Candida infections can occur at any time in a woman’s life (including pregnancy and menopause) and are very common: it is estimated that two-thirds of women of childbearing age have had at least one episode of candida vaginitis, also called candidiasis.
The infection is due to a mycete (or a fungus), Candida albicans, which usually resides inside the body, on the skin and on the mucous membranes of the vagina and intestines, without causing discomfort. However, some factors can cause excessive proliferation and give rise to a mycosis, causing the typical symptoms of candida.
In addition to irritation and redness of the mucous membranes, characteristic manifestations of patients with candidiasis are pain, burning hours and intimate pruritis and swelling of the external genitalia (if the inflammation also affects the vulva area, it is called candida vulvovaginitis). Characteristic is the appearance of whitish losses with an appearance similar to that of curdled milk or cottage cheese. It is frequent pain felt during sexual intercourse and also during urination, due to the fact that urine runs through stretches of inflamed mucosa. Sometimes from the vaginal canal the infection extends and reaches the bladder, causing inflammation (cystitis). In this case, pain during urination may be associated with symptoms such as the need to urinate more frequently and the presence of blood in the urine.
Among the factors that determine candida infection are, for example, antibiotic therapies. Other triggers concern conditions that involve the lowering of the immune defenses, such as a trivial flu. In addition, candidiasis can be favored by diseases such as AIDS or diabetes, previous episodes of infection or a period of intense stress.
Hormonal causes
Throughout her life every woman is subject to hormonal variations that can favor the onset of vaginal infections.
Increased estrogen production, for example, increases the amount of sugars present in the mucous membranes of the vagina, making them an ideal breeding ground for the development of pathogenic microorganisms. And it is for this reason that candidiasis begins to manifest itself after puberty and is frequent in pregnancy
Diagnosis of candida
To diagnose candidiasis in most cases it is sufficient for the patient to report the symptoms to her gynecologist, who could confirm the diagnosis with a medical examination and without the need for further examinations.
In the event that a woman has already had a previous episode of candida, she will most likely be able to recognize the infection on her own. Leucorrhoea associated with candida has typical characteristics (in particular the “ricotta” appearance) that make it difficult to confuse with physiological secretions or with those caused by other disorders, such as bacterial vaginosis. In the latter case the losses are in fact milky and homogeneous, greyish-white in color and accompanied by a strong and bad smell, similar to that of spoiled fish, which is completely absent in case of candidiasis.
During the months of pregnancy, however, it is frequent to observe the presence of viscous vaginal discharge, whitish and transparent in color with an appearance similar to that of egg white. These are physiological secretions coming from the glands of the uterine cervix which, at this stage, due to the variation of hormonal levels and due to the swelling and congestion of the genital mucous membranes induced by pregnancy hormones, become more intense and take the name of leucorrhoea gravidarum. This increase in secretions, completely physiological, should not be confused with an episode of candida.
General treatment of candidiasis
To solve the infection it is always advisable to seek advice from your doctor or pharmacist. During gestation, in particular, the risk of exposing the fetus to harmful substances should not be overlooked.
In general, treatments for candidiasis are based on antifungal drugs, to be taken orally or for local use, useful to stop the multiplication of fungi, such as clotrimazole, miconazole, nystatin, etc. For this reason, and since relapses are frequent, the treatment of the infection must also include actions aimed at restoring the balance of intestinal and vaginal bacterial flora. It is important to act on the body’s natural defenses, for example by cyclically taking supplements based on probiotics and lactobacilli, or to intervene on possible “weak points”.
A correct therapy, moreover, should not neglect the man, to avoid within the couple the so-called “ping-pong effect”, or the continuous passage of the infection from one sexual partner to another in case of unprotected intercourse. Even men, in fact, can contract the infection, which can start asymptomatically or which can manifest itself with redness and burning at the glans and sometimes the foreskin, possibly accompanied by whitish secretions and painful urination.
Therapies in pregnancy
In addition to being very annoying, as in any other period of life, some vaginal infections are potentially dangerous during the weeks of pregnancy, such as those responsible for chlamydia or bacterial vaginosis, which must be treated promptly in the pregnant woman as they can increase the risk of miscarriage, preterm birth or early rupture of membranes.
This is not the case with candida, which does not endanger the health of the mother or child. The only risk is, in fact, the possibility that babies contract the infection at the time of delivery, developing the so-called thrush at the level of the mucous membranes of the mouth. It is a condition that is not dangerous for newborns, but it is useful to prevent it by resolving the maternal infection before delivery.
As far as drug therapy is concerned, during pregnancy it is not advisable to take oral antifungals with systemic action since they represent a risk to the fetus.
As a substitute it is therefore advisable to use a topical antifungal during gestation, such as antifungal creams, which represent the first-line treatment for pregnant women. It should be remembered that in any case it is essential to contact your gynecologist and strictly follow his instructions.
During gestation it is also essential to restore and preserve the balance of the vaginal microbiome with the help of topical probiotics based on lactobacilli, also called lactic ferments. Formulated in vaginal capsules and ova, these “good” bacteria are introduced into the vagina and produce lactic acid, an essential element for maintaining a physiologically acidic vaginal pH, which keeps the proliferation of potentially dangerous microorganisms under control.
Preventing candidiasis: some useful tips
There are simple rules that allow you to prevent candida by avoiding conditions that can trigger or favor the proliferation of the fungus. There are several areas on which it is possible to act, first of all hygiene, eating habits and lifestyles. A correct intimate hygiene is very important: for example, in order not to infect the vaginal area with germs coming from the intestine it is first of all important to take care to wash from the vagina to the anus and not in the opposite direction. In addition, too aggressive soaps, which can cause alterations in vaginal acidity, and intimate deodorants should be avoided. Internal vaginal douches during pregnancy, unless they have been expressly prescribed by the specialist, are generally not recommended because they could excessively deplete the bacterial flora and make it vulnerable. The most suitable cleansers have a physiological pH, that is, similar to vaginal pH.
It is also important to take care to always dry the part and avoid wearing wet swimsuits for a long time, since humidity favors the proliferation of candida. Tight pants, panty liners and underwear made of synthetic fabrics can also create a warm-humid environment, as well as cause rubbing that irritates the mucous membranes.
It is therefore better to use cotton underwear and a delicate intimate cleanser or, why not, a few drops of calendula in warm water to relieve external burning and itching. As with all infections, the immune system is responsible for protecting the body. It is therefore useful to observe a lifestyle that supports its efficiency. In addition to turning to the products available in pharmacies, to heal faster and avoid relapses it is good to take care of the diet, eliminating foods that favor the development of candida, such as yeasts, carbohydrates and sweets.
The ideal diet should be rich in vegetables, low-sugar fruit, proteins from fish and lean meats and small amounts of carbohydrates. It is also important to ensure proper fluid intake, which will also favor the regularity of the intestinal tract, very important in the prevention of candidiasis, favored by the stagnation of feces.
Natural remedies for candida in pregnancy
There are several “grandmother’s remedies” that in popular tradition are considered useful to alleviate the discomfort of candidiasis, such as baking soda. As with medicines, even for natural remedies it is always advisable to consult with your doctor before embarking on treatment. This rule is even more important during pregnancy, when in addition to one’s own health it is also necessary to safeguard that of the fetus.
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.
The blog covers a wide range of topics related to health and wellness, with articles organized into several categories.