Vaginitis means inflammation of the vagina. A number of things can irritate the vagina: infections with bacteria, fungi, and protozoa; harsh chemicals in personal care products; and even the loss of estrogen after menopause. Yeast, a type of fungus, normally colonize the vagina though in small numbers relative to health-promoting bacteria such as lactobacilli. An overgrowth of certain types of yeast, such as Candida albicans, produces vaginal yeast infections (also called yeast vaginitis or vaginal candidiasis). Usually the labia and clitoris are also inflamed. About 75 percent of women have at least one episode in their lifetime; 5 to 10 percent have recurrent attacks.
The following factors raise the risk of yeast vaginitis:
• Antibiotics kill the “friendly” bacteria that normally defend the vagina.
• Douches and some vaginal “hygiene” sprays can irritate the vagina and disrupt the microbial ecology.
• Cancer chemotherapy, cortisone-like medications, and HIV infection suppress the immune system, allowing disease-causing microbes to flourish.
• Diabetes mellitus raises glucose (sugar) levels in bodily fluids, allowing feasting yeast to proliferate.
• Other factors include receptive oral sex (cunnilingus), pregnancy (because of hormonal shifts), and some contraceptives (contraceptive sponges, hormonal contraceptives, and intrauterine devices).
Symptoms include itching, burning, a thick white discharge, and discomfort during intercourse. Health professionals diagnose the condition with visual inspection and microscopic examination of the discharge. Treatment centers on intravaginal antifungal creams and suppositories. Oral antifungal drugs may be prescribed for more severe cases.
Before you try home remedies or over-thecounter antifungal creams, we recommend you get a medical diagnosis. Women correctly self-diagnose yeast vaginitis only about half the time. Other pathogens that don’t respond to antifungal drugs—some with potentially serious complications—can cause similar symptoms or may coexist with the yeast overgrowth.
Home management is only appropriate if you’re sure you have yeast and your symptoms are mild. If you’re pregnant, do not try any home remedies (with the exception of eating yogurt) without consulting your physician.
Recipes to prevent and manage vaginal yeast infections
Healing Honeyed Yogurt
1 cup (235 ml) water 2 tablespoons (40 g) raw (unprocessed) honey 2 tablespoons (30 g) plain, active-culture yogurt
Preparaton and use:
Boil the water in a kettle or saucepan. Allow it to cool so that it’s very warm but not scalding. Place the honey in a bowl. Raw honey can be very thick, so add just enough of the warm water (no more than 1 to 2 teaspoons [5 to 10 ml]) so that you can blend the honey with the yogurt. Add the yogurt and blend thoroughly with a clean spoon. Transfer the mixture to a clean jar. With clean fingers, apply about 1 teaspoon (11.5 g) to the vagina and vulva. (Don’t doubledip. If you have a clean vaginal applicator, you can spoon the mixture into it and apply it that way.) Repeat two times a day for seven days. We recommend you wear a panty liner. Store the jar in the refrigerator between applications. Toss after one week.
Yield: twelve 1-teaspoon (11.5 g) applications
How it works:
Raw honey has antifungal activity. Yogurt contains Lactobacilli, which is the type of bacteria normally found in the vagina. These friendly bacteria promote healthy immune system function and lower pH (more acidic environments are hostile to fungi). In a study published in 2012 in the Archives of Obstetrics and Gynecology, researchers created a blend of distilled water, local honey, and yogurt and then assigned pregnant women with yeast vaginitis to use the honey-yogurt blend or topical antifungal cream. Both were effective, but the honey-yogurt blend more so. Note: Raw honey hasn’t been processed or heated, thus retaining all active ingredients.
Intravaginal Yogurt Plain, active-culture yogurt
Preparaton and use:
Apply to the vagina and vulva two or three times a day.
Yield: multiple applications
How it works:
Yogurt contains lactobacilli, which protect against yeast vaginitis. Despite a long folk tradition, clinical trials have not evaluated intravaginal yogurt used alone for women with recurrent yeast infections. Such use may have more potential value as a preventive rather than a treatment for an active yeast infection. Lactobacilli do, however, interfere with the ability of disease-causing bacteria to colonize the vagina.
Garlic Suppository
1 garlic clove, peeled
Preparaton and use:
Wrap the clove in a single layer of sterile gauze and twist, to create a “tail” that’s 1 to 2 inches (2.5 to 5 cm) long. (If you have no irritation after the first application, you can gently nick the clove next time.) Insert the gauze-covered clove into the vagina, leaving a small piece of the tail-end of the gauze at the vaginal entrance. (Adding a bit of K-Y Jelly or other lubricant to the end can ease the insertion). Remove after 1 hour. Repeat three times a day.
Yield: 1 application
How it works:
Garlic is antimicrobial, with activity against fungi. However, no clinical trials have evaluated this folk remedy. Warning: Prolonged use of topical garlic can irritate skin and mucous membranes. Some people are allergic. Discontinue use if irritation occurs.
Yogurt and Berries Breakfast Treat
1 cup (230 g) plain nonfat, active-culture yogurt (We like Greek yogurt, which has a satisfying thickness even when low in fat.) ¼ cup (36 g) fresh berries (or other favorite fruit)
Preparaton and use:
Scoop the yogurt into a bowl. Top with the berries. Spoon into your mouth and enjoy.
Yield: 1 serving
How it works:
Yogurt contains probiotics, live microorganisms (mainly bacteria), that promote human health. Regularly eating yogurt seems to help prevent yeast infections. Active-culture yogurt contains bacteria normally found in the intestinal tract and vagina. These organisms promote healthy immune function.
Quickie Kimchi
1 head savoy cabbage 1 cup (110 g) grated carrot ¼ cup (60 g) sea salt ½ teaspoon minced fresh garlic 4 scallions, chopped 1 teaspoon (5 ml) Asian fish sauce 1 tablespoon (13 g) sugar ½ teaspoon ground ginger 2 teaspoons (5.2 g) chili powder, or to taste
Preparaton and use:
Trim the bottom of the cabbage, slice it lengthwise, and cut each half into chunks. Mix together the cabbage chunks and carrot in a large glass bowl. Toss with the salt to coat the vegetable mixture. Cover the bowl securely with plastic wrap and allow to sit at room temperature for 5 to 6 hours. Transfer the mixture from the bowl to a colander, rinse off the salt, and then drain the vegetable mixture, thoroughly, pressing out all the liquid. Return the mixture to the rinsed bowl and stir in all the remaining ingredients, except the chili powder. When all the ingredients are combined, add the chili powder and stir well to coat. You can knead it in by hand, but wear plastic gloves to protect your fingers from the heat. Transfer the mixture to a clean 24-ounce (710 ml) glass jar. Cap the lid tightly. Set the jar in a cool, dry place for four days. Refrigerate, then serve. Refrigerated, the mixture keeps for about four weeks.
Yield: 4 servings
How it works:
Fermented foods contain probiotics. The intestines are the source of fungi that infect the vagina (and also of the bacteria that cause bladder infections and a non–sexually transmitted vaginal infection called bacterial vaginosis). Disruption in the microbial ecology of the gut (due to antibiotics and other causes) can promote fungal overgrowth in the vagina. Although oral probiotics are unlikely to treat an active yeast infection, regular consumption may help prevent them.
Antiyeast Bath
1 cup (235 ml) apple cider vinegar
Preparation and use:
As you run a warm bath, pour in the apple cider vinegar and disperse it with your hand. Luxuriate for at least 20 minutes as the vinegar works to inhibit yeast growth.
Yield: 1 appLication
How it works:
Vinegar can help arrest the growth of Candida albicans, a common cause of yeast infections. All three essential oil alternatives are antifungal. Recipe Variation: Add essential oils to your bath, along with the vinegar: tea tree oil, eucalyptus, or, lavender.
Antifungal Wash
2 cups (475 ml) water 1 tablespoon (6 g) green tea 1 tablespoon (3 g) dried rosemary or (2 g) sage 1 tablespoon (15 ml) apple cider vinegar 1 drop tea tree essential oil
Preparaton and use:
Boil the water. Add the tea and rosemary. Cover and steep 15 to 20 minutes. Strain into a jar. Add the vinegar and oil and shake well to disperse the oil. Moisten a tampon with the mixture and insert into the vagina. After 15 minutes, remove the tampon. Wear a panty liner.
Yield: 1 application
How it works:
Some natural medicine practitioners use diluted tea tree oil to manage vaginitis. Tea tree essential oil is antimicrobial against a number of organisms, including Candida albicans. Ensure that it is diluted as local irritation and allergic reactions are possible. Tea tree essential oil is very strong and should only be applied externally; it can be toxic if ingested. Tea (Camellia sinensis), rosemary, and sage are also active against Candida yeast. Vinegar contains acetic acid, which discourages yeast overgrowth. Warning: Do not douche or insert tampons while pregnant. Note: This formula has not been tested in any clinical trial. Alternatively, you can very gently douche with this mixture. Although it’s okay to do so if you have a yeast infection, do not continue douching on a regular basis. Doing so can disrupt the normal ecology of vaginal microbes. Be sure to wear a panty liner.
When Simple Doesn’t Work
Some antifungal creams, such as miconazole and clotrimazole, are available over the counter. Boric acid suppositories have also been successfully used, though the method is less well researched than antifungal creams. Boric acid is antiseptic and inhibits fungi. Some products are available over-the-counter. Most studies have used 600 milligrams of boric acid in a gelatin capsule inserted into the vagina. Boric acid is toxic if eaten, should not be used long term in the vagina, and should not be used at all by pregnant women. Side effects include watery discharge, redness, and mild burning. Probiotic supplements have preventive value. Some studies show that oral or intravaginal capsules or suppositories containing certain strains of lactobacilli (Lactobacillus acidophilus, L. rhamnosus gR-1, L. fermentum Rc-14, L. crispatus, and L. reuteri) help reduce recurrences of yeast vaginitis and bacterial vaginosis (caused by imbalances in vaginal bacteria). Products made from the juice of fresh echinacea pupurea have been shown to be useful add-on therapies to an antifungal cream to prevent vaginal yeast infections. They also improve immune system function during an acute infection. Doctors use topical antifungal agents to prevent recurrences. Combining the cream with oral echinacea (a product made from the juice of the above-ground parts of the plant preserved in alcohol) significantly increased the effectiveness.
When to call the Doctor
• This the first time you have had vaginal irritation and discharge. It’s important to get a proper diagnosis.
• The infection hasn’t cleared after you finish a round of antifungal cream.
• Two days of home treatment have not improved symptoms or symptoms have worsened.
• You have recurrent episodes of vaginitis.
• You have multiple sexual partners and now have vaginal discharge. Sexually transmitted bacteria can lead to pelvic inflammatory disease (infection of the uterus and fallopian tubes). If not treated immediately, it can lead to infertility and ectopic (out of place) pregnancy.
• You have not been consistently using a condom during intercourse. (If you’re in a long-standing and strictly monogamous relationship, ignore this one.)
Thursday, 3 April 2014
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