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,

While yeast infections are very common (three out of four women get one at some point), it sounds like there is more to this problem than meets the eye. Yeast infections are often treated effectively with over-the-counter (OTC) medications, but it is important that you see your healthcare provider to ensure that the cause of your vaginal discomfort is in fact a yeast infection. Several diseases and infections appear to be yeast infections, but are not. Using yeast infection medication when you don't have a yeast infection may create new problems. Having your health care provider diagnose your symptoms each time can be helpful in figuring out an appropriate treatment.

Did your health care provider say your yeast infections are "chronic," or did s/he use another term, such as "recurrent?" The distinction between chronic and recurrent is subtle, but it's good to point out. Chronic means that a disease or condition will be present most, or all, of the time for a very long period of time, possibly for the rest of your life. Chronic yeast infections are usually indicative of a more serious health problem, such as a lowered immune response or diabetes. If you do have chronic yeast infections, you may want to have a complete medical checkup, including testing for all sexually transmitted infections (STIs) and HIV. This may help determine what, if any, systemic problem is causing these yeast infections.

Recurrent implies that you are able to effectively treat a certain infection or condition, but that it's likely to return. With recurrent yeast infections, it is a good idea to have a culture of the yeast done to figure out what strain of yeast you have. There are strains of yeast that do not respond to the usual antifungal creams. If this is the case, your health care provider may be able to prescribe a more appropriate medication. Moreover, you may want to speak with your health care provider before taking lactobacillus or acidophilus tablets, as research shows mixed results for yogurt remedies for yeast infections.

What do yeast infections and bread have in common? Having just the right amount of yeast! The following tips may help keep you balanced and decrease your risk of acquiring a yeast infection:

  • Avoid overusing antibiotics. Prolonged and overly aggressive use of antibiotics can kill the good bacteria that live inside of the vagina, leading to the overgrowth of yeast.
  • Stay away from spermicidal creams and jellies, which alter the vaginal flora and increasing the adhesion of organisms that can cause yeast infections.
  • Avoid douching and using scented tampons, pads, or other feminine hygiene sprays. Chemicals in these products can be irritate the skin and mucous membranes, and change the natural pH balance of the vagina.
  • Wear cotton underwear and loose fitting pants, skirts, and/or pantyhose — this leaves more room for ventilation.
  • Change out of wet clothes such as swimwear and exercise clothes as soon as possible.

It sounds like your situation calls for a more thorough investigation. An accurate diagnosis may make it easier to treat your symptoms and steer clear of frequent infections. Consider getting a second opinion if you are unsatisfied with your current health care provider's recommendations. Here's to staying itch-free!

Last updated Jun 03, 2015
Originally published Dec 05, 1996

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