DEAR DOCTOR K: I have a vaginal yeast infection. The itching and burning are unbearable. How should I treat it? And how did I get it in the first place?
DEAR READER: Vaginal yeast infections are caused by a fungus that is usually present in small amounts on our skin, particularly moist areas such as under the breasts and in the groin. They also are present in small numbers in the vagina. Sometimes the amount of fungus increases, causing a yeast infection.
Women are more susceptible to vaginal yeast infections when their bodies are under stress. The cause of this stress might be poor diet, lack of sleep, illness, pregnancy or taking antibiotics. (The antibiotics kill off bacteria that compete with the fungus, helping the fungus to multiply.)
People with diabetes also are more susceptible, though no one seems to know why. The explanation I've sometimes heard -- that the fungus thrives on the higher levels of sugar in the body -- doesn't seem likely to me.
You're already familiar with the burning and itching that accompanies vaginal yeast infections. You may also experience vaginal soreness or a thick, white, cheese-like discharge.
The first priority is to treat your infection. With proper treatment, it should be gone within a few days.
If this is your first vaginal infection, visit your doctor, who should confirm that your symptoms are caused by yeast and not by some other condition.
If this is not your first episode, you can treat your yeast infection with an over-the-counter antifungal medication. These medicines are usually inserted directly into the vagina as tablets, creams, ointments or suppositories. These medications include:
-- butoconazole (Femstat);
-- clotrimazole (Clotrimaderm, Canesten);
-- miconazole (Monistat, Monazole, Micozole);
-- nystatin (several brand names);
-- tioconazole (GyneCure);
-- terconazole (Terazole).
A single dose of fluconazole (Diflucan Oral), prescribed by your doctor and taken by mouth, can also help. But this treatment is not recommended during pregnancy.
Once you've treated your current infection, do the following to prevent future yeast infections:
-- Keep your outer genital area clean and dry.
-- Avoid irritating soaps (including bubble bath), vaginal sprays and douches.
-- Change tampons and sanitary napkins frequently.
-- Wear loose cotton underwear that doesn't trap moisture.
-- After swimming, change quickly into dry clothing.
-- Take antibiotics only when prescribed by your doctor -- and never for longer than your doctor directs.
-- If you are diabetic, keep tight control over your blood sugar levels.
Dr. Komaroff is a physician and professor at Harvard Medical School. To send questions, go to AskDoctorK.com, or write: Ask Doctor K, 10 Shattuck St., Second Floor, Boston, MA 02115.
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