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Vaginal Inflammation

There are many types of vaginitis of which 40 percent are caused by candida a yeast-like fungus. When it multiplies in the vaginal tract the disorder is called vulvovaginitis. Women often refer to it as a "yeast infection." About 75 percent of women get candida vaginitis at some time in their lives.

Signs and Symptoms

bulletItching in the vagina and vulva
bulletVaginal discharge (small amounts are normal however)
bulletRed swollen painful vaginal mucous membranes and external genitalia
bulletSatellite lesions (tender red pus-filled bumps which can spread to thighs and anus)

What Causes It?

Candida is a yeast-like fungus that grows in the vagina. When there is too much of it it causes infection. The following increase your chance of getting a yeast infection.

bulletAntibiotics—especially broad-spectrum types
bulletPregnancy—from increased heat and moisture and hormonal shifts
bulletDiabetes
bulletCorticosteroid use
bulletHuman immunodeficiency virus (HIV) infection
bulletTaking birth control pills
bulletBeing overweight
bulletHigh sugar intake
bulletWearing panty hose tight clothing or non-cotton underwear

What to Expect at Your Provider's Office

Your health care provider will give you a pelvic examination and swab your vagina to check for candida. You probably will also have a Pap smear. Some women have chronic yeast infections. If this happens your provider may want to do additional tests.

Treatment Options

Treatment Plan

Usually topical treatments are started before systemic drugs (for which you take pills). However you can tell your provider which you prefer. When you have an infection avoid overheating sweating and sexual relations until symptoms clear. Use unscented soap take showers instead of baths and use proper hygiene after bowel movements by wiping from front to back. Wearing cotton underwear and avoiding pantyhose and tight-fitting pants can help prevent infection.

Drug Therapies

Prescription

bulletTopical therapies—first application may cause burning; place cream or vaginal suppository in the vagina; 70% to 90% effective; no systemic side effects; some brands also may be used externally for lesions
bulletOral therapies—75% to 92% effective; do not take if pregnant

Over the Counter

N/A

Complementary and Alternative Therapies

Alternative therapies may help to treat acute and chronic vaginitis.

Use only one of the following douches at one time. Do not douche during menstrual periods. For first time or acute infection try the vinegar douche or boric acid capsules. For chronic vaginitis use the herbal combination douche. For recurrent vaginitis use the Betadine douche. Stop douching if you are in pain or your symptoms get worse.

bulletWhite vinegar: 1 to 2 tbsp. to 1 pint of water. Douche daily for 10 to 14 days.
bulletBoric acid: One capsule (600 mg) inserted daily for 10 to 14 days. May cause irritation or problems from systemic absorption.
bulletHerbal combination: Mix equal parts of oregano leaf (Origanum vulgare) goldenseal root (Hydrastic canadensis) and coneflower (Echinacea purpurea). Steep 1 heaping tbsp. of herbal mixture in 1 pint of water. Cool and douche daily for 10 to 14 days.
bulletPovidone iodine (Betadine): Douche with one part iodine to 100 parts water twice daily for 10 to 14 days. Prolonged use can suppress thyroid function.

Nutrition

bulletAvoid simple and refined sugars (breads pasta baked goods sweets) dairy products alcohol peanuts fresh or dried fruit fruit juice and food allergens. Eat plenty of protein vegetables and grains.
bulletLactobacillus acidophilus re-establishes normal bacteria in the body and prevents the overgrowth of candida. Take one capsule orally two to three times per day. Insert one capsule into the vagina nightly during treatment (not to exceed 14 nights).
bulletVitamin A (10 000 IU per day) or beta-carotene (50 000 IU per day) enhances the integrity of the vaginal lining. Remember to avoid high doses of vitamin A in pregnancy or if you may become pregnant within the next three months.
bulletZinc (30 mg per day) and vitamin E (400 to 800 IU per day) are essential for immune function.
bulletVitamin C (1 000 mg three to four times per day) enhances immunity and helps restore the integrity of vaginal lining.

Herbs

Herbs may be used as dried extracts (capsules powders teas) glycerites (glycerine extracts) or tinctures (alcohol extracts). Unless otherwise indicated teas should be made with 1 tsp. herb per cup of hot water. Steep covered 5 to 10 minutes for leaf or flowers and 10 to 20 minutes for roots. Drink 2 to 4 cups per day.

bulletPau d'arco tea has antifungal effects.
bulletGarlic (Allium sativum) has antimicrobial antifungal and immune-stimulating properties. Prepare a tea with two cloves of garlic. May add fresh lemon and honey for flavor.

Homeopathy

Some of the most common rededies for vaginitis are listed below. Usually the right dose is 12X to 30C every one to one to four hours until your symptoms get better.

bulletCalcarea carbonica for intense itching with thick white or yellowish discharge that is worse before you start your period.
bulletBorax for burning pains with egg-white colored discharge.
bulletSepia for burning pains with milky white discharge and pressure in vaginal area especially if you feel depressed and irritable.
bulletGraphites for backache with thin white discharge that is worse in the morning and when walking.
bulletArsenicum album for when you have burning discharge.
bulletHomeopathic combinations are available as creams to apply vaginally.

Acupuncture

Acupuncture may be helpful in improving immune function.

Following Up

To keep infections away use unscented soap take showers instead of baths and cleanse after bowel movements by wiping from front to back.

Special Considerations

Yeast infections occur twice as often during pregnancy.

Supporting Research

Dambro MR. Griffith's 5-Minute Clinical Consult–1999. Baltimore Md: Lippincott Williams & Wilkins; 1999:358–361.

Fauci AS Braunwald E Isselbacher KJ et al eds. Harrison's Principles of Internal Medicine. 14th ed. New York NY: McGraw-Hill; 1998.

Habif TP. Clinical Dermatology. 3rd ed. St. Louis Mo: Mosby-Year Book; 1996.

Morrison R. Desktop Guide to Keynotes and Confirmatory Symptoms. Albany Calif: Hahnemann Clinic Publishing; 1993:43 69 85 171 346.

Murray MT Pizzorno JE. Encyclopedia of Natural Medicine. 2nd ed. Rocklin Calif: Prima Publishing; 1998:530–535.