CANDIDIASIS: DIAGNOSIS AND TREATMENT
The description of the symptoms and the fairly typical appearance of the affected area is usually enough to make a diagnosis. A swab can be taken to confirm this, and this is often done in cases which are recurrent, or not typical, or to exclude other bugs.
Treatment. The routine, traditional treatment of thrush is usually an anti-fungal cream or pessary (little tablet of cream). The cream or pessary is inserted high into the vagina each night for a few nights, and this usually does the trick. The sexual partners) usually do not need treatment, unless they have symptoms.
There are other treatments available which are aimed at getting rid of the reservoir of Candida in the gut, where it usually lives. These are mainly used for people who have recurrent thrush. These tablets are not absorbed into the blood stream, but knock out the yeast in the bowel.
Newer tablets have been developed which do enter the blood stream, and eradicate the yeasts pretty well. These tablets have been mainly recommended for women who suffer from recurrent or difficult-to-treat thrush, and are generally not considered first line management at the moment. They are not without potential side-effects, so using them for every episode of thrush may not be a good idea. The creams and pessaries and gut-clearing tablets seem to have very few potential side-effects in comparison.
Thrush has been around for a long time and an old remedy, used by many people—with varying success it seems—is yoghurt. Yoghurt contains other bugs, called lactobacilli, which are also found in the normal vaginal environment. (It is like a zoo down there, with lots of different organisms in residence.) The lactobacilli compete with the yeasts, and get the balance back to normal. Natural yoghurt (not fruit-flavoured or sweetened) is apparently best, applied
a couple of times a day into the vagina. Eating yoghurt or taking acidophilus tablets (available from health food shops) may help to increase the level of lactobacilli in the gut, and help particularly with recurrent thrush.
Various potions and mixtures have been used to wash out the vagina to treat thrush. (Washing out the vagina is called ‘douching’, and used to be more popular many years ago, when it was mistakenly thought to be contraceptive; it has no effect on preventing pregnancy at all.) Vinegar douches have been used to treat thrush, because vinegar acidifies the vagina, and the vagina is usually more acid than alkaline. Vinegar does not seem to be particularly effective against thrush, but may be more useful for other bug overgrowths, like gardnerella. Some women find they get some relief from vaginal irritation by sitting in a bath which has some salt in it.
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