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Yeast Infections
A study from the University of Leeds shows that women who get yeast infections over and over, have the same type of yeast that recurs; it is not a new infection. This means that women with recurrent yeast infections and their partners should be treated for several weeks with oral drugs to kill yeast such a Diflucan, and not just with vaginal suppositories (3).
When a woman develops a white discharge and vaginal itching, her doctor often diagnoses yeast infection, even though he may be wrong because every healthy woman has yeast in her vagina. A doctor diagnoses yeast by inserting a cotton swab into the vagina, placing it in a drop of water and examining the fluid for yeast under a microscope. Cultures should not be used to diagnose vaginal yeast infections as most healthy women have yeast in their vaginas, mouths and intestines.
Yeast overgrowths often follow taking antibiotics or birth control pills. When yeast causes a rash on the genitals, it often is acquired through making love (1) or it is caused by immune defects associated with diabetes, hepatitis C or HIV. When normal healthy people develop rashes caused by yeast, doctors should look for a special type of yeast that is able to break though the skin.
Since yeast is a normal inhabitant in the vagina, it is often diagnosed as the cause of vaginal itching when it is only an innocent bystander. When a physician takes cultures for many different types of infections and finds only a yeast, he usually prescribes suppositories (over-the-counter clotrimazole vaginal suppository, once a day for three days) to kill yeast and the patient feels better for a week or so because the suppository lubricates the irritated area. Then the itching returns because these women often are infected with mycoplasma, which is extraordinarily difficult to find on culture, and can be cured when they and their partners take azithromycin (250 mg once a day for 9 days) to kill the mycoplasma. If a woman really has a vaginal yeast infection, she usually clears up when she and her partner take fluconazole (150 mg/day) for at least a week. See report #W175.
1) J Warszawski, L Meyer, N Bajos. Is genital mycosis associated with HIV risk behaviors among heterosexuals? American Journal of Public Health 86: 8 Part 1(AUG 1996):1108-1111.
2) One recent paper recommends a vaginal suppository containing metronidazole and miconazole, twice a day for two weeks, to kill gardnerella, Trichomonas and yeast. S Kukner, T Ergin, N Cicek, M Ugur, H Yesilyurt, O Gokmen. Treatment of vaginitis. International Journal of Gynecology & Obstetrics 52: 1(JAN 1996):43-47. Metronidazole 500 mg and miconazole nitrate 100 mg (Neo-Penotran(R), Embil Pharmacy Company, Istanbul, Turkey) insert twice daily for 14 days.
3) An investigation into the pathogenesis of vulvo-vaginal candidosis. Sexually Transmitted Infections, 2001, Vol 77, Iss 3, pp 179-183. SS ElDin, MT Reynolds, HR Ashbee, RC Barton, EGV Evans.
Checked 3/3/09