What Symptoms Have Been Attributed with Recurrent Yeast Infections?

The following are a number of real-life symptom scenarios:

Told on multiple occasions that it was yeast by looking at slides but cultures were all reported as being negative. Seen by several doctors and given multiple courses of fluconazole, boric acid vaginal suppositories and treated with gentian violet all without sustained relief.

Thick white discharge has persisted for months causing itching, slight odor, and burning on urination. The diagnosis was yeast but did not respond to multiple treatments including topical antifungals, oral fluconazole (Diflucan®), or gentian violet.

Itching and burning for several years with yellowish discharge. Sometimes told by a physician that it’s a yeast infection, sometimes told it’s a bacterial infection.

Chronic vaginal infection with itching, burning, irritation, and tingly sensation. One doctor thought it was yeast and so did a second doctor but both vaginal cultures came back negative. No response to Diflucan® or boric acid suppositories.

Without weekly use of an antifungal, vaginal itching, burning and soreness invariable becomes a problem. Off treatment the vaginal culture always grows out Candida Galbrata.

What Causes Recurrent Yeast Infections?

The vagina has a normal micro-flora ecosystem consisting of 30+ co-existing strains of bacteria at any one time. Normally, the “good” bacteria known as lactobacilli predominate and are numerous enough to coat the entire vaginal mucosal surfaces forming a protective barrier. Lactobacilli make certain chemicals that provide additional defense against other organisms. These include lactic acid, hydrogen peroxide, and other peroxidases which suppress the other “bad” bacteria normally present in the vagina to keep them at low concentration levels where they rarely cause harm. Problems arise when the lactobacilli do not thrive and a shift in bacteria milieu occurs where the “bad” bacteria dominate causing one of several “Altered Vaginal Micro-Flora Patterns.” Symptoms can arise from one of two pathways or a combination of the two: First, the resulting secretions bathe the vaginal walls all the way down to and including the tissues surrounding the vaginal opening causing variable symptoms of discharge, odor, irritation, itching, burning, and urinary urgency/frequency depending on the innate sensitivity of the vaginal and external genital tissues. Second, the altered micro-flora pattern can act like a culture media which enables yeast to grow in the vagina. The most common vaginal yeast is Candida Albicans but women who have true recurrent yeast often have one of the non-albicans strains which tend to be more resistant to treatment such as C. Galbrata, C. parapsilosis, C. tropicalis, C. Krusei and C. pseudotropicalis, and others. Eradication of these strains includes restoring the vaginal mucosa to its usual state of good health so the conditions are not conducive to yeast growth. Treatment with only antifungals in this setting will result in a transient response then relapse.  This is why you may be among many women who have visited their physicians multiple times only to be told over and over that you have a yeast infection on one occasion and then a bacterial infection on another occasion.  Sound familiar?  In actuality, you may never have had either! It could be that you just have an altered vaginal micro-flora pattern. Often there is no documentation of the diagnosis. The healthcare provider may have just told you that it’s recurrent yeast; well knowing they weren’t sure about the cause of your problem. Many women are treated for yeast despite negative vaginal yeast cultures. By the time most women with these symptoms find a vaginal expert, they have a bag full of failed medications; none of which have resulted in a sustained response. While a very small percentage of women with these symptoms do have true recurrent yeast, the vast majority do not. AND if you actually do have recurrent yeast, there is an underlying condition in the vagina increasing the propensity for the recurrence which needs to be corrected! 

In any event, you are probably wondering how your vagina got out of kilter in the first place. There is a number of what FGI refers to as “vaginal insults” that can affect the health of the vagina mucosa. The full list of vaginal insults will be provided to you embedded in your personalized treatment protocol. If the vaginal insult was transient and the correct diagnosis truly was yeast, then a standard course of antifungal therapy should have solved the problem. However, if the vaginal insult that affects the vaginal nutrients is sustained, then the treatment needs to encompass that portion of vaginal health. At FowlerGynInternational, the approach is to fix the underlying vaginal problem as well to restore the normal flora to the vagina rather than providing a band aide for the symptoms.