Most women have had an episode of “candida”, a vaginal infection that causes very annoying disorders due to a microorganism belonging to the kingdom of fungi, in particular to the family of saccharomycetes.
What is Candida?
Candida albicans is normally present in the body with the role of contributing to the digestion of sugars through a fermentation process. It is a commensal germ: fungi of the genus Candida are in fact part of the microbial flora of the skin, as well as that of the mucous membranes of the mouth, gastrointestinal tract and vagina.
There are several species of candida. Candida albicans is the best known and most widespread species and the one that most often gives rise to candidiasis, that is, vaginal candida infections. In common parlance, however, candidiasis is generically, and improperly, referred to as “candida” or “vaginal candida“.
A delicate balance
The vaginal mucosa is populated by numerous microorganisms: bacteria, fungi and viruses, belonging to different species that in normal conditions and good health coexist in balance.
In this ecosystem the “good” bacteria keep pathogenic bacteria under control; The harmful bacteria thus remain present in minimal quantities and in spore form, i.e. “dormant”. In this situation the presence of candida is physiological; The fungus adheres to the cells of the vaginal epithelium without damaging them, and therefore does not give signs of itself.
When then does candidiasis occur? If the balance of the vaginal bacterial flora is altered, which can happen for various reasons, one of the minority species can begin to reproduce quickly and excessively, with consequences also for the vaginal mucosa. The activation and proliferation of candida causes microorganisms to invade the epithelial lining of the vagina, releasing toxins that cause acute inflammation and pain.
However, the effects can also affect the bladder, with the appearance of cystitis, or the mucous membranes of the mouth and give rise to stomatitis. Finally, it is not uncommon for candida infection to occur in newborns: in this case the appearance of white dots on the mucous membranes of the mouth is better known as “thrush”.
Symptoms of candida infection
Vaginal candida infections can be of varying degrees, but they are united by typical symptoms such as redness, intense itching, swelling and burning in the genital mucous membranes and during urination. The mucosa becomes painful and sexual intercourse is also painful. A characteristic symptom is represented by dense and whitish discharge similar in appearance to curdled milk or cottage cheese.
However, not all infectious forms are symptomatic and in some cases the infection may be present without giving particular signs. It may also happen that the symptoms appear after a long time from the onset of the infection.
Candida infections can also affect men; In this case the infection is more frequently asymptomatic than in women. Male symptoms include inflammation and burning only of the glans (balanitis) or even of the foreskin (balanoposthitis), with the possible appearance of red patches and, more rarely, of dense and whitish discharge with a bad smell.
In some cases a candida infection can be mistaken for bacterial vaginosis, an alteration of the vaginal microflora characterized by an abnormal proliferation of anaerobic bacterial strains, such as Gardnerella vaginalis, completely harmless if kept at low concentrations.
However, the observation of the color, texture and smell of secretions, as well as the presence or absence of inflammatory symptoms and the value of the vaginal pH, can however allow them to be easily distinguished.
Candida | Bacterial vaginosis | |
---|---|---|
Features of secretions | Whitish and lumpy losses, similar to cottage cheese |
Greyish colour losses, more viscous, sticky and homogeneous, without granulations |
Smell of secretions | Absent | Marked and very similar to that of “rotten” fish |
Itching and genital burning | Present, of variable intensity | Absence of inflammation, burning and itching |
ph | 3,5-4,0 | > 4.5 |
Triggers
The transformation of candida into a pathogen occurs as a result of a weakening of the immune system generally determined by antibiotic therapies or which may be due to the presence of important diseases such as AIDS, diabetes, tumors, or external factors such as stress.
Also guilty are hormonal variations that occur in particular periods of a woman’s life. The activation of the fungus is facilitated for example in the phase of puberty, due to the increase in estrogen production. These in turn increase the sugar levels of the vaginal mucosa, creating a favorable environment for the reproduction of the microorganism, and favor its adhesion to the epithelial cells of the vagina. The risk of developing the infection is also increased by the use of birth control pills and pregnancy, also in this case due to the high levels of estrogen that characterize it.
Another risk factor is pharmacological therapies based on antibiotics, which cause intestinal dysbiosis and vaginal mucosa, i.e. the imbalance of bacterial flora. It has been shown that there is a direct relationship between antibiotics and candida, so much so that the risk of developing the infection triples after a course of only three days of treatment.
Among the triggering causes, nutrition should not be overlooked; A diet too rich in sugars, leavened or fermented products (such as bread, pizza, beer, aged cheeses) and artificial sweeteners can promote the activation of the fungus.
Candidiasis can also be caused by self-contamination of the vaginal mucosa by fecal residues. To avoid contact of the genital organs with feces and urine, naturally carriers of fungi and bacteria, during intimate hygiene it is always advisable to cleanse the vulvar area from the vagina to the anus and never the other way around. Contagion also occurs with the promiscuous use of towels, swimwear, trousers, linen.
Especially during the period of infection it is advisable to avoid using the towel after intimate hygiene, which must however be changed often as a receptacle of microorganisms present on the vaginal mucosa, and prefer instead disposable material such as paper towels.
Another factor that favors the uncontrolled multiplication of candida is the presence of inflammatory bowel diseases (irritable bowel syndrome, ulcerative colitis or diverticulitis), all united by inflammation of the colon wall. In this case the infection can be triggered by the passage of candida inside the body through the cells of the intestinal mucosa, which lose their barrier function.
Although candidiasis cannot be considered a sexually transmitted disease, to date the “ping-pong effect” remains a cause for debate, the advice is to refrain from intercourse during treatment and experts recommend extending therapy to the partner only in case symptoms are present (candida balanitis).
Diagnosis and treatment
If this is the first time you suspect a candida infection, it is best to contact your doctor for diagnosis: the symptoms may be similar to those of other vaginal infections.
In addition to a clinical examination, candidiasis can be diagnosed through a vaginal swab. The secretions thus taken are subjected to a culture test which, in case of positive result, will confirm the presence of infection and will be useful to accurately identify the “offending” strain of candida, in order to optimize drug therapy. It must be said, however, that a negative outcome does not always necessarily exclude infection.
The therapy of vaginal candidiasis is based on antifungal drugs, while antibiotics are absolutely to be avoided. Treatment can be administered locally, with creams, eggs and soft capsules, or systemically. In both cases, the treatment should be continued in the manner indicated by the doctor.
Prevention of relapses
The infection must be treated properly. However, it happens that, even if the prescribed treatment is strictly followed, candida vaginitis can recur, and in some cases become recurrent. When a woman presents at least four episodes of infection over a year, it is called recurrent candidiasis.
This also occurs because, in addition to antifungal therapy, to eradicate the infection it is necessary to restore the balance of intestinal flora in favor of a strengthening of the immune system.
It is therefore important to take some precautions to facilitate the recovery of a state of well-being and prevent the appearance of relapses. Taking probiotics regularly, as well as during the period of acute infection, helps for example to counteract dysbiosis.
Treating a candida infection is also equivalent to making changes to your lifestyle. As far as nutrition is concerned, this must be as free as possible of natural and artificial yeasts, refined sugars and aged cheeses. The intake of alcohol, dairy products, fermented or carbonated drinks should be limited, to favor fruit, vegetables and yogurt, for the benefit of maintaining good intestinal regularity.
It is also important to drink water in abundant quantities: good hydration contributes to intestinal transit avoiding stagnation of feces. In addition, since the fungus reproduces more easily in an airless environment, it is recommended to wear cotton underwear and avoid tight pants, synthetic undergarments, nylon tights or microfiber.
Joycelyn Elders is the author and creator of EmpowerEssence, a health and wellness blog. Elders is a respected public health advocate and pediatrician dedicated to promoting general health and well-being.
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