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Think you have a yeast infection? It's a gamble at best.
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So you think you have a yeast infection?
It’s definitely possible; up to 75% of women have at least one yeast infection in their lifetime. This translates into more than 1 million doctor visits every year and another 3 million or so infections treated with either an over the counter (OTC) anti fungal or left over fluconazole (Diflucan) from the last go round.
Vaginal yeast infections are due to the overgrowth of yeast normally present in the vagina. The most commonly implicated yeast is Candida albicans, but others can be involved as well. This is not the pass-it-back-and-forth kind of thing. Jock itch, a guy’s yeast infection, is due to Trichophyton rubrum, not typically a big problem for women.
Healthy bacteria, called lactobacilli, keep yeast and other vaginal bacteria in check. Some factors are obvious causes of a yeast infection. Antibiotics kill the good vaginal bacteria, and without the supervision of these important gatekeepers yeast can overgrow. Excess estrogen, such as during pregnancy or from medications, also favors the growth of yeast. However, there are also many other poorly understood factors involved in transitioning from this asymptomatic colonization to an actual yeast infection.
The classic symptoms of a yeast infection are intense vaginal itching associated with a heavy, curd-like, white discharge. Other symptoms can include vaginal irritation, external itching (on the labia, or lips, and also around the rectum), pain with intercourse, and a sense of vaginal dryness. Some women can get a rash in the genital area.
The problem with OTC therapies or taking a left over pill is misdiagnosis is common. Women who believed they had a yeast infection and actually purchased an OTC therapy were recruited for a study. Once they were properly evaluated only 34% actually had a yeast infection, meaning two-thirds would have treated themselves incorrectly! Women who had been previously diagnosed with yeast were no better than first timers at making the right call. Causes of the symptoms for the two-thirds who did not have yeast included bacterial vaginosis (another vaginal infection), allergic reactions, skin conditions, and sexually transmitted infections (STIs).
Why this misdiagnosis?
Yeast infections have become the catchall for every vaginal symptom. We are bombarded with ads on TV and in print about medications for yeast while little attention is given to other more common, and potentially harmful, causes. Because many conditions can produce the same symptoms and the presence of yeast in the vagina can be normal putting the pieces of the puzzle together can be difficult, even after a thorough medical exam.
So the next time you think you have yeast infection, think again. Countless studies indicate it is difficult to make the correct diagnosis without a exam. And women at risk for STIs, especially those younger than 25 or with more than one sexual partner, could be brewing a much more serious problem.
It might be easier to buy an OTC product or pop that last fluconazole rattling around your medicine cabinet, but it’s a gamble with your health and the odds are not good.
Additional Resources: www.cdc.gov/STD/
Remember, information in this column does not constitute individual medical advice.
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