Candida albicans
What is a Vaginal Yeast Infection and where does it come
from?
Yeast infections are among the most
common ailments in the female genital tract (1). Our body naturally harbors
bacteria and fungi as a part of our normal flora. It helps keep our body
functioning through symbiotic relationships. However, like any relationship,
nothing is perfect. Due to imbalances and other factors that will be discussed
later, the balance of bacterial and fungal growth can be shifted, allowing
infection to occur.
Vaginal
yeast infections will occur in 75% of women during their reproductive age and
nearly 80% of these yeast infections will be caused by the over growth of the
yeast Candida albicans (2). C. albicans is
a fungal species that is found in and on the human body naturally occurring in
the vagina, mouth, digestive tract, and skin (2). Due to the dark, moist, warm
features of the vagina, it is a breeding ground for Candida to
grow and thrive (5). Our body naturally accounts for this through a
control system that consists of both bacterial “warriors” that keep fungal
growth at bay and natural features of the body such as maintaining the vagina
at a slightly acidic pH to discourage fungal over growth. However, this balance
is easily shifted and can fail at self-protection from a fungal infection. When
this occurs a woman may experience a yeast infection.
So what is a yeast cell and what does it have to do with an
infection?
Yeast is a unicellular organism
classified as a fungus and is commonly found in the phylum Ascomycota (16). Candida
albicans is the leading yeast species in vaginal yeast infections.
Yeast cells are diploid and reproduce asexually (16). There is no known sexual
reproductive stage of C. albicans (16). Asexual reproduction
occurs through a process known as budding, in which a mother cell divides to
create a second, daughter, yeast cell (16). Additionally, Candida can
go through a process called morphogenesis that allows it to develop into germ
tubes called hyphae or pseudohyphae (16).
When a
women’s vaginal homeostasis is altered, yeast that was previously at a
controlled level can multiply without restraints classifying it as an
opportunistic pathogen (16). This allows the controlled levels of present yeast
in the vagina to multiple and change from its harmless yeast form into its
hyphal form permitting the penetration into cell causing the irritating
infection (3).
What Causes a Vaginal Yeast Infection?
Many
factors can cause a shift in the balance maintaining the fungal growth within
the vagina including both internal and external factors.
Internal Factors:
1. The Use
of Antibiotics: By using antibiotics, the bacterial community is
decreased or killed off in the process of eliminating a bacterial infection
(8). The body’s normal bacterial flora decreases in the presence of antibiotics
eliminating the essential competition that maintains the level of yeast
present. When it is depleted, yeast is able to grow unchecked and cause
infections.
2. Use of birth control pills or other contraceptives: Hormonal balance plays a large role in maintaining a controlled yeast level within the vagina and using contraceptives alters the hormonal balance possibly creating an environment that yeast can thrive in.
3. Menstruation: it has been recorded that many women receive yeast infections the week leading to or after a menstruation due to the changes in hormones present. If this occurs you may be considered to have chronic yeast infections (9)
4. Diabetes: the altered presence of blood sugar in diabetic individual is like candy for yeast. It sets up a “sweet environment” that yeast tends to thrive in which increases an individual’s risk at contracting a yeast infection (11).
2. Use of birth control pills or other contraceptives: Hormonal balance plays a large role in maintaining a controlled yeast level within the vagina and using contraceptives alters the hormonal balance possibly creating an environment that yeast can thrive in.
3. Menstruation: it has been recorded that many women receive yeast infections the week leading to or after a menstruation due to the changes in hormones present. If this occurs you may be considered to have chronic yeast infections (9)
4. Diabetes: the altered presence of blood sugar in diabetic individual is like candy for yeast. It sets up a “sweet environment” that yeast tends to thrive in which increases an individual’s risk at contracting a yeast infection (11).
Physical Factors:
Physical factors that increase the
risk of contracting a yeast infection are mainly due to creating an ideal
environment for the yeast to thrive and grow in. Wearing tight clothing or
clothes that do not breathe well allows moisture to be retained in the vagina
creating a moist environment for the yeast to thrive in. Another factor that
plays a large role in yeast growth is diet (9). Diets that are heavy in sugars
and carbohydrates increase the ability of yeast to thrive and grow within the
vagina (5).
Sex plays a large role in
contracting a yeast infection. Yeast cells can be transmitted from one
individual to another during intercourse and greatly increases the risk of
vaginal infections. However, due to the ability to contract a yeast infection
without sexual activity restricts it from being considered a sexually transmitted
disease (9).
Do I have a Yeast Infection? – Symptoms
One tell-tale sign of a yeast infection is the presence of
itch occurring in the vaginal region. This itch may also be accompanied by
(12):
· Burning during urination
· Vaginal discharge, white
cottage cheese appearance
· Pain during intercourse
· Swollen red vulvar region
Stop! Why not to self-diagnosis
yeast infections
According to a study at the Medical
College of Georgia, the rate of women accurately self-diagnosing themselves
with a vaginal yeast infection is only 1 out of 3 times (6). Yeast infections
have similar symptoms to diseases such as bacterial vaginosis, trichomoniasis
or a simple vaginal irritation (6). Misdiagnosis can lead to many other health
implications such as pelvic inflammatory disease, infertility, and miscarriage
(if the disease occurs during pregnancy) (6). Due to the similarity in symptoms
it is always good to contact a doctor when a yeast infection is in question.
In some cases a yeast infection may not be as straight
forward to diagnosis even for doctors.
Case study
1 – College Student Suffering from Chronic Yeast Infections: Disseminated
Yeast
A college student at Boston College was displaying symptoms
including mild vaginal itching and slight discharge. She was diagnosed with a
yeast infection by her doctor and put on a regimen of a topical cream. Her
symptoms we relieved at first however they reoccurred shortly and started
having other fungal infections such as athlete’s foot and skin rashes. Along
with the physical inconvenience of fungal infections, she was also feeling
fatigued all the time. After seeing multiple physicians, being treated for many
different disorders that only seemed to make the situation worse, she was
diagnoses with a systemic yeast infection caused by Candida albicans.
The yeast that had originally caused chronic vaginal yeast infections was
misdiagnosed as a simple yeast infection, allowed it to grow, develop, and
spread throughout her body. After her final diagnosis, she was placed on anti fungals for yeast infections and the itching stopped. However she still has chronic yeast infections due to the high levels of yeast present in her body (4).
Case study
2- Adult Woman Suffering from Chronic Yeast Infections: HIV
indicator
A 32-year-old woman
has been dealing with chronic reoccurring yeast infections for the past three
years. Antifungal creams only seemed to give her temporary relieve. In her
first visit to a physician she tested positive for a yeast infection and again
was put on an antifungal. Yet again temporary relief occurred only to result in
the return of a constant itch in her vaginal region.
Going to a second physician, she was diagnosed with a bacterial infection and
prescribed a triple-sulfa cream. Yet again the prescription only provided
temporary relief and she was no experiencing painful intercourse and was
feeling hopeless that the itch would never go away.
Patient history revealed that both of her parents had adult onset diabetes and
her boyfriend was a chronic drug user. In her next visit to the
physician, she was tested for several STDs and had her blood glucose level
checked. All of her tests came back negative but was again tested positive for
yeast and put back on an over the counter antifungal. A month later her
symptoms worsened including a reddened appearance around the vulva and it
extended down to the upper thigh. Additional testing was taken and tested
positive for HIV. To treat her chronic yeast infections she was placed on
nystatin vaginal suppositories for 14 days and instructed to take a boric acid
douche twice a week. (7).
Yeast infections are never fun to deal with and sadly, after
one occurrence you are more likely to have yeast infections and each additional
infection is harder to treat (15).
Prevention:
· Wearing
loose clothing
· Not
wearing wet bathing suits
· Daily
washing (do not use normal soaps as they may disrupt the bacterial community
and pH balance. Additionally using antibacterial soaps can cause even more
damage as they eliminate the competition.)
· Consumption
of yogurt – Consumption of yogurt at least once every day for six months
decreases the risk of contracting a yeast infection greatly (13)
Treatment:
Today, women can pick up over the counter products that have active ingredients
such as butoconazole nitrate, clotrimazole or miconazole that effectively cure
vaginal yeast infections (9). They can either come in the form of topical
treatments or insertions that are implanted into the vagina (9).
Can women use antifungals during pregnancy?
Pregnancy commonly causes an increase in risk to contracting
a yeast infection. Common over the counter medications are safe to use during
pregnancy to cure a yeast infection (14). However it is strongly advised that you
consult a physician before using them and also receiving a complete diagnosis
to ensure that it is a yeast infection causing the symptoms.
I Commonly Get Yeast Infections- What is my body telling me?
Chronic yeast infections can often be a symptom for other
more serious health complications (10).
· Diabetes:
A stubborn hard to treat yeast infection is often the first symptom of
diagnosing diabetics (11).
· Learning
Disabilities: A chronic yeast infection present in children is often a sign of
hyperactivity or learning disabilities developing (3). At a young age for children it is hard to diagnosis learning disabilities such as ADD or hyperactivity and in some cases the presence of chronic yeast infections may be the first sign to a child with learning disabilities.
· HIV:
Women that suffer from frequent cases of yeast infections may be an early
warning sign of an HIV infection (10). HIV is a disease that lowers the body’s
ability to fight off diseases as it lowers the immune system. This allows for
the ease of growth and contraction of yeast infections. It has been noted that
that women who contract chronic yeast infections is not a symptom of HIV,
However 38% women that are HIV positive suffer from chronic yeast infections
(10).
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