Chronic yeast infections?

Dear Alice,

I have chronic yeast infections. My doctor basically said that I have a pH imbalance and to stock up on Mycelex or similar creams. This answer, to me, is unsatisfactory. There must be something I can do to keep my pH level in balance, or at least on the acidic side. Do lactobacillus and acidophilus tablets keep the vagina more acidic to prevent a yeast infection?

Dear Reader, 

It can be quite frustrating when a health care provider comes up with an unsatisfactory answer about your health needs. Keep in mind that you understand your body best and if you would like a second opinion about a medical condition, that’s your right! Luckily for you, there are many ways to keep your pH, or power of Hydrogen, in balance without having to visit a medical professional. While external over-the-counter (OTC) creams, like your doctor mentioned, may help to get rid of a yeast infection, things like taking probiotics, making minor changes in your daily eating habits, and maintaining genital hygiene can all contribute to a balanced pH.

The vagina is a dynamic microbial ecosystem that’s always slightly acidic. Recent studies on adults between the ages of 18 and 50 consistently found the average pH of a vagina to be slightly acidic. The vagina is home to different types of healthy, acid-producing bacteria (e.g., lactobacillus acidophilus) which help to maintain its chemical balance, protect against bad bacteria, and prevent dryness. When the pH of the vagina is thrown off-balance (often signified by a higher pH), it creates the perfect environment for unhealthy bacteria to grow and thrive. This is typically when vaginal yeast infections occur. Around 75 percent of people with vaginas will experience a yeast infection in their lifetime, with 45 percent having repeat infections (so you're not alone!).

That said, what causes a pH imbalance in the first place? Certain factors such as taking antibiotics, having unprotected sex, vaginal douching, and your menstrual cycle can all contribute to an unbalanced pH. Other lifestyle factors like taking birth control pills, sitting in a wet bathing suit for an extended period of time, using scented tampons, eating foods high in sugar, and not changing out of sweaty clothes can also impact the vaginal microbiome. While each method has a different way of altering pH, they all tend to raise the pH.

So how can you “tip the scale” to bring your vagina back to its acidic state? Often the first step in treating a yeast infection is talking to a health care provider. They may prescribe an antifungal medication that works by fighting the overgrowth of yeast in your body. These medications can be applied topically (think creams like your doctor recommended), consumed orally in the form of a pill, or inserted directly into the vagina (typically a suppository).

That said, there are also methods you may choose to maintain the natural acidity of your vagina and prevent future yeast infections such as:

  • Avoiding the overuse of antibiotics. Prolonged and overly aggressive use of antibiotics can kill the good bacteria that live inside the vagina, leading to the overgrowth of yeast.
  • Being conscious of certain food groups. Meals that are high in sugar multiply the amount of yeast in our body and thus contribute to recurrent yeast infections. By reducing of the amount of food or drinks fermented with yeast and foods made up of simple sugars, you may be able to reduce the growth of yeast in your body.
  • Eating foods rich in pre- or probiotics. Pre- and probiotics can help to increase good bacteria to bring the vagina’s environment back to equilibrium. Foods like yogurt, cottage cheese, sauerkraut, and kimchi can all be good sources for these bacteria. In terms of Acidophilus (also known as Lactobacillus acidophilus), it falls into the probiotic category and may help with restoring your pH balance since it works to restore the acidic environment in your vagina.
  • Employing a “less is more” mindset when it comes to the vagina. Since the vagina is self-cleaning, avoid douching and using scented tampons, pads, or other feminine hygiene sprays. Chemicals in these products can irritate the skin and mucous membranes, causing the natural pH balance of the vagina to change.
  • Being conscious of clothing choices and keeping the area dry. In order to provide ventilation to the area, consider wearing cotton underwear as well as loose-fitting bottoms whether that be pants, skirts, shorts or pantyhose. Changing out of wet clothing such as swimwear and exercise clothes can also help to keep the area dry, which can reduce the chances of extra bacteria growth.

If you decide to opt for a second opinion from a health care provider, you might consider asking what other treatment options are available aside from OTC creams. Given that your yeast infections are chronic, it may be helpful to ask if there’s a prescription medication that can be taken over multiple weeks to help treat recurrent infections or which methods the professional has found most effective in preventing recurrent infections.

Here's to staying itch-free!

Last updated Jul 21, 2023
Originally published Dec 05, 1996

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