By Dr. Shawna Darou, ND
Women commonly come to the clinic with chronic, annoying yeast infections that just won’t clear up with conventional treatment. This is in contrast to the occasional yeast infection coming from too much time in a wet swimsuit, sweaty workout clothes, a new sexual partner or a single round of antibiotics.
Common causes of recurring yeast infections include:
- prolonged or frequent antibiotic use (ex. antibiotics taken for acne, frequent urinary tract infections, sinus infections, or others)
- birth control pill or other hormonal contraceptives
- Over-consumption of high-carbohydrate foods (i.e. food containing white flour and sugar)
- Stress (because it lowers your immune resistance)
- Diabetes and pre-diabetic conditions (high blood sugar levels create an environment favorable to yeast)
- Pregnancy (hormone changes in pregnancy can also predispose you to yeast overgrowth)
What most people don’t know, is that when yeast infections reoccur, we actually need to treat the gut. An imbalance in the gut microbiome can cause the chronic issues with vaginal yeast. Given our general over-consumption of sugar, frequent use of antibiotics through life, and lack of daily fermented foods to replenish healthy bacteria, most people’s gut health is out of balance to begin with. Yeast are opportunistic and ubiquitous micro-organisms which is why yeast overgrowth and vaginal yeast infections are extremely common.
There are other signs that there may be too much yeast in your body:
- Gas and bloating (because yeast ferments sugars creating gas)
- Constipation, diarrhea, or more commonly an alternation of both
- Intense ‘unreasonable’ cravings for sugar
- A thick white coating on the tongue, especially at the back
- Cracks and irritation at the corners of the mouth
- Fatigue or fogginess with difficulty concentrating
- Recurrent or difficult to clear fungal skin rashes
By the time most women come to see a Naturopath they have been going through this cycle of monthly yeast infections for a while, and are not getting lasting results from standard treatments. It’s interesting to note that the pattern is almost always the same. Is this your pattern too?
Here are some characteristics of these stubborn vaginal yeast infections:
- they tend to come back the week before menstruation every month
- they get worse with more regular intercourse
- the initial testing was clearly yeast, but since then sometimes swabs and cultures come back negative
- although the first round of infection may be classic with white thick discharge, the main symptoms with subsequent ones are itching and irritation – there may be very little change in discharge at all
- they partially go away with over-the-counter creams, ovules or tablets but they come right back the next month
- they can lead to chronic irritation of the vaginal area with swelling, itching, burning and even small cuts
Treating recurrent yeast infections
Treating intestinal yeast overgrowth has four components:
- First – eliminate foods that feed the yeast – sugar, simple carbohydrates, fermented and yeasted foods
- Second – use natural substances to kill off the yeast
- Third – help reestablish a normal intestinal flora with the use of probiotics.
- Forth – Treat vaginal imbalance locally with a combination that may include sitz baths, probiotic suppositories or boric acid suppositories.
This approach is definitely more involved than a three day over-the-counter treatment, but when faced with recurrent yeast infections, it is an approach that works, and also has the side benefits of also improving digestive and immune health overall!
What if it’s not a yeast infection?
There are four other vaginal issues that cause similar symptoms. If there is absolutely no relief from an over-the-counter treatment, it is not likely yeast at all. Here are other conditions to consider:
- Bacterial vaginosis: Symptoms include a thin, grey or white discharge, foul smelling or ‘fishy’ vaginal odor, vaginal itching, burning during urination. (Vaginal pH more alkaline).
- Cytolytic vaginosis: This condition is the least frequently diagnosed, but mimics vaginal yeast infection almost entirely in symptoms: vaginal itching with discharge, burning during urination, increase in symptoms the week before menstruation, but negative culture / testing for yeast, and does not respond to anti-fungal treatment. (Vaginal pH more acidic).
- Low estrogen: Thinning of vaginal tissues due to low estrogen can cause itching, irritation, dryness and discomfort. If this is also accompanied by missed or lighter periods, night sweats, hot flashes, or you are approaching menopause or just started a new low-dose oral contraceptive, this may be the answer.
- Irritation or yeast overgrowth from menstrual products: If your symptoms are coming immediately after your period ever month, I would be highly suspicious that you are reacting to the tampons or pads that you’re using. It is quite common to have skin irritation from menstrual care products, and even more common to develop yeast infections from non-breathable pads. They quite simply create an ideal environment for yeast to grow. There are many un-bleached, natural and breathable alternatives.
(There are natural treatments for each of the conditions above).
I hope this brief article has given you an overview of the underlying causes and treatment of recurrent vaginal yeast infections. Remember, you’re not alone…
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