Candidiasis Vaginal - Causes, Symptoms and Treatment

The vaginal candidiasis, also called vaginal thrush, is a gynecological infection caused by the fungus Candida albicans. This mycosis is so common that 3 out of 4 women will experience at least one episode of vaginal candidiasis lifelong.

Candidiasis Vaginal
Candidiasis Vaginal

The Candida albicans causes a flash picture in the vagina and the vulva (the outside of the vagina), which is why it is also known as vulvovaginitis by Candida. Genital candidiasis inflation is characterized by signs and symptoms of local redness, intense itching and vaginal discharge.

Vaginal Candidiasis can be easily treated with antifungal medications, but some women who have recurrent episodes of candidiasis may require prolonged treatment to get rid of the infection.

In this article we will explain what is vaginal candidiasis, what are its causes, symptoms and treatment. We will also speak of recurrent candidiasis, which may be difficult to be eliminated.

How appears vaginal candidiasis?

As explained in the introduction of the article, vaginal candidiasis is an infection of the vagina and vulva caused by the fungus of the genus Candida. Among all species of Candida, a Candida albicans is the most common, accounting for 90% of cases. Vulvovaginal candidiasis can also be caused by the species Candida glabrata and Candida parapsilosis, but such cases are rare and tend to have a milder clinical picture.

Candida is a fungus that occurs naturally in our biological flora, being present in the mouth and digestive system of up to 50-80% of people, depending on the population studied. In normal situations, our immune system and the presence of other microorganisms of our natural flora prevent the Candida to multiply excessively, keeping the population under control. So be colonized by Candida fungus is not synonymous with having a Candida infection. Candida is only one entity millions of germs that are part of our natural flora of microorganisms.

This means that Candida is an opportunistic germ, or a microbe that can live innocently in our body without causing disease, but at the slightest sign of weakness of our immune system or disturbance in our natural flora germs can multiply up and move causing infections.

Between 20-50% of women have their vaginal colonized by the fungus Candida without this, however, means there is an infection by Candida. These women are completely asymptomatic, as the pH of the vagina acid, the immune system and the presence of vaginal bacterial flora prevent Candida can multiply. Vaginal candidiasis arises only if there is a disturbance in at least one of these three aforementioned protective factors.

How do you get vaginal thrush?

The above question is very common, but it is conceptually flawed because, in most cases, will not stick candidiasis anyone; candidiasis arises because the Candida albicans, which already existed in your body, found ways to overcome the defenses of our body and managed to multiply uncontrollably.

Usually the Candida albicans that colonizes the women's vagina has its origin in the perianal region. Candida that exists in the gastrointestinal tract and colonize the perianal region can migrate the perineum to reach the vagina and settle in this new region. A common way this occurs is through the incorrect cleaning the anus after defecation. If the woman is clean from back to front, it ends up bringing germs from the perianal region in duration to the vagina. This favors not only vaginal colonization by Candida, as well as the occurrence of urinary tract infection by bacteria of the gastrointestinal.

Eventually, Candida albicans can be transmitted from one person to another. As the mouth and gastrointestinal tract are the most common habitats of Candida in the body, oral sex and anal sex are possible sources of transmission. The vaginal sex can also be a form of transmission if the partner's penis or vagina of the partner are colonized.

It should be a caveat, the transmission of Candida through sex does not necessarily indicate that a woman will develop candidiasis. Candida recently acquired will have to face the same defense factors that a Candida organism itself must face. As we have seen, have the fungus Candida albicans is not synonymous with having infection by the fungus Candida albicans. Therefore, despite the Candida can be transmitted sexually, candidiasis itself is not considered a sexually transmitted disease because the vast majority of cases vaginal candidiasis is unrelated to sex. The number of partners a woman has in life does not interfere in the risk of it developing candidiasis, and women who practice celibacy can develop vulvovaginitis by Candida albicans.

Risk factors for vaginal candidiasis

In general, Candida albicans proliferates in the following situations: reduction of vaginal acidity (increase in vaginal pH), changes in microbial flora of the vagina, hormonal changes or weakened immune system.

Several risk factors for vulvovaginal candidiasis are already well known, the most important being:
  • Diabetes mellitus - diabetic women, especially those with poorly controlled blood sugar chronically, individuals are particularly prone to develop vulvovaginitis by Candida.
  • Recent use of antibiotics - about 25 to 30% of women requiring a course of broad spectrum antibiotics eventually develop an episode of vaginal candidiasis. This is because antibiotics work against the natural bacteria in the vaginal flora, but are inert against fungi.
  • Hormonal changes - too high or too low levels of estrogen interfere with the vaginal environment and increase the risk of candidiasis. This explains why situations like pregnancy, hormone replacement therapy, menopause, use of hormonal contraceptives and to the ovulatory period may facilitate the emergence of Candida vulvovaginitis.
  • Immunosuppression - immunosuppressed women, either by diseases such as HIV or use of immunosuppressive drugs, are at increased risk of developing candidiasis.

Risk situations unproven yet

Risk factors listed above are those that are proven to influence the woman's risk of developing a thrush. There are many others, but these do not show consistent results in clinical studies. So it is possible, but it is definitely not correct to say that the following factors increase the risk of candidiasis:
  • Tight clothes.
  • Wet bikini
  • Intravaginal contraceptive methods such as the IUD, diaphragm or vaginal sponge.
  • Vaginal douching.
  • Tampons.

As these possible risk factors, although not proven, may be avoided, it makes sense that women with recurrent candidiasis try to guard. However, those who never had vulvovaginal candidiasis or had only one or two episodes over several years do not have to worry about these possible risk factors, as they are not so relevant.

Recurrent vaginal candidiasis

About 5% of women have recurrent vaginal candidiasis, which is characterized by the occurrence of more than four episodes a year of candidiasis. The recurrence usually occur due to lack of efficacy in the treatment of an earlier infection, which allows the same strain of Candida to grow again after some time. Rarely, recurrent candidiasis is by a new infection caused by a different strain of Candida albicans.

Studies suggest that women with recurrent vaginal candidiasis can be genetically more susceptible to infection by Candida albicans, by changes in the vaginal region defense system.

Symptoms of vaginal candidiasis

Vulvar itching (vaginal itching) is the most important symptom of candidiasis. Burning or pain in the vaginal area are also common and may be accompanied by dysuria (painful urination) and dyspareunia (pain during intercourse).

Other common signs are redness in the area of the vulva and vaginal discharge. The discharge of vaginal candidiasis is usually milky, or type cottage cheese, and odorless.

Symptoms of candidiasis may worsen in the days before the fall of menstruation.

Diagnosis of vaginal candidiasis

None of the symptoms described above is exclusive of vulvovaginitis by Candida. Various gynecological infections such as bacterial vaginosis and trichomoniasis, may cause similar symptoms. In fact, all women who seek the gynecologist with vaginal itching complaint, less than 50% have candidiasis. Most have other causes of gynecological infection.

Therefore, the diagnosis of vulvovaginal candidiasis can only be established with certainty through laboratory tests landslide. To this end, the gynecologist must perform a gynecological examination in which he uses a kind of swab to collect vaginal wall material. This material is sent to the laboratory so that the germ causing vaginitis can be identified.

Treatment of vaginal candidiasis

The simplest cases of vulvovaginal candidiasis can be treated with vaginal application of creams, including cotrimazol, nystatin and miconazole. Another option is the pill fluconazole 150 mg single dose. Both forms of treatment have success rates above 90%, but the dosage orally is more comfortable because it is simple and short, currently the most widely used form.

In cases of recurrent candidiasis, treatment is usually done with oral fluconazole for up to 6 weeks.

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