The Standard Group Plc is a multi-media organization with investments in media platforms spanning newspaper print
operations, television, radio broadcasting, digital and online services. The Standard Group is recognized as a
leading multi-media house in Kenya with a key influence in matters of national and international interest.
By Dr Brigid Monda
‘Thrush’ or ‘yeast’ is the layman’s term for vaginal candidiasis. It is caused by a yeast type of fungus called Candida Albicans that resides in the vagina, mouth and large intestines as a harmless non-paying long-term guest.
Thrush is neither a true infection because it does not emerge from outside into the body nor a sexually transmitted infection — a common misconception and the cause of many quarrels between couples!
Women can suffer candidiasis anytime from puberty to before menopause, with some more frequently than others. Thrush presents with a relentless itching and burning in and round the vagina and a thick white discharge that looks like curdled milk. If the infection is severe, the vulva may get tender and swollen making walking, urinating or sex very painful.
Besides candida, the vagina has another important tenant, a bacteria called Doderlain’s Bacilli or Lactobacilli that creates a protective acidic environment in the vagina by converting glycogen, a ‘sugar’ found in abundance in the vaginal cells, into lactic acid that makes the vagina acidic. This protects it from being colonised by disease-causing organisms, which easily ascend into the upper parts of the reproductive tract with disastrous effects. This acidic environment also prevents the overgrowth of the yeast and bacteria.
Thrush triggers
Any time the conditions in the vagina allow the yeast to multiply, it increases beyond what is normal causing the symptoms of thrush. This is because the vagina becomes less acidic — like after sex or during pregnancy and just before and after one’s menses due to the hormonal changes that occur then. Other triggers are long-term steroid treatment, hormone replacement therapy, thyroid hormones, some birth control pills and antibiotics; frequent vaginal douching, anaemia, obesity, stress and a poor diet, as well as diabetes and HIV because these diseases suppress the immune system. Thrush is also common during very hot weather, in women who wear nylon underwear or tight trousers repeatedly because the yeast thrives in warm moist conditions.
Antibiotics and thrush
It is common to hear women say they are allergic to antibiotics because they get genital itching after using them but this is not an allergy. Although antibiotics are designed to kill ‘bad’ bacteria that make us ill, they are not selective. They also kill ‘beneficial’ Lactobacilli resident in the vagina. With no lactobacilli to manufacture lactic acid, the vagina becomes less acidic allowing the overgrowth of candida and you get thrush. If you get yeast infections whenever you take an antibiotic, always ask your doctor to prescribe something to take after the course of antibiotics.
Men and thrush
Men do not have a vagina where the Candida can reside and grow. Instead, they carry the spores or ‘seeds’ of Candida which need a warm and moist environment like the vagina to grow in. However, uncircumcised men with poor hygiene can develop an infection of Candida called Balanitis. They will get redness, irritation and itching at the tip of the penis and will need to be treated with an antifungal cream or ointment.
Because a man’s semen is alkaline it makes the vagina less acidic after intercourse and the Candida is then able to multiply.
Treatment
Thrush is very easy to treat using anti-fungal vaginal creams, pessaries or medicines that you can swallow. However, treatment does not mean cure because all the medications do is just clear the overgrowth of Candida. Being a natural resident of the vagina, all you need for a repeat episode of thrush is a change in the conditions or acidity of the vagina.
Why you must see a doctor
Women who treat themselves for a vaginal discharge before seeing a doctor are often off the mark because what they may consider as thrush may in fact be a bacterial infection, a urinary tract infection, a sexually transmitted disease or the signs of something more serious. Using anti-fungal drugs when they are not needed may also lead to resistant Candida, which is very difficult to treat.
So it is very important to see a doctor so that the right problem is diagnosed.
Douching — a definite ‘no-no’
Douching is cleaning out the vagina by squirting water or other solutions such as vinegar, saline water or dettol (antiseptic) into it. Unless using a medicinal douche for treating a yeast overgrowth, douching is unnecessary and potentially harmful because you can push infectious bacteria into the upper parts of the reproductive organs causing pelvic infections and eventually infertility.
Douching makes the vagina less acidic by washing out the vaginal fluid rich in the lactobacilli that maintain the protective acidic environment in the vagina. Besides, women who douche have frequent thrush.
It is also unnecessary because the vagina is a self-cleaning organ and does not need ‘washing’ though manufacturers of douches, scented tampons and pads would have us believe the vagina is dirty and smelly. Douching fluids also mask changes in the natural vaginal odour, which may signal an infection and can also irritate the skin and vaginal lining.
join