Many women suffer from recurrent vaginal burning and itching, whitish discharge and discomfort when they make love. Some are diagnosed as having yeast infections, even though this is far less common than most doctors think.
Because yeast is found in every healthy woman's vagina, Doctors often misdiagnose a yeast infection when none is there. The only way that a doctor can diagnose yeast infection is to insert a Q-tip into the vagina, place it in a fraction of a drop of water and then look at it immediately under a microscope. Seeing the yeast strands gives a diagnosis. A culture is not a dependable way to diagnose yeast infections because every healthy woman can have yeast grow on culture (1).
Yeast infections occur most commonly in women who have depressed immunity such as that caused by diabetes, HIV or hepatitis, or they have a yeast that is different from the common yeast and is spread through sexual contact (2). Women with vaginal itching and burning should have their doctors look at vaginal fluid to see if they have a yeast infection. If the doctors sees yeast under a microscope, he should test her for depressed immunity and if she is normal, as she usually is, both she and her partner should take a 150-mg Diflucan tablet once a day for at least four days.
If the doctor does not see yeast under a microscope, he should test her for other causes of vaginitis. If none are found, he should assume that she and her partner are infected with mycoplasma, chlamydia or ureaplasma that can be missed by presently available laboratory tests, and treat her partner and her with doxycycline 100 mg twice a day for a month or Zithromax 250 mg once day for nine days. More on Yeast Infections
1) P Giraldo, A von Nowaskonski, FAM Gomes, I Linhares, NA Neves, SS Witkin. Vaginal colonization by Candida in asymptomatic women with and without a history of recurrent vulvovaginal candidiasis. Obstetrics and Gynecology, 2000, Vol 95, Iss 3, pp 413-416. Address: Giraldo P, Cornell Univ, Weill Med Coll, Dept Obstet & Gynecol, Div Infect Dis & Immunol, 515 E 71st St, New York,NY 10021 USA.
2) 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.
3) One recent 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(R), Embil Pharmacy Company, Istanbul, Turkey) insert twice daily for 14 days.
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