The Mycotic Vaginitis – CANDIDA VAGINITIS

CANDIDA VAGINITIS (Vaginal Thrush or Vulvovaginitis) is a real infectious genital torment for many women.

Candida Albicans

Candida Albicans. About 75% of women have had or will have at least one episode of Vulvovaginal Mycosis caused in 90% of cases by a fungus called Candida Albicans. Another fact: further episode of infection occurs in approximately 40-50% of women.

About 5% of the entire adult female population has 4 or more episodes of vulvovaginal mycotic during the year.

Candida although in small concentrations is normally present in the Vagina along with other bacteria (more numerous), in particular Doderlein Bacillus; all together form what is also called the vaginal ecosystem. The right balance between these components helps maintain a normal pH (between 3.8 and 4.2) and the right lubrication of the vagina. Candida is also present in other body areas, particularly in the Intestine.

Predisposing conditions are identified: right through the alteration of this ecosystem allow its development and the occurrence of the infection symptoms. Pregnancy is one of these conditions: many women during their pregnancy (the pH increases) have a first episode or a recurrence. Other conditions are those in which there is an impairment of the immune system such as congenital or acquired immunodeficiency states and diabetes. Even the use of certain medications such as Cortisone or antibiotics (directly alter the vaginal flora) may lead to the onset of a vulvo-vaginitis by Candida. A special rate of infection was found in users of oral contraceptives (would promote greater adhesion of the fungus to the cell wall), in obese women and in those who usually wear very tight pants.

The Candida infection (vaginal thrush) most common symptoms are losses, whitish vaginal secretions generally very gritty resembling cottage cheese. These secretions are associated with burning sensation and / or itching at times particularly intense in both vulvar (external) and vaginal. Sometimes it is also burning during urination as a result of vulvar irritation and possible Urethra contamination.

Sexual transmission of Candida Vaginitis is possible but not secure and therefore the classification of this infection in the context of sexually transmitted diseases is questionable; you can get sick of Candida even without having sex. On the basis of these beliefs currently the treatment of any male partner is recommended only when he has a symptomatic Balanitis (Penis infection).

Vulvitises and vaginitis Mycotic (predominantly Candida) therapies are based in most cases on  topical (local) use of antifungal drugs in the form of pessaries and douches. Ketoconazole, Fluconazole and Itraconazole are the medications most commonly used in systematic treatments: they are generally given by mouth according to very different schemes. The use of these medications should always be evaluated by your GP or specialist gynecologist. During therapy periods is good to abstain from coitus.

How to prevent the Candida recurrence? The “Prevention” argument is certainly interesting and is probably the most frequently asked question regarding this disease.

  • Certainly, a good treatment of the first episode is a key moment: do not overlook an abnormal vaginal secretion and even in absence of burning consult a professional.
  • It is important to identify and to correct situations of possible predisposing (such as certain diseases)
  • Particular attention should be given to “broad-spectrum” antibiotic therapy. Especially during prolonged therapy, the simultaneous use of antifungal pessaries or douches may prevent recurrence.
  • Personally, I also recommend the use of intestinal enzymes during antibiotic therapy even if there is an intestinal disorders; we must not forget that the intestine, the rectal ampulla, is the main Candida “reservoir”.
  • The use of antifungal douches during menstrual period ( in this period many relapses are triggered) and after coitus (semen changes the vaginal pH ) has proved useful but be aware that these measures should nevertheless be carried out for limited periods and more precise indication and under medical supervision.
  • Small hygiene and behavioral attentions  may be useful. During the daily hygiene practices avoid that water in the anal region get in contact with Vulva and Vagina. Wear more skirts and avoid tight clothing or synthetic fibers; everyone agree that a good Vulva breathability  is very useful.
  • In some cases administration of antifungal drugs by mouth is used sometimes for very long periods. In these particular therapies it is required periodic inspections and constant medical supervision but very often give good results.
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Filiberto Di Prospero
Medical Doctor, Consultant in Gynecology and Obstetrics, Endocrinology and Metabolism. Director of Gynecologic Endocrinology Unit at Civitanova Marche General Hospital (Italy). Private clinics in Civitanova Marche, Rome and Milan.

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