Vaginal Candidiasis (Monilial)

WHAT IS VAGINAL CANDIDIASIS?

Infection or inflammation of the vagina caused by overgrowth of a yeastlike fungus – Candida (Monilia) albicans, involving vagina and adjacent skin.

SEX OR AGE MOST AFFECTED

All females, especially after puberty.

SIGNS & SYMPTOMS

Severity of the following symptoms may vary between individual women and from time to time in the same woman:

  • White, "curdy" (characteristic of Candida) vaginal discharge, (resembles lumps of cottage cheese). The odor may be unpleasant, but not foul.
  • Swollen, red, tender, itching labia and surrounding skin.
  • Burning while urinating.
  • Change in color of vaginal mucosa from pale-pink to red.

CAUSES

Monilia (or candida) are normally present in a healthy vagina and require a certain pH for normal functioning. If the pH and/ or hormone balance of the vagina and surrounding tissue are disturbed these can multiply and cause infection. Monilial vaginitis tends to appear before menstrual periods and improves as soon as the period begins. Factors that may disturb the pH of vagina include:

  • Pregnancy.
  • Diabetes mellitus.
  • Antibiotic treatment.
  • Oral contraceptives.
  • High carbohydrate intake.
  • Hot weather or non-ventilating clothing, which increase moisture, fostering fungal growth.
  • Immunosuppression from drugs or disease.

HOW TO PREVENT

  • Keep the genital area clean. Use plain unscented soap.
  • Wear cotton panties. Avoid panties made from non-ventilating materials.
  • Don't sit around in wet clothing.
  • Limit your intake of sweets.
  • Ask your doctor about eating yogurt and buttermilk when you take antibiotics.
  • After passing urine or passing stools, cleanse by wiping or washing from front to back (vagina to anus). See pic
  • Lose weight if overweight.
  • Adhere strictly to treatment plan, if diabetic.
  • Avoid antibiotics unless absolutely necessary.

DIAGNOSTIC MEASURES

  • Classical symptoms.
  • History and examination (including PV).
  • Laboratory studies, such as a Pap smear, and culture and microscopic exam of the vaginal discharge.

POSSIBLE COMPLICATIONS

Secondary bacterial infections of the vagina and other pelvic organs PID.

PROBABLE OUTCOME

Usually curable with 2 weeks of treatment, but recurrence is common.

TREATMENT

GENERAL MEASURES

  • Follow the first 4 instructions under How to Prevent.
  • If urination causes burning:
    • Urinate through a tubular device, such as a toilet-paper roll or plastic cup with the end cut out.
    • Urinate while bathing.

MEDICATION

Your doctor may prescribe antifungal drugs, either in oral form or in vaginal creams or suppositories (usually). Keep creams or suppositories in the refrigerator. Ensure proper completion of treatment. These pessaries are to be inserted even during menstruation.

Ask your doctor, about beginning treatment quickly if the infection recurs.

Follow the prescription carefully.

ACTIVITY

Avoid overexertion, heat and excessive sweating. Delay sexual relations until symptoms cease.

DIET

Increase consumption of yogurt, buttermilk or sour cream.

CALL YOUR DOCTOR, IF

  • You have symptoms of monilial vaginitis.
  • Despite treatment, symptoms worsen or persist longer than 1 week.
  • Unusual vaginal bleeding or swelling develops.
  • After treatment, symptoms recur.