Testing for candida or other infections

To distinguish between the different intimate disorders it is useful to observe the appearance and smell of secretions, but also to measure the vaginal pH with a simple colorimetric test.

Vaginitis and vaginosis are intimate disorders very common in women of childbearing age and, especially if frequent or recurrent, can create significant discomfort due to the symptoms that characterize them, interference with couple life and with some daily activities (attending swimming pools, spas, beauty centers, etc.).

To cause them can be different types of microorganisms: especially fungi, such as Candida, and a series of bacteria normally residing in the vaginal canal in balance with the healthy endogenous microflora that, in particular circumstances (alterations of the immune system, antibiotic therapies, systemic diseases, inadequate diet / diet rich in sugars, incorrect intimate hygiene, prolonged stress, contamination from the intestinal canal, etc.), They can begin to multiply more than they should and create more or less important annoyances.

Although the resulting vaginal infections (candidiasis and bacterial vaginosis) are not contagious or dangerous to general health, when they arise they must be recognized and managed appropriately from the onset to quickly restore the balance of the microflora present on the vaginal mucosa, thus avoiding to last too long the symptoms and reducing the risk of complications and recurrence.

Precise and timely diagnosis and targeted treatments of any type of vaginal infection (as well as careful prevention of all possible gynecological pathologies) become particularly important during pregnancy, a period in which they can determine, in addition to a reduction in the well-being of the woman, also serious problems with the development of the fetus and increase the risk of preterm birth and / or low birth weight of the child.

The typical manifestations of Candida

Although both cases are infections of the vaginal environment by microorganisms, candidiasis and bacterial vaginosis are characterized by some distinctive signs and symptoms that help to recognize the exact nature of the disorder present and to orient the treatment, different depending on whether the problem is caused by a yeast or bacteria.

The typical manifestations of candidiasis include the appearance of whitish and lumpy secretions, similar to cottage cheese, more or less abundant depending on the case, as well as burning and genital itching of variable intensity (from mild to an intensity difficult to bear), pain or discomfort during sexual intercourse and, sometimes, burning when emitting urine. In addition, since inflammation is always present, the genital mucosa may appear reddened, while there are no rashes of any kind, nor bad smell.

In the presence of manifestations of this type, the diagnosis of candidiasis is almost certain and the most useful treatment involves the local application of a preparation in cream, gel or endovaginal capsules based on azole derivatives, to be applied once a day for a few days, before going to bed.

The exact duration of treatment varies depending on the specific azole active ingredient and dosage used, as well as the severity of the disorder and the specific strain of Candida involved, since some fungi in this group are more difficult than others to eliminate.

Signs and symptoms of bacterial vaginosis

Also in the case of bacterial vaginosis, vaginal secretions with different characteristics from the usual are often present. In this case, however, the secretions have a grayish color, they are more viscous, sticky and homogeneous, without granulations. Their quantity can be very different from episode to episode (even in the same woman), in relation to the number of bacteria present and the more or less marked reactivity of the vaginal mucous membranes.

Although, in general, quite easy to distinguish for the expert eye of the gynecologist, secretions do not represent, as a rule, the main point of reference for the doctor to issue the differential diagnosis between candidiasis and bacterial vaginosis and, even less, they are for self-diagnosis by the woman. A much more characteristic and easily recognizable aspect is the smell: almost absent or, in any case, not unpleasant when the origin of the disorder there is Candida; marked and very similar that of “rotten” fish when it comes to bacterial vaginosis.

The development of the bad smell typical of vaginosis is due to the release of foul-smelling volatile substances (putrescine, cadaverine and trimethylamine) produced by the anaerobic bacteria responsible for vaginosis itself, but not by the other microorganisms normally present in the vaginal canal or on the genital mucous membranes. On the symptom front, however, to direct the diagnosis towards bacterial vaginosis is above all the general absence of inflammation, burning and itching (almost inevitable and very disturbing, however, in case of candidiasis).

A further distinctive element, less evident, but easily measurable also through home self-tests, is the pH of vaginal secretions which, in the presence of a candida colonization, remains very similar to that of the healthy vaginal environment (pH 3.5-4.0), while during bacterial vaginosis it tends to become less acidic, approaching neutrality and almost always being greater than 4.5.

This basification of the vaginal environment is, on the one hand, at the origin of the development of bad smell (since the foul-smelling compounds produced by the bacteria are released into the air when the pH is less acidic) and, on the other, of a further compromise of the vaginal ecosystem, with a marked reduction in the share of protective microorganisms (lactobacilli) and consequent increase in the propensity to contract sexually transmitted diseases.

When the characteristics of the secretions, the presence of odor and the pH > 4.5 indicate that in all probability it is bacterial vaginosis, it is necessary to contact the doctor to obtain precise indications of treatment and the prescription of suitable antibiotics. The most difficult bacterial vaginosis may require taking medication by mouth.

	Candida	Bacterial vaginosis
Vaginal discharge	Whitish and lumpy losses, similar to cottage cheese	Greyish colour losses, more viscous, sticky and homogeneous, without granulations
Itching and genital burning	Present, of variable intensity	Absent
Smell	Absent	Marked and very similar to that of “rotten” fish
ph	3,5-4,0	> 4.5

The self-test for Candida

To measure the vaginal pH to support the diagnosis of bacterial vaginosis it is not necessary to consult a doctor or perform laboratory tests, with related queues and loss of time. Simply go to the pharmacy and buy a colorimetric test for pH measurement, easily usable at home and able to provide the necessary answer in a few minutes.

If the vaginal pH is below 4.5, this excludes bacterial vaginosis or trichomoniasis (another fairly common vaginal infection caused by a different type of microorganism, Trichomonas vaginalis). The pH test will be negative and no color change of the swab tip will be observed. In this case, any vaginal discomfort and/or the presence of secretions must be referred to another cause, such as, for example, a Candida colonization or an irritative or allergic sensitization (for example, caused by the use of inadequate or poor quality detergents or intimate products).

If the vaginal pH has risen above 4.5 most likely there is bacterial vaginosis or Trichomonas vaginalis infection. In this case the pH test will be positive and a change in color of the tip of the swab will be observed that will turn from yellow to green.

To distinguish between these two types of infections and undertake the appropriate treatment, in addition to the evaluation of vaginal pH, the symptoms present should be carefully analyzed and, in particular:

– color, texture and smell of secretions

– presence, absence and intensity of itching, burning and pain while urinating.

The operation may not be simple, because the symptoms are often not clear or well recognizable: in case of doubt, it is always advisable to contact your doctor.