Last week, I made a statement that women do have wrong notions about vaginal discharge being acquired from the toilet.
It was said that conditions leading to these symptoms are, most times, not contacted by using dirty toilets but rather are either sexually transmitted or through poor hygiene; while they may also be transmitted through intimate contact with the clothing of people who have such conditions.
Vaginal thrush, also known as vaginal yeast infection was also discussed and defined as an inflammation caused by a type of yeast called Candida albicans.
Most women have a vaginal yeast infection at some time. Candida albicans is a common type of fungus. It is often found in small amounts in the vagina, mouth, digestive tract, and on the skin. Most of the time, it does not cause infection or symptoms.
Miss Yetunde is a fresh graduate who was diagnosed with candidiasis. She went for vagina swab culture in the laboratory on her own. The result came out to be heavy growth of yeast, confirming the diagnosis of candida albican.
She was placed on both pessaries and oral antifungal for the candida. Today, the story is different, as she feels very okay and well.
Candidiasis is the commonest cause of vulvovaginitis and can be confirmed by microscopic examination and growth of yeast from a swab from the vagina.
The importance of having a vaginal swab taken before starting any treatment needs to be particularly emphasised to the patient because laboratory confirmation of each suspected infection is an integral part of the management.
Women should be advised to have a vaginal swab taken whenever they suspect a recurrence.
A glucose test and an HIV test should also be done in cases of recurrent yeast infections.
Specific treatment for candidiasis involves inserting an antifungal pessary into the vagina when the patient is symptomatic.
A pessary is a small tablet that’s inserted into the vagina. Many preparations are effective in the treatment of candidiasis. A vaginal imidazole, inserted nightly for one week, is recommended as the standard treatment for candidal vulvovaginitis.
The use of an oral form of treatment, combined with vaginal pessaries and a cream for external itching, will definitely help to reduce recurrence.
Patients with recurring infections may need long-term prophylaxis with an oral antifungal drug. The diagnosis must be reviewed if patients do not respond to treatment.
Patients with frequently recurring thrush should seek medical advice to make sure they do not have a medical condition such as diabetes, HIV or immunosupression.
Some women are placed on long-term vaginal and oral antifungal treatment. This therapy may be continued for six months in the more troublesome cases.
Pregnant women who have had more than one proven infection during their pregnancy will also benefit from vaginal antifungal pessaries.
Male sexual partners of women with thrush do not require treatment, except very occasionally when a woman has recurrent infections or when the male has a rash or a sore penis.
Complications of vaginal thrush
Persistent thrush infection may be difficult to control and requires repeated treatments. Recurrent infections can cause discomfort and affect sex life. Women affected may feel down or anxious because of this.
The following tips may help to reduce the risk of vaginal thrush:
Wearing of cotton underwear and loose-fitting clothing.
Avoidance of contributing factors (e.g., douching, wearing tight pants, using perfumed soap or bath cream).
Avoid use of products that irritate the vulv area, including antiseptics or disinfectants, as these may disturb the natural protective acidity of the vagina.
Women should always wipe from front to back after using the toilet, to avoid spreading yeast from the anus to the vagina.
Women should practise hanging of their underwear in the sun to help in the reduction of persistent yeast infections when convenient and appropriate.
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