Q: I'm 28, and am being driven crazy by recurring yeast infections. The pattern seems to be that I feel aroused in the middle of the month, around ovulation. When I have sex, I immediately get an outbreak of thrush, so I stop having sex to treat the symptoms. By then I have PMS, followed by my period, so, basically, I'd be lucky to enjoy carefree sex once a month. How can I break this cycle?
A: Ah, thrush – that little bird that flies in the window as love walks out the door. This annoying yeast infection is very common, with 75 per cent of women affected at some time. It is usually the result of an overgrowth of Candida albicans in the gut. This harmless fungal condition occurs naturally and only causes problems when things are out of balance.
This annoying yeast infection is very common, with 75 per cent of women affected at some time.
Thrush occurs in the vagina, and in the mouth, but is not a sexually transmitted infection. It is safe to have sex during an attack, although some men do experience some itching. However, the uncomfortable symptoms usually make the idea of having intercourse unappealing.
The main symptoms are a burning, itching feeling around the vulva, and a white, yeasty discharge that resembles cottage cheese. The symptoms are easily treated with antifungal medication, used both internally, and topically. The problem is that, as you have found, recurring outbreaks can turn this into a vicious cycle.
Factors such as being on oral contraceptives or antidepressants, hormonal changes, and pregnancy can make outbreaks more common.
Antifungal creams and pessaries can be bought without a prescription, but even if you are sure that you have thrush, it is still important to see your doctor. These outbreaks can be a symptom of other health conditions such as an STI, or diabetes, so it is important to get an accurate diagnosis, especially when the symptoms recur.
There are simple steps that you can take to improve the situation, or to relieve the symptoms. One of these is something that all girls should be taught at toilet training. As the fungus lives in the bowel, she should always wipe backwards, away from the vulva.
Try to wear natural, breathable fibres next to your skin, and avoid tight pants, especially in warm weather. A moist, humid environment makes the fungus flourish. Do not use soap when washing your genitals. Avoid highly scented products such as essential oils, douches, deodorisers, and laundry products, particularly fabric softeners, as these can cause irritation.
Not a lot of research has been done on dietary factors, but, anecdotally, it might be a good idea to cut back on your sugar intake, and eat a good quality natural (unsweetened) yoghurt. Some woman find the yoghurt soothing when applied topically.
As I have said, if you are up for it sex is possible at this time. You need to use a lot of personal lubricant, but look out for cheap brands. Many of these contain sugar, which feeds yeast. Also, if you use condoms, be aware that the antifungal treatments can weaken them, so use these treatments after sex.
If you follow all the precautions, but this cycle continues you can ask your doctor about a treatment that deals with the fungal load in your gut. Called fluconazol, it is designed to be swallowed. This is a stronger treatment that is not recommended for pregnant women. It is quite expensive, and would not be used as a first level treatment, but it can be effective when the condition keeps returning.
The pattern you describe can have a negative impact on your relationships, your libido, and your sexual self-esteem. Talk to your partner about what is happening, and listen to how it is affecting each of you. It can be useful to get informed about the condition together. There are innumerable medical websites online, but not all of them are accurate. The Victorian government has a site which is trustworthy. It is called the Better Health Channel, and is your best health information resource. It also offers a list of resources and support organisations in the local area. Visit betterhealth.vic.gov.au/health/conditionsandtreatments/vaginal-thrush
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