If you've ever been in the uncomfortable, itchy and frantic position of wondering why your stubborn yeast infection won’t go away, you're not alone. When the creams that always worked in the past are ineffective and online searches for “yeast infection home remedies” yield nothing, you start wondering what's going on with this yeast infection that won't go away. The answer might surprise you: You may not have a yeast infection at all, says Christy Beyer, MD, an ob/gyn clinician with Midi Health, a national virtual healthcare clinic for women over age 40. “There are many other conditions that can present with symptoms similar to yeast infections,” she adds. Read on for the must-know info that will help you feel better fast!
What is a yeast infection?
A yeast infection occurs when a fungus, most commonly Candida albicans, which naturally inhabits the skin, mouth, throat, gut and vagina, overgrows, explains Barbara DePree, MD, a certified menopause practitioner and founder of MiddlesexMD.com, an educational resource for women in perimenopause and beyond. Nearly 75% of women will have a vaginal yeast infection at some point in their lives, and even the most mild of infections can be intensely uncomfortable. You can even have yeast infections in your mouth or on your breasts. Dr. DePree says prescription antifungals as well as over-the-counter yeast infection treatments like Monistat are effective at eliminating most yeast infections. (Click through to learn more about this common under-boob rash and how to treat it.)
Yeast infection symptoms
The symptoms of yeast infection in women can range in severity, according to the Mayo Clinic. Although the symptoms can vary from woman to woman, they usually include:
Itching and irritation in the vagina and the tissues at the vaginal opening
Burning sensation, especially during intercourse or while urinating
Redness and swelling of the vulva
Vaginal pain and soreness
Thick, white, odor-free vaginal discharge with a cottage cheese appearance
Possible causes of a yeast infection that won't go away
There are a few factors that could explain why you're experiencing a yeast infection that won't go away, says Dr. Beyer. “That’s why it’s important to see your physician, who can give you the most accurate diagnosis and appropriate treatment recommendations.” Read on for possible causes:
1. Overgrowth of a tough-to-treat strain of yeast
Most yeast infections are caused by an overgrowth of a specific strain of yeast called Candida albicans, but if your antifungal treatment isn’t working, it’s possible you’re harboring a different species of yeast called Candida glabrata, says ob/gyn Laura Corio, MD, author of The Change Before the Change. Both are part of the normal vaginal microflora, but while drugstore medications are effective against C. albicans, C glabrata is highly resistant to them, Dr. Corio explains. In fact, Swedish researchers found that C. glabrata can survive even when treated with 10 times the medication dose typically used for C. albicans infections.
How to treat it: Boric acid vaginal suppositories can treat C. glabrata, says Dr. DePree, who adds, “It’s an inexpensive option that’s been used to treat yeast infections for more than 100 years.” She suggests using a suppository like pH-D Boric Acid Vaginal Suppositories (Buy on Amazon, $26.99 for 30 capsules). Women who've used this product rave about the results, including the 24,000 reviewers on Amazon, like Angela B, who battled yeast for 18 months before trying this product, which she calls "miraculous!" If this strategy doesn’t bring relief, your doctor can isolate the specific form of Candida behind your infection and suggest appropriate treatment.
2. Bacterial vaginosis
Bacterial vaginosis, or BV, is one of the most common vaginal infections, says Dr. Beyer. And it shares yeast infection symptoms such as vaginal and vulvar itching, burning and discomfort. The main difference? Although BV discharge can be white, it’s generally thin and can also be yellow, gray or even green. The discharge also tends to have a fishy odor, while a yeast discharge (which is thick, white and clumpy) lacks a noticeable odor.
How to treat it: Your doctor can diagnose BV through a Pap test. Since BV is caused by an overgrowth of bad bacteria in the vagina, an antifungal treatment won't help. You need an antibiotic to treat the infection. But beefing up the “good” lactobacillus bacteria in the vagina can also help, says Dr DePree. She suggests taking a probiotic containing lactobacillus once daily, like Nature’s Way Pearls. (Buy on Amazon, $22.79 for 90 softgels). Note: Sometimes, BV occurs alongside a yeast infection. Click through to learn what to do if you have BV and yeast at the same time.
3. Cytolytic vaginosis
Commonly called lactobacillus overgrowth syndrome, this type of irritation occurs when the population of lactobacillus bacteria that normally live in the vagina spirals out of control. “Lactobacillus help to maintain an acidic vaginal pH that limits other bacteria from growing,” Dr. Beyer says. If lactobacillus becomes too plentiful, it’s generally a sign that something has thrown off the bacterial balance, she adds. This could include prolonged use of medications, and a sensitivity to soaps, wipes, pads or lubricants.
Because lactobacilli produce lactic acid, an overgrowth makes the vagina too acidic — and that can lead to the itching, burning and discharge that can be mistaken for a yeast infection.
How to treat it: To tame the overgrowth, try sitting in a sitz bath. To do: Fill your bathtub with enough warm water to cover your hips. Add 2 to 4 Tbs. of baking soda to the water, stir to dissolve and soak for 15 to 20 minutes twice daily. The strategy helps make the vagina’s pH less acidic to nix the overgrowth. Dr. Beyer also recommends using mild, unscented soaps that won’t disrupt the healthy balance of bacteria. “The vagina is self-cleaning, so douching isn’t necessary,” she says. “And wearing cotton underwear can help maintain proper airflow to help prevent moisture retention that can increase risk of bacteria growth.”
This parasite, which can be transmitted during sex, causes symptoms that mimic a yeast infection, including itching, burning and discharge, although according to the Mayo Clinic, the discharge it triggers is more similar to the foul-smelling discharge that accompanies BV.
How to treat it: Your doctor can diagnose trichomoniasis by examining vaginal fluid under a microscope; if the results are positive, he or she will prescribe an oral antibiotic.
5. Menopausal hormone flux
The drop in estrogen that happens during the menopause transition can make some women more prone to yeast infections, says Dr. DePree. She explains that the loss of estrogen can change vaginal pH, making it more difficult to fight off yeast overgrowth. What’s more, genitourinary syndrome of menopause (GSM), a phenomenon that encompasses the variety of physical changes that can happen in the vagina, on the vulva and in the urinary tract, can be misinterpreted as a yeast infection, says Suzanne Gilberg-Lenz, MD, author of Menopause Bootcamp. “The tissue changes themselves — thinning, loss of collagen and elastin, and decreased blood flow — contribute as much, if not more, to the discomfort and potential of a yeast infection misdiagnosis than a change in the microflora.” Plus, these physical changes also create a more perfect environment for yeast to grow.
How to treat it: Dr. Gilberg-Lenz says the most important and effective treatment for restoration of vaginal resilience and microflora is prescription vaginal estrogen, which is placed in the vagina via a cream, ring, or tablet. Lucy McBride, MD, a Harvard-trained primary care physician in Washington, DC, agrees. “Topical estrogen can be a good choice for women to reduce vaginal yeast infections, especially if the infections are recurrent or complicated.” By that, she means if you have severe pain or symptoms, skin irritation or are immune-compromised.
This content is not a substitute for professional medical advice or diagnosis. Always consult your physician before pursuing any treatment plan.
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