Candidiasis in women: Who is at risk and how to treat it

What is candidiasis?

Candidiasis is a fungal infection caused by Candida albicans. This Candida lives in and outside the body. Inside the body, it can be found in the mouth, vagina and intestines, and rectum. Outside the body, it’s found on the skin.

At normal levels, they are not problematic but when the fungi begin to grow out of hand, they cause the condition,  Candidiasis. The fungus grows rapidly in moist and dark areas of the body. Skin folds, nylon underwear, and tight clothing are conducive for their growth1

The overgrowth of Candida in the vagina causes vaginal candidiasis which is commonly referred to as ‘white’. It may also be referred to as vulvovaginal candidiasis or candida vaginitis.

It is not considered to be a sexually transmitted disease/infection as it is not mainly transmitted through sex. Scientist have estimated that about 20% of women normally have Candida without  having any symptoms2 and out of the three quarters of women who have vaginitis in their lifetime, about 25% to 30% of it is caused by Candida.3

Who is at risk of candidiasis?

  •  Individuals with weak immune systems (people who are on steroids, chemotherapy, patients with HIV,  etc)
  • Diabetic individuals   
  • Pregnant women
  • People who abuse Antibiotics
What is candidiasis, Who is at risk and how is it treated?

What are the symptoms of candidiasis?

  • Itchiness of the labia in women and the head of the penis in men.
  • Curd-like discharge that is thick and white.
  • Reddening of the labia majora and minora
  • Burning sensation during urination
  • Pain during sex

How is vaginal candidiasis tested?

A swab (a bud stick with a soft cotton at the tip) of the discharge is taken to the laboratory for testing and a wet-mount test or potassium hydroxide (KOH) preparation is used to confirm the presence of Candida. If the diagnosis is uncertain a fungal culture may be done.

Cotton Swabs Vector Images (over 2,000)
Swab for taking a sample of discharge
(Image from: https://www.vectorstock.com/royalty-free-vectors/cotton-swabs-vectors)

How is vaginal candidiasis treated?

Antifungal medicines are used for the treatment of candidiasis. These medicines may be inserted into the vagina as a pessary or taken orally as tablets or capsules. Some antifungals used include clotrimazole, miconazole, terconazole, and fluconazole. 

If the infection keeps recurring then further investigations may be needed and other medications added. Less than 5% of women have recurrent infections that often need long-term oral azole therapy.

Also, wearing of cotton underwear is encouraged as the nylon ones keep the moisture of the vagina; avoid douching as this destroys the normal bacteria, disrupts the pH of the vagina and causes the excessive growth of vagina candida. Finally some studies have also shown that eating yoghurt may help to prevent this condition4.

REFERENCES 

1. https:www.medscape.com/viewarticle/721459_2

2. https://www.cdc.gov/fungal/diseases/candidiasis/genital/index.html

3. https://emedicine.medscape.com/article/781215-overview#a6

4. https://emedicine .medscape.com/article/213853-treatment

WRITTEN AND EDITED RESPECTIVELY BY:

Dr. Patience Binambiba Jaman (Medical Doctor)
Medical Officer at Tamale Teaching Hospital

Dr. Patience Binambiba Jaman is a practicing medical doctor who currently works at the Accident and Emergency department of the Tamale Teaching Hospital, Ghana.

Chief Editor at Wapomu.com

MPSGH, MRPharmS, MPhil.

Isaiah Amoo is a practicing community pharmacist in good standing with the Pharmacy Council of Ghana who has meaningful experience in academia and industrial pharmacy. He is a member of the Royal Pharmaceutical Society, England, UK and currently pursuing his overseas pharmacy assessment programme (MSc) at Aston University, UK. He had his MPhil degree in Pharmaceutical Chemistry at Kwame Nkrumah University of Science and Technology. He has about 5 years’ experience as a community Pharmacist and has also taught in academic institutions like KNUST, Kumasi Technical University, Royal Ann College of Health, and G-Health Consult. He likes to spend time reading medical research articles and loves sharing his knowledge with others.

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