Download YEAST INFECTIONS Written by: Robert B. Hartmann, Jr., MD

YEAST INFECTIONS
Written by: Robert B. Hartmann, Jr., MD, FACOG
of Dedicated to Women OB-GYN
What exactly is a yeast infection? From the term it seems like an infection one might get from
baking bread or working in a bakery? Actually a yeast infection is a fungal infection of the
vagina. It is primarily caused by a fungus called Candida Albicans. In women with multiple or
recurrent infections, it may be caused by other candidal organisms. The correct medical
terminology is vulvovaginal candidiasis.
There are multiple symptoms of a yeast infection. The most common system is vulvar itching.
Women may also experience a heavy whitish vaginal discharge, note small ulcers on her vulva, or
experience painful urination. Yeast infections may also be asymptomatic. This is because
Candida can be part of a woman’s normal vaginal environment. Women experience the
symptoms of a yeast infection because of sensitivity to the fungus. Some women may experience
symptoms with very minimal Candida present especially if they are hypersensitive to it.
The diagnosis of a yeast infection is established by patient symptoms and by obtaining a
microscopic slide of the vaginal secretions and measuring the PH of the secretions. The majority
of diagnoses can be made this way. However, there are instances when there is not a lot of
Candida present. The patient may be hypersensitive to a small amount of yeast. In this case, a
culture of the vaginal secretions can be obtained. It takes about one week for the yeast to culture.
Although the diagnosis of a yeast infection is relatively simple, many women will self diagnose.
Multiple studies have shown that women make the correct diagnosis only 25% of the time.
Studies have also shown that if a physician makes the diagnosis, using only the patient’s
symptoms, the physician is correct only 30% of the time. This is because there is a significant
amount of symptom overlap between yeast infections and other vaginal infections. Almost all
vaginal infections will have the symptoms of itching and discharge. At Dedicate to Women, we
recommend patients be diagnosed properly by a physician. We try to see all patients with vaginal
infections within 24 hours.
The preferred therapy for vaginal yeast infection is one of the many antifungal creams available
by prescription or over-the-counter. The vaginal preparations are available in 1, 3, or 7 day
treatments. The cure rate of the 3 day or 7 day therapies show significant differences in
effectiveness between prescription and over-the-counter therapies. With any of the creams, there
can be up to a 20% relapse rate. Single dose oral therapy is also available. Diflucan given as a
single 150mg dose is approximately 75% effective. Many women prefer this type of treatment
because it is easy and effective; however, Diflucan can interact with some medications.
Many women will also experience recurrent yeast infections. This can be distressing to the
patient and perplexing to the physician. If a woman believes she is experiencing recurrent yeast
infections it is recommended that she see her physician. Occasionally, this may be the first sign
of diabetes, an immune disorder, a resistant strain of yeast, or an incorrect diagnosis. As more
research is being done, we are instituting different treatments for the patients with recurrent
infections.