEAST INFECTIONS") for ease of use.

NOTE: We already delete many YI posts, but this guide means that even more YI posts are going to be deleted in the future. One of our most common complaints is that YI posts are cloging up Friends Pages. Before you post about (what you think might be) a YI, please read this guide carefully. Chances are, you'll find all the answers you need. We hope this becomes a valuable resource for everyone.

Your comments are welcome, of course. And hey, if this is the first time you're seeing this item, be sure to scroll all the way down to the bottom to read member comments/tips.

Let's begin, shall we?

Yeast Infection Connection
I think I have a Yeast Infection--how can I tell? And what are some remedies that don't involve Monistat or going to the doctor? What can I do to prevent YIs in the future?

This Top 20 Question covers the following items:
+ What is a yeast infection and how do you get one?
+ How do you know if you've got one? What are the symptoms?
+ OK, I’ve got a yeast infection. How do I treat it?
+ Can men get yeast infections too?
+ It seems like I always have a yeast infection—what’s the deal?!
+ How do I prevent YIs in the future?
+ Is it OK to have sex while I'm treating my yeast infection?
+ Can I treat my infection while I'm on my period?

What is a yeast infection and how do you get one?
The New Our Bodies, Ourselves tells us that:

Candida Albicans, a yeast fungus, grows in the rectum and vagina. In a healthy vagina, the presence of some yeast may not be a problem. When your system is out of balance, yeast-like organisms may grown profusely and cause a thick, white discharge that may look like cottage cheese and smell like baking bread. If a woman has a yeast infection when she gives birth, the baby will get yeast in its throat or digestive tract. This is called thrush and is treated orally with nystatin drops.

Candida grows best in a mildly acidic environment. The pH in the vagina is normally more than mildly acidic (4.0 to 5.0), except when we take birth control pills or some antibiotics, are pregnant, have diabetes and when we menstruate (when the pH rises to between 5.8 and 6.8, because blood is alkaline). Obviously, we often find ourselves with a vaginal pH favorable to candida, so preventative measures are especially important.

In addition, the National Library of Medicine and National Institutes of Health tell us that YIs are "common among women who use estrogen-containing birth control pills and among women who are pregnant. This is due to the increased level of estrogen in the body. The increased hormone level causes changes in the vaginal environment that make it perfect for fungal growth and nourishment. Yeast infections may also occur in association with diabetes or problems that affect the immune system (such as AIDS or HIV). Vaginal candidiasis is not considered a sexually transmitted disease."

The NLM and NIH also note that a "yeast infection may follow a course of antibiotics (particularly tetracycline) that were prescribed for another purpose. The antibiotics change the normal balance between organisms in the vagina by suppressing the growth of protective bacteria that normally have an antifungal effect." You can read more about that here as well as elsewhere in this post.

Take a look at an illustration of a yeast infection.

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How do you know if you've got one? What are the symptoms?
OBOS says that "Microscopic analysis of vaginal secretions (known as a wet mount) is the only way to be sure that the infection is candida and not something else. Several other conditions (such as cytolytic vaginosis) may respond temporarily to candida treatments and then recur a short time later, so accurate diagnosis is important."

Sometimes you can tell by feel, look and/or smell that you've got yeast. Many doctors recommend that you get diagnosed by an MD the first time so that you'll know what you're looking for next time and don't repeatedly misdiagnose yourself (thus potentially making things worse). Symptoms of a yeast infection can--but do not always--include:

FEELS LIKE: An intense itching, burning sensation, localized in your vagina and vulva. (This itching is not always present, but can get really bad, so bad you can hardly walk, let alone ride your bike to the pharmacy or doctor to get it treated.) Urination and/or intercourse may also be painful.

LOOKS LIKE: Clumpy white stuff. Most medical descriptions compare the discharge to ricotta or cottage cheese, but it can range from thick and not clumpy to faintly yellow to thin and clear. The labia majora and minora (click here to see a diagram of the vulva [graphic, NSFW]) may be red, swollen and/or dry. While the medical sources we reviewed to put this FAQ together don't list small cuts as a symptom, many VP-members anecdotally indicate that they experience small cuts as part of their YI symptoms. (Click here for an image of one woman's vaginal YI [graphic, NSFW], but keep in mind that symptoms vary from person to person and not all YIs look the same.)

SMELLS LIKE: bread or beer. In fact, it smells pretty much exactly like yeast, although the yeast used in brewing and baking is an entirely different species (Saccharomyces cerevisiae). (Adapted from here and here)

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OK, I’ve got a yeast infection. How do I treat it?
There are essentially three ways to treat a yeast infection:
1. Prescription treatment from a doctor
2. Non-prescription or over-the-counter (OTC) remedies such as Monistat, etc.
3. Natural, at-home methods

Easy At-Home Methods to Rebalance the Vaginal pH from the Feminist Women’s Health Center
Many women use non-medical methods for treating yeast, because the cost of over-the-counter methods is high, because they are unimpressed with OTC methods, or simply because they prefer more natural methods. Following is a partial list of at-home methods that may be helpful:
  • Insert unpasteurized, plain yogurt (this works with soy yogurt as well as long as it still contains active cultures--check regular yogurt ingredients for this too!) with a small spoon or spatula or vaginal cream applicator. Insert at night and wear a pad. Repeat for three to seven nights, until symptoms disappear. Yogurt can be inserted with an empty tampon inserter, vaginal cream inserter or a turkey baster (the baster works best). Symptoms should be relieved within 48 hours. (Douching with yogurt and water can help, too. It also helps to eat a lot of yogurt.)

  • "Paint" the vagina, cervix (you'll need a speculum) and vulva (outside area including the labia or "lips" of vagina) with gentian violet. It stains so you'll want to wear a pad. This usually works after one treatment.

  • Insert a garlic suppository. Carefully peel one clove of garlic. Wrap in gauze and insert into the vagina. Leave in for up to twelve hours. Repeat as necessary. It also helps to eat a lot of garlic.

  • Drink cranberry juice. Unsweetened is best. (This works best as a preventative measure.)

  • Insert Potassium Sorbate. This is used in home beer-making and can be found at wine-making stores. Dip a cotton tampon into a 3% solution (15 grams of Potassium Sorbate in one pint of water) and insert into the vagina at night. Remove in the morning.

  • Drink or eat Acidophilus. It's available in powder or capsules in health food stores or found in some milk and yogurt products. (Read the label; some dairy products have added acidophilus.)

  • Nix the "feminine deodorant sprays." No soap, nylon bathing suits, or pantyhose without a cotton crotch.

  • Wear only cotton or nothing at all. Hot, moist environments incubate yeast.

  • If neither acidophilus nor yogurt cures the yeast, you may need to re-acidify your vagina. Boric Acid is efficient, and you can purchase it in the drug store. Dilute it one teaspoon to one cup of warm water and mini-douche daily with the barrel of a syringe, or use a diaphragm jelly inserter which can be bought at the pharmacy without having to buy the jelly, or buy empty 00-sized capsules and fill them with boric acid powder and insert two of them nightly. Don't use if the skin is raw or broken, and discontinue if an irritation develops. This is wet and messy but boric acid is anti-bacterial and will cleanse some non-specific vaginitis as well. (Click here to read more about how to use Boric Acid to treat YIs.)

  • Apple cider vinegar douches (two tablespoons vinegar to a pint of warm water) are very effective. Even though yeast flourishes in an acidic environment, there is something in vinegar that inhibits its growth. Vinegar can also inhibit the growth of bacteria and trichomonas by establishing the proper acidity (pH) for the proliferation of "good" bacteria. Don't douche for longer than 10 days.

  • Regular douching should be discouraged. The vagina is a self-cleaning environment, so routine douching shouldn't be necessary and could make your vagina too alkaline. Women who douche more than three times a month are four to five times more likely to have rampant yeast.

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Can men get yeast infections too?
Yes! Especially if you're a woman with a heterosexual partner, it's something to educate yourself about since it's possible to pass the yeast back and forth. In fact, the NLM and NIH tell us that "12% to 15% of men will develop symptoms such as itching and penile rash following sexual contact with an infected partner." You can read more about yeast infections and men here.

NOTE: If your YI “is persistent and you experience chronic or repeated overgrowths, then all of your lovers need to be treated as well. If your partner is male, have him soak his penis in yogurt or diluted apple cider for 5 minutes daily to kill the yeast living in or on the glans; this way he won't keep re-infecting you.” (Feminist Women’s Health Center!)

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It seems like I always have a yeast infection—what’s the deal?!
Some women are prone to yeast conditions and get them frequently. These women may want to pay attention to precipitating factors, which can vary from person to person. Some things which commonly cause or worsen yeast overgrowth are:

+ stress
+ sudden diet changes
+ weather changes
+ birth control pills
+ use of the contraceptive sponge
+ a high sugar, carbohydrate, caffeine, or yeast diet (very common!)
+ douching
+ pregnancy
+ diabetes

Perhaps the biggest contributing factor in the creation of yeast overgrowth, however, is the use, and overuse, of antibiotics. Although designed to kill "bad" bacteria (those that make us ill) antibiotics, to varying degrees, kill "beneficial" bacteria (those that keep us well, such as the digestive bacteria in our intestines). Any use of antibiotics will kill off some good bacteria and prolonged and overly aggressive use of antibiotics can cause systemic problems for both men and women. When the balance of good and bad bacteria is thrown off, yeast can build up in the intestines and cause a whole host of health problems. Whenever you take antibiotics, keep in mind this is strong medication. Ask your provider: How does it work? Is there a topical antibiotic I could use instead? Sometimes, antibiotics are needed but their overuse can cause serious problems. Adding acidophilus and bifidus to your diet (in capsules) can re-balance the intestinal bacteria, and build up resistance to future overgrowths.

Women experiencing persistent vaginal yeast overgrowth who are using a cervical cap or diaphragm need to wash and dry it well after use. Some women have found relief from tenacious conditions with the "sucking air" method of douching. In a bathtub, a woman can insert yogurt, vinegar or other remedy. Lying on her back, hands at her side and palms down, she can bring her feet back over her head. This action causes the vagina to balloon out and pulls the vinegar or yogurt all the way in to fill the vagina and get every fold of skin.

Systemic yeast is a system-wide infection/overgrowth throughout the body. It requires dramatic changes in diet and long-term attention to avoiding things that encourage yeast to grow. (Feminist Women’s Health Center)

CAUTION: Sometimes chronic yeast infections can be indicative of a larger, much more serious problem that needs medical attention/treatment. If you are experiencing chronic yeast, it is a good idea to check with a health professional.

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OK, great. But how do I prevent YIs in the future?
D. Ashley Hill, MD tells us the following:

Preventing yeast infections is obviously more desirable than treating them. Wearing loose clothing, cotton underwear (or at least underwear with a cotton crotch panel), removing damp clothing soon after swimming or working out, and carefully drying the vulvar area after bathing will all help prevent yeast infections. Some advocate using a blow dryer on warm to briefly blow dry the vulva after bathing to insure adequate drying. Others suggest using vaginal or oral yogurt [...] However, there are articles in the medical literature that support eating 8 ounces a day of yogurt containing lactobacillus acidophilus, which may reduce the yeast infection recurrence rate by threefold. IF you choose to do this, however, please make sure the yogurt you buy specifically contains lactobacillus acidophilus, as many do not. Some also advocate taking anti-fungal medications intravaginally or orally at specific intervals to prevent overgrowth of yeast. In some diabetic patients this is very helpful. Yeast infections are common and sometimes difficult to treat, but with the appropriate evaluation and treatment they can be effectively treated. Any symptomatic vaginal discharge should be evaluated to ensure proper treatment. (obgyn.net)

Specifically in the instance of antibiotic-induced yeast infections, boric acid can be used as prevention. You buy boric acid powder (typically available at your pharmacy in the first aid section for around $5US per 4 ounces) and size 00 empty gel caps (also available from the pharmacy or health food stores). Fill the caps with the powder and insert two nightly (right before you get into bed) for every night that you take the antibiotic. This method works by keeping the environment in your vagina nice and acidic, which keeps the yeast from over-proliferating when the other vaginal flora die from the efforts of the antibiotic. (Read more about how to use Boric Acid here.)

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Is it OK to have sex while I'm treating my yeast infection?
Some health professionals advise that women avoid vaginal intercourse during treatment (source). Especially if you are treating your yeast infection vaginally (rather than with oral medication), it seems optimal to avoid intercourse until the treatment is finished.

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Can I treat my infection while I'm on my Period?
This doctor-reviewed site says that "[t]ampons can absorb medication, so use sanitary napkins if you are being treated with vaginal medications during your period."

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**NOTES AND DISCLAIMERS: This guide (and VP) is no substitute for medical care. Much of the information above has been adapted from the indicated sources. Click on the links to see their original text or to get more information. Any non-quoted items come from the VP Team's personal experience, which, again, is no substitute for medical care. It is a good idea to see a health care professional for your first YI diagnosis or if you are experiencing chronic yeast.
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janejellyroll 6th-Aug-2005 08:51 pm (UTC)

This is fantastic.

I really didn't want to take VP off my friends page and somedays it felt like half my friends page was taken up by these questions. This seems like a really great way to deal with this issue.

One thing that you might want to add to this around the "it seems like I always have a yeast infection" area is that really frequent yeast infections can be a sign of HIV infection. If you have this problem, you should check your HIV status if you don't already know it. I had a bout with frequent yeasties last year and that was one of the first things that the doctor recommended I do. Fortunately, it turned out to be unrelated, but it is always a good thing to check out.

I appreciate all the hard work you and the other mods do to make this site so awesome!
constructingme 6th-Aug-2005 11:00 pm (UTC)
I've also been reading lately that what seem like frequent and severe yeast infections can actually be herpes. Here's one link I found on it: http://herpes-coldsores.com/std/herpes.htm

It's still a little confusing (not to mention freaky to me), but it is definitely another reason to see a doctor if yeast infections are frequent.
electric_colors 6th-Aug-2005 09:34 pm (UTC)
That's awesome! Thank you! I added that to my memories in my journal for later reference. :)
punk_is_so_dead 6th-Aug-2005 09:53 pm (UTC)
Thank you.
_keta 7th-Aug-2005 12:04 am (UTC)
How ironic that I almost made a post here complaining about how my birth control gave me yet another yeastie..
dial_zero 7th-Aug-2005 03:01 am (UTC)
Ooh, drinking cranberry juice is good for preventing yeast AND UTIs? (confused face)
exit__music 7th-Aug-2005 05:52 pm (UTC)
just out of curiosity, does anyone know if yeast infections can be passed to a male partner even if condoms are used? thought i'd ask here rather than making a big post.
jennifer0246 8th-Aug-2005 04:12 pm (UTC)
I would say yes, possibly, because the yeast could be transmitted to any area the condom did not cover (base of the penis, testes, etc).
so_cruel 8th-Aug-2005 03:35 pm (UTC)
I'd like to add that the prevention part is really key. Being on birth control, I've found that certain things can send my vagina into "shock" (i.e. swimming pools, antibiotics, sex, etc).

I have a sort of system for prevention. I've learned my vagina can only handle one shocking event for every 48 hours. That said, for example, if I swim on Monday (and rinse off afterwards!) and then have sex on Tuesday ... two acidophilus capsules go up in my vag Tuesday night without question. It's really a great rule to live by (for me) and saves me from getting more yeast infections.
pfctdayelise Yogurt9th-Aug-2005 01:57 am (UTC)
I would just like to add that make sure the yogurt you're using has live acidophilus cultures in it, which is rather the point of using yogurt to begin with. Also make sure it is unsweetened, as sugar could further irritate the vag.

And with garlic, sometimes people are worried that they will "lose" the garlic up there. If you're worried about this, you could tie floss around it (after it's covered in gauze), and then you'll have a little string to find it by, like a tampon.

If it does get lost, your only option is to squat down and have a good feel around - or suck it up and ask someone else to for you. (Just another good reason to be familiar with your anatomy - you realise there's not that many places it can be!)
malantha Re: Yogurt15th-Aug-2005 05:11 am (UTC)
2 things:

I was under the impression that giving sugar to a yeast infection wouldn't irritate the vag, but *would* give the yeast something to feed on (therefore making it happier, rather than killing it).

And if you're going to tie floss around garlic and insert it, I'd go for the unflavored kind. Just sayin.. ;)
rockstarbob On transmitting YIs to guys:9th-Aug-2005 03:18 pm (UTC)
rockstarbob Lubes containing glycerin can cause YIs:11th-Aug-2005 03:27 pm (UTC)
iwakurajessi Re: Lubes containing glycerin can cause YIs:16th-Jul-2006 09:42 pm (UTC)
OMG. Well, that might explain it.... I'm going to check the lube I used to find out if that might have been what caused the symptoms I'm now experiencing. Thanks! (Even if you posted this over a year ago, it's helping me now!)
xevv 16th-Aug-2005 03:25 am (UTC)
does it have to be apple cider vinegar, or can it be any vinegar?
rockstarbob 16th-Aug-2005 07:27 am (UTC)
Wow, that's a great question and we're not really sure. We suspect that because all vinegar is acidic in nature all vinegar would prove helpful with yeast, but we can't find anything to verify that suspicion. Maybe someone else will chime in. Or, if you find any information, please come back and update us!
rockstarbob But Isn't Boric Acid Poisonous?16th-Aug-2005 07:20 am (UTC)
rockstarbob Can a YI just go away?20th-Aug-2005 07:59 pm (UTC)
rockstarbob Another Superstar's YI Info22nd-Aug-2005 07:46 pm (UTC)
rockstarbob Can a YI cause labia to swell?23rd-Aug-2005 02:58 am (UTC)
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