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Your Complete Guide to Developing, Preventing and Treating Yeast Infections By AskAwayHealth

Yeast infections happen due to certain types of fungi known as 'yeasts'. There are several types of yeasts from the species 'fungus' - some we use in cooking and brewery. But one of the most common types responsible for sickness in humans is known as Candida albicans.

Contributed by Dr Fisayomi Aturamu

Read on to see how Candida affects men, women and children and common questions you care about addressed.

Collection of fungal cells multiply to cause yeast infections.

What is a Yeast Infection?

When you hear about yeast infection, you probably think straightaway of vaginal thrush.

And you wouldn't be wrong - vulvovaginal thrush is another name for yeast infecting the woman's genital area.

Thrush develops following infection with a member of the species of fungus.

Candida one of the most common causes of fungal infections in humans. [1]

Candida albicans, the particular organism that causes a yeast infection is usually naturally occurring in the vagina.

(All over our bodies - on our skin or gut we have different germs that exist harmlessly - some of them are bacteria or fungi of different types)

However, thanks to the ‘good bacteria’ in the vagina - they keep the growth of Candida under control and harmless.

So when anything upsets the normal balance of the ‘good bacteria’ reducing their numbers, yeast colonies may multiply leading to infection. [2]

And so vaginal thrush infection presents as a common problem that many women experience throughout life.

However, men of any age can also be affected by yeast infection.

Yeast can also affect other parts of the body.

Overgrowth of Candida can develop in your mouth.

Known as oral thrush, it often looks like white patches in the mouth, especially inside the cheeks, lips, gums and the tongue.

It can also affect other areas like the skin of the underarms, between the thighs or the crease areas between the buttocks.


Yeast Infections in women affect the vulva and vagina
Image of Yeast Infections in the Vagina

Yeast Infection in Women

It is the second most common cause of vaginal infections, after bacterial vaginosis.

Studies suggest that 4 out of every 10 women visiting a clinic with vaginal infections may have candida. [1]

Approximately three out of every four women will develop a yeast infection in their lifetime. [2]

Reasons Women May Develop Infection with Yeast

Hormone Changes

Vaginal infections with yeast are more common in women of childbearing age. [1] They very frequently happen in pregnancy and just before menstruation. [2]

What these two conditions have in common (pregnancy and menstruation) is a change in your usual hormone balance.

Scientists believe this could lead to overgrowth of yeasts.

Antibiotic/Other Drug Treatment

Another reason for thrush is following a recent course of antibiotics for other problems such as chest or urinary tract infections.

Or when you abuse antibiotics - using them more often than you need to.

While antibiotics destroy bad germs, they may get rid of your good bacteria at the same time.

This leads to overgrowth of candida and therefore, thrush.

As a woman, this is most likely to result in vaginal thrush, though thrush in other areas could develop.

If you use some types of birth control (combined pill), you may be at a greater risk of Thrush.

Poor Personal Hygiene

Poor personal hygiene is another significant factor for developing thrush.

Yeast germs thrive in warm, moist areas.

With inadequate care, some parts of your body could make it really easy for the yeasts to grow and multiply.

Examples where this could happen are:

  • Under and in between your breasts
  • In the armpits
  • The groin - between the thighs and buttocks.

Failing to wash regularly every day, after exercise or to clean properly after opening your bowels, makes it easier for yeasts to grow.

Similarly, wearing stale, damp clothing like underwear or socks/stockings makes the likelihood of developing an infection with yeast highly likely.

Chronic Health Problems

Other problems that can lead to thrush are common among both sexes.

Health conditions like Diabetes or those that suppress your immunity also contribute to developing Thrush.

Examples of these are HIV (Human Immunodeficiency Virus) infection as well as Cancer.

Taking medicines to treat cancer also weakens your immunity and makes you susceptible to thrush.

Symptoms of Women's Yeast Infections

  • Whitish (creamy/yellow) vaginal discharge that is thick, typically without a smell, and resembles cottage cheese or curd
  • Itching of the vulva and vagina, with swelling, redness and scaly dry skin in these parts - can be intensely uncomfortable
  • Discomfort (soreness) that may occur during sexual intercourse because of the soreness of the vagina[2]
  • There is pain when passing urine from the contact between your (acidic) urine and inflamed/sore skin in the vulva


Men's Yeast Infection

Yes, men do also get thrush/yeast infections.

It can affect the genitals, mouth and other skin areas just as in women, but to a less frequent degree.

Candida infection in men is also the most common cause of inflammation affecting the head of the penis. [1]

Reasons Men May Develop Infection with Yeast

  • Being uncircumcised.
    • The presence of the foreskin may create pockets of space around the penis where yeast can multiply causing thrush.
    • Pay attention to cleansing the area by pulling back the foreskin to clean around it helps reduce your risk.
  • Poor personal hygiene.
    • Just as in women, poor personal hygiene contributes to the development of thrush in men.
    • It's important to pay attention to regular bathing; reducing the collection of sweat and avoiding damp clothing which promotes the growth of the yeasts.
    • Your private areas between the legs and anal areas are moist, warm sites where fungus easily multiplies to cause infection.
  • Chronic medical conditions.
    • Diabetes Mellitus or Chronic Kidney Disease are examples of such health problems.
    • Poorly controlled blood sugar or a weak immune response respectively could lead to yeast infections as can infection with HIV.
  • Remember that prolonged use of antibiotics - even when medically appropriate leads to the death of both good and bad bacteria.
    • Losing your good bacteria increases the risk of developing thrush

Symptoms of Yeast Infection in Men:

  • Thick whitish (creamy) discharge on the head of the penis, it may accumulate under the foreskin in uncircumcised men
  • Very itchy or burning sensation around the head of the penis
  • Inflammatory appearance - redness, bruised appearance to the head of the penis
  • Discomfort while urinating [2]


Young baby smiling with open mouth - oral yeast infections are common in babies
The mouth, tongue, gums are common sites for yeast infections in babies.

Yeast Infections in Babies and Young Children

A yeast infection can affect babies and young children.

Babies' immune systems are still developing, so they are more at risk of developing an infection.

The common areas that a baby can be affected are in the mouth and 'nappy area'.

Your baby's mouth makes regular with your nipple/breast during breastfeeding.

Oral thrush in a baby causes soreness and can affect baby's breastfeeding.

Some symptoms of oral thrush are:

  • Whitish, or creamy patches in the mouth, tongue or over the gums
  • Being unable to feed from soreness in the mouth
  • Unsettled, crying a lot, are other signs your baby may have thrush.

Carefully cleaning your breast and nipples between feeds helps prevent thrush developing in your baby.

It is important to get prompt treatment for you and your baby if either shows signs of thrush.

The other common problem area is the 'nappy region'.

  • The skin of the upper thigh folds,
  • All the area between the thighs
  • The skin of the vulva or penis
  • And the space between the buttocks from front to back.

Babies can develop diaper rash or nappy dermatitis which are most often due to yeast infection.

In these cases, some or all of these areas develop a very red, shiny, inflamed, raised, pimply or bumpy rash [3].

It is uncomfortable and leads to pain when urinating as the acidic urine rubs against the sore skin.

Some of the conditions that may increase the risk of nappy dermatitis are:

  • Leaving on wet/soiled nappies for long periods or
  • Failing to clean and dry baby's skin properly when changing the nappy.


Common Questions You Ask

Yeast infections lead to irritation and discomfort - mostly symptoms are not severe but can complicate your usual activities.

Here are a few common enquiries we get about yeast infections.

Is a Yeast Infection Contagious?

Yeast infection is typically not sexually transmitted.

It can be passed from one person to another from bodily contacts - such as during sex.

Another instance is when a breastfeeding baby develops thrush as the yeast can grow in both baby's mouth and on the mother's nipple.

Yeast infections are not toilet infections.

Poor personal hygiene from not washing properly, dirty clothing, personal habits like douching etc.

These are more likely conditions than a dirty toilet for developing thrush.

Can Yeast Infections Affect Your Periods?

Having a yeast infection during your period may make menses uncomfortable.

The itching sensation that accompanies a yeast infection may worsen especially when sanitary pads are worn over a long period of time.

This is why maintaining good hygiene during your periods is so important.

  • Change sanitary towels and tampons often especially if you bleed heavily.
  • If you use menstrual cups, change them as recommended by the manufacturer
    • Ensure your wash the cups thoroughly and that you dry them properly in between use.
  • Take frequent, regular baths especially when on your periods
  • Wear clean, fresh, thoroughly dry underwear - preferably made from cotton materials.

How to Prevent Yeast Infections

As we've seen, the yeast cells live in our bodies but are usually kept under control by the presence of good bacteria.

Therefore, anything that depletes the vegetation of ‘good bacteria’ in the vagina would predispose you to a yeast infection; or when your immune system is weak and cannot protect you from the germs.

Do the following to prevent a yeast infection:

Personal hygiene care for women:

  • Avoid Douching. This is a very old practice of washing the inside of the vagina using 'feminine products'.
    • However, douching with these products result in some changes:
      • Disturbs your normal vaginal acidity and the good germs (bacterial flora) which live there.
      • Both of these can allow overgrowth of the yeast leading to infection.
    • Your vagina is able to clean itself. Fluid made by cells in the vagina and cervix remove dead cells/dirt.
    • When cleaning, focus on the areas between the legs, outside your vagina, ie the vulva, the groin and your anal area. Avoid washing inside the vagina.
    • Don't forget to clean from front to back after using the toilet and when bathing to avoid germs getting to the vagina from the anal area.
  • Avoid inserting foreign bodies into the vagina
  • Stay away from using tight underwear; instead, wear dry or freshly cleaned cotton underwear.
  • If you suffer frequently from thrush, check your soaps - fragranced soap, bubble baths or feminine sprays.
    • Just like douching, they could affect the acidity of your vagina and increase the growth of yeast cells.

  • Personal Hygiene Care for Men is also important for preventing thrush.
    • When you fail to clean the penis properly, it can lead to a build-up of smegma.
    • Smegma is the name we give to the natural lubricant which keeps the penis moist.
    • It's usually its found around the head of the penis and the foreskin.
    • When the penis is not washed regularly (or properly) at least once a day or after exercise, sex etc, smegma builds up.
    • This makes a good breeding area for germs like bacteria or yeast to cause infections.
  • Use loose cotton boxer shorts instead of tight 'jock' shorts to reduce yeast overgrowth.

General Prevention Tips

Avoid unnecessary or prolonged antibiotic use wherever possible.

Eating certain types of foods called Probiotics can help your body control the overgrowth of yeast or other bad germs.

  • This is because probiotics like yoghurt or buttermilk contain some good live bacteria.
  • They are helpful in improving the health of your bowel, reducing problems with gas/bloating, diarrhoea or reduce lactose intolerance.
  • But in addition, taking these regularly in moderate quantities could help the overall balance and reduce your risk of yeast infections.  

  • If you are diabetic, work with your specialist to ensure a program where your blood sugars are well controlled.
    • This helps to reduce the risk of frequent candida overgrowth and infection.

  • Practice good personal hygiene, and keep your clothes fresh.
    • Look after your gym/exercise clothing and kit. Have them washed and dried in between sessions.
    • If you sweat a lot, don't wear the same clothing on consecutive days - especially underclothes.
  • Air dry your clothing - sun-dried is best, or dry them thoroughly in a dryer before wearing them.
  • Yeast only requires little encouragement to overgrow - by keeping personal items clean you reduce the chances for this to happen.

Where Else Can You Get a Yeast Infection?

Apart from the genitals, anal area and the mouth, it is also possible to get a yeast infection on the nipples and around the breasts.

Breast and nipple yeast infection happens in breastfeeding mothers whose babies have oral thrush.[4]

Most yeast infections are mild, but in some cases, they can become overwhelming or extensive.

These are often complications of weak immune systems from conditions like Cancer or HIV; as well as a side effect from the medicines used to treat these conditions.

So in addition to yeast infection of the mouth, the deeper tissues of the throat or pharynx can be involved.

Another complication is blood poisoning - this also happens when the immune system is suppressed.

Most often it happens when the yeast becomes overgrown on objects placed within the body like catheters.

Can a Yeast Infection cause Urinary Tract Infections?

Yeast infection in men may cause urethritis which is an inflammation of the urethra, the urinary tube which runs in the penis and into the bladder. [5]

Candida albicans is a common cause of opportunistic infections especially for people in hospital.

An opportunistic infection is a special type of infection when a germ that would usually not cause harm takes advantage of the opportunity given by a weakened immune system to cause serious illness.

A very common example is when Candida causes urinary tract infections in people with urinary catheters. [6]

Opportunistic infections are also common in people HIV who have weakened immune systems.

What's the Reason I keep Getting Thrush?

Recurring thrush is the term doctors give to thrush infection that keeps returning after treatment. It may get better for a while, then you get thrush again. This may happen if you did not complete your course of treatment or take the medicines as advised.

It may also be the case that there is an underlying condition which means that despite treatment the yeast germs are able to survive or multiply very easily.

This could happen with:

  • Poorly controlled Diabetes Mellitus
  • Taking medicines that weaken your immune system (immunosuppressants or other cancer-fighting drugs)
  • Suffering from conditions which also reduce your immune's system's ability to work well.
  • Continuing to take medicines which could increase your risk of thrush-like the Combined birth control pill.
  • Pregnant women may experience repeat bouts of thrush during their pregnancy - as a result of hormone and immune changes.
  • Failing to treat your sexual partner at the same time as you may also explain why you keep getting thrush.
    • It is possible that your partner may have yeast cells in their private parts without obvious signs of the infection.
    • During sexual contact, they pass the yeast to you leading to your re-infection.

But in some cases, you may suffer from a thrush infection which simply does not go away following standard treatment.

  • Severe thrush infection may need more than one single course of treatment and for a prolonged period of time.
    • Your doctor may arrange for you to have blood tests to diagnose the cause of the problem if it does not settle after a few weeks.
    • In some cases, you may need to have up to 6 months of treatment if you continue to have recurring thrush infection.

How To Treat Yeast Infections

Yeast infections are generally treated with antifungal drugs.

These are a special class of medicines which kill and stop the growth of the yeasts.

They can be taken by mouth (oral); used directly on the skin as creams or as capsules inserted into the vagina (pessaries).

Creams

These are generally used for yeast infections affecting the skin:

  • The vulva,
  • the head of the penis and skin around the shaft
  • the folds around the armpits or thighs,
  • under/in between the breasts
  • or for nappy dermatitis.

Tablets/ Capsules/Gels/Sprays/Mouth Drops

You may be given antifungal medicines to take by mouth instead of (or as well as) creams to treat your yeast infection.

More severe and extensive candida/yeast infections are more effectively treated with oral antifungals than with creams.

We use these for treating thrush in the vagina, penis, other skin infections like over the nipple, armpit, groin and so on.

Oral gels, sprays and mouth drops are specially designed for infections in the mouth.

They are especially preferable for babies and adults who have swallowing difficulty.

Their advantage is allowing the drug to concentrate within the tissues of the mouth and quickly target the yeast cells.

Vaginal Pessaries

These are medicines in the form of capsules or creams within applicators that deliver the drug right within the vagina.

Similar to oral drops or gels, they allow the drug to concentrate within the vaginal tissues and kill yeast cells.

You may get a course of treatment for 1 or 2 weeks, but there are 'single-dose' preparations which are easier to use and adhere with.

Pessaries can also be used by a woman during her menstrual period.

The best way to use the vaginal pessary is to apply it high up in the vagina at bedtime.

This allows the medicine to remain inside the vagina after application while you are lying still.

If your symptoms do not improve following a course of treatment, it is important to seek medical advice.


What about Over-The-Counter Treatments?

Well, a lot of the time, mild cases of thrush in adults can be treated without seeing a doctor. This could be the case with slight vulval/vaginal infection or irritation around the penis.

Most often, these are antifungal creams or pessaries, and you may find these convenient and simple to use.

A common prepration is Clotrimazole, marketed as Canesten in many places.

However, if you feel you have a heavy yeast infection, or you have other symptoms such as:

  • vaginal bleeding,
  • or type of discharge from the penis/vagina that is different from what has been described earlier,
  • or feeling unwell with pain in your abdomen or fever,

please visit a clinic/hospital to ensure you get the proper treatment.


Can You treat Yeast Infections Naturally?

There is some evidence that mild cases of vulval thrush; or vulval and vaginal infection can be treated naturally.

You may prefer a natural remedy if you want a discreet, at-home remedy but it is important to emphasise that these remedies may be limited in moderate/severe infections where you may also be feeling ill.

These remedies are also NOT recommended if you:

  • Are pregnant.
  • Intend to use them for babies or children - please seek medical advice in this case.
  • Have been diagnosed with an immunosuppressive illness like HIV, or poorly controlled Diabetes.
  • Suspect a sexually transmitted infection (STI).
  • Have had recurring thrush infections in the past.

Some of these home remedies are:

  • Apple Cider Vinegar (diluted and used in the bath)
  • Coconut Oil applied to affected areas
  • Hydrogen Peroxide (diluted)
  • Garlic (in food)
  • Some Probiotics like yoghurt or supplement forms.

If you will like to learn more about home remedies and how to use them safely, read here.

When Will the Symptoms Improve After Starting Treatment?

Yeast infections can last three days to two weeks, so there are one-day, three-day, or week-long treatments available.

Generally, the sooner you begin treatment, the quicker the yeast growth can be controlled and stopped.

For creams, pessaries, mouth gels or drops your response may begin within the first 24 to 36 hours.

The tablets/capsules require digestion and may take slightly longer to begin working.

Pregnant women are a special group who need a longer duration of treatment, usually about 7 days, to clear the infection.

Oral antifungal treatment should be avoided during pregnancy.

Regardless, the failure of any treatment should be reported to your doctor for help.

Have you any experience of Candida infection that you'd care to share - was it hard to get a diagnosis or the right treatment? We'd love to hear from you in the comments' section. Till next time, stay well.

Read More:

References

  1. Jacqueline M. A and Bettina C. F, 2010. Candida Infections of the Genitourinary Tract. Clin Microbiol Rev. 2010 Apr; 23(2): 253–273. doi: 10.1128/CMR.00076-09
  2. U.S. Department of Health and Human Services, 2013. Yeast Infection. [online] Available at: <http://www.womenshealth.gov/publications/our-publications/fact-sheet/vaginal-yeast-infections.cfm> [Accessed 20 September 2020]
  3. Pickering LK, Baker CJ, Kimberlin DW, 2015. Long SS eds. Red Book: 2015
  4. Report of the Committee on Infectious Diseases. Elk Grove Village, IL: American Academy of Pediatrics; 2015:[275-280]
  5. Louisa H and Stacie AC, 2011. Candida Mastitis: A Case Report. Perm J. 2011 Winter; 15(1): 62–64. doi: 10.7812/tpp/10-088
  6. Liesl Brown, 2018. Treating Vaginal Yeast Infections. [online] Available at:  <researchgate.net/publication/328542185_Treating_vaginal_yeast_infections> [Accessed 27 September 2020]
  7. Payam B, Elham B, and Reza R, 2015. Urinary tract infections and Candida albicans. Cent European J Urol. 2015; 68(1): 96–101. doi: 10.5173/ceju.2015.01.474

Editing By AskAwayHealth

Disclaimer

All AskAwayHealth articles are written by practising  Medical Practitioners on a wide range of health care conditions to provide evidence-based guidance and to help promote quality health care. The advice in our material is not meant to replace the management of your specific condition by a qualified health care practitioner.
To discuss your condition, please contact a health practitioner or reach us directly through info@askawayhealth.org

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