Yeast

[Guest guest]

found this and thought I would share. I think this is what is

ahpping to me right now with this rash and fissure.

YEAST INFECTIONS

Gabe Mirkin, M.D.

When a woman develops a white discharge and vaginal itching, her

doctor often diagnoses yeast infection, even though he may be wrong

because every healthy woman has yeast in her vagina and cultures of

the vagina almost always grow yeast, even in women who have no

symptoms at all. A doctor diagnoses yeast by inserting a cotton swab

into the vagina, placing it in a drop of water and examining the

fluid for yeast under a microscope. Cultures should not be used to

diagnose yeast as most healthy women harbor yeast in their vaginas,

mouths and intestines.

Yeast infections often follow taking antibiotics or birth control

pills, but when yeast cause a rash on the genitals, it often is

acquired through heterosexual contact (1) or it can be caused by

immune defects associated with diabetes or HIV. When normal healthy

people develop rashes caused by yeast, doctors should look for a

cause. Genital infections caused by yeast are often associated with

a special type of yeast that is able to break though the skin to

cause a red, itchy rash. Men and women with genital rashes caused by

yeast either have an immune defect such as diabetes or they have a

special yeast that can be acquired through sexual contact.

Women who have documented yeast infections and a rash from it can be

cured when they and their partners take ketoconazole, 400mg daily

for 14 days, or fluconazole,150 mg/day for 4 days. Women who keep on

getting documented yeast infections may need to take itraconazole 50

to 100mg daily or fluconazole 100mg weekly or 150mg monthly. Short

courses of topical therapy, e.g. 500mg clotrimazole pessaries as a

single weekly dose for 6 months or 100mg miconazole pessaries twice

weekly for 3 months, followed by once weekly for 3 months may also

be used (3).

Since yeast is a normal inhabitant in the vagina, it is often

diagnosed as the cause of vaginal itching when it is only an

innocent bystander. When a physician takes cultures for many

different types of infections and finds only a yeast, he usually

prescribes suppositories (over-the-counter clotrimazole vaginal

suppository, once a day for three days) to kill yeast and the

patient feels better for a week or so because the suppository

lubricates the irritated area. Then the itching returns because

these women often are infected with mycoplasma/ which is

extraordinarily difficult to find on culture/ and can be cured when

they and their partners take azithromycin (250 mg once a day for 9

days) to kill the mycoplasma. If a woman really has a vaginal yeast

infection, she usually clears up with a pill called fluconazole (150

mg/day for 4 days).

A study from the University of Leeds showed that women who get yeast

infections over and over, have the same type of yeast that recurs;

it is not a new infection. This means that women with recurrent

yeast infections and their partners should be treated for several

weeks with oral drugs to kill yeast such a Diflucan, and not just

with vaginal suppositories (4).

1) J Warszawski, L Meyer, N Bajos. Is genital mycosis associated

with HIV risk behaviors among heterosexuals? American Journal of

Public Health 86: 8 Part 1(AUG 1996):1108-1111.

2) One paper recommends a vaginal suppository containing

metronidazole and miconazole, twice a day for two weeks, to kill

gardnerella, Trichomonas and yeast. S Kukner, T Ergin, N Cicek, M

Ugur, H Yesilyurt, O Gokmen. Treatment of vaginitis. International

Journal of Gynecology & Obstetrics 52: 1(JAN 1996):43-47.

Metronidazole 500 mg and miconazole nitrate 100 mg (Neo-Penotran®,

Embil Pharmacy Company, Istanbul, Turkey) insert twice daily for 14

days.

3) NC Nwokolo, FC Boag. Chronic vaginal candidiasis - Management in

the postmenopausal patient. Drugs & Aging, 2000, Vol 16, Iss 5, pp

335-339.

4) An investigation into the pathogenesis of vulvo-vaginal

candidosis. Sexually Transmitted Infections, 2001, Vol 77, Iss 3, pp

179-183. SS ElDin, MT Reynolds, HR Ashbee, RC Barton, EGV .

Checked 8/9/06