Vaginal Fungus: What is it, what are its symptoms, why does it occur and how is it cured?

Vaginal infections are one of the most common problems among gynecological diseases. The physiological vaginal flora has a balanced microbiota with many bacteria and microorganisms. However, some situations such as intensive antibiotic use, inadequate genital hygiene, and unhealthy eating habits can disrupt the floral balance of the vagina. In this case, beneficial microorganisms in the vagina decrease and the density of harmful microorganisms increases. The most common infection is vaginal fungal infection, also called vaginal candidiasis.

Vaginal infections are one of the most common problems among gynecological diseases. The physiological vaginal flora has a balanced microbiota with many bacteria and microorganisms. However, some situations such as intensive antibiotic use, inadequate genital hygiene, and unhealthy eating habits can disrupt the floral balance of the vagina. In this case, beneficial microorganisms in the vagina decrease and the density of harmful microorganisms increases. The most common infection is vaginal fungal infection, also called vaginal candidiasis.

Vaginal infections are one of the most common problems among gynecological diseases. The physiological vaginal flora has a balanced microbiota with many bacteria and microorganisms. However, some situations such as intensive antibiotic use, inadequate genital hygiene, and unhealthy eating habits can disrupt the floral balance of the vagina. In this case, beneficial microorganisms in the vagina decrease and the density of harmful microorganisms increases. The most common infection is vaginal fungal infection, also called vaginal candidiasis.

What is Vaginal Fungus?

Vaginal yeast infection is an infection of the vaginal mucosa that occurs in approximately 75% of women around the world and is usually caused by a microorganism called Candida albicans. Candida albicans microorganism, which is responsible for approximately 90% of infections, is one of the microorganisms naturally found in the mouth, throat, intestine and vagina flora of healthy individuals. However, generally in pregnancy, in the presence of systemic diseases such as HIV, diabetes and obesity, and as a result of the use of drugs such as antibiotics, oral contraceptives and steroids, the floral balance in these structures is disrupted and the density of Candida albicans increases. This results in a fungal infection.

What are the Symptoms of Vaginal Fungus?

Severe itching in the vagina is one of the most common symptoms of vaginal yeast infection. Edema, erythema and tenderness of the vulva may develop due to itching. In addition, disruption of the healthy vaginal flora also causes changes in physiological vaginal discharge, and especially fungal infection causes vaginal discharge with a white curd or cheese-like appearance.

Vaginal infections are widespread disorders that affect the entire urogenital system. Therefore, in the presence of vaginal fungus, the urinary system is also affected. Complaints such as pain and burning during urination may occur. In addition, the complaint of pain during sexual intercourse (dyspareunia) is one of the common complaints in the presence of vaginal fungus. Symptoms such as pain, burning, stinging, itching and restlessness seen especially in the groin area during sexual intercourse are defined as dyspareunia and are usually caused by an underlying vaginal infection.

What Causes Vaginal Fungus?

Fungi are organisms naturally found in a person’s mouth, throat, intestine and vaginal flora. However, in some cases, the microbiota balance is disrupted and the fungal density increases in these organs.

As the person’s immune system weakens, the number of beneficial microorganisms decreases and as a result, fungal infection may develop. The use of antibiotics aims to control harmful microorganisms that multiply in the body, but some antibiotics can also affect beneficial microorganisms. In this case, the beneficial microorganisms that control the fungal density decrease and a fungal infection develops in the relevant organ.

One of the most important conditions for maintaining healthy vaginal flora is keeping the environmental pH at an optimum level. The pH value of the vaginal environment varies depending on many factors such as age, hormone level, presence of sexual activity, preferred birth control method, metabolic disease status, medications used, antibiotics and surgical intervention. Normal vaginal flora has an aerobic environment, and organisms called Lactobacilli are largely responsible for maintaining this environment. As the lactobacillus density decreases, the aerobic environment weakens and the bacterial balance in the vaginal flora is disrupted.

Hormonal imbalance also plays an important role in the development of vaginal fungus. Especially the deficiency or excess of estrogen hormone is highly associated with the occurrence of vaginal infections. Some secretions that are constantly present in the vagina are extremely important for maintaining the healthy pH level of the vaginal environment. Normal secretions of the vagina consist of sebaceous secretions originating from the vulva, physiological secretions from the Bartholin and Skene glands, secretions of the glands in the uterus and cervix, watery secretions leaking from the vaginal epithelial tissue, cell structures shed from the cervix and vagina tissues, microorganisms and their metabolic wastes. While estrogen hormone ensures the proliferation, renewal and maturation of the vaginal epithelium, it is also responsible for glucose storage in epithelial cells. As a result of the storage of glucose in epithelial cells, lactic acid is released and lactic acid keeps the vaginal pH at an optimum level by reducing it to 3.5-4.5. Due to low estrogen secretion before puberty and after menopause, the vaginal epithelium cannot proliferate and renew and cannot store large amounts of glucose. This causes the vaginal epithelium to become thinner and vaginal secretions to be less during these periods of life. Therefore, susceptibility to vaginal infections increases in these age groups.

How to Diagnose Vaginal Fungus?

Vaginal fungus diagnosis is usually made based on the patient’s complaints and examination findings of the vaginal area. Edema in the external and internal genital organ called the vulvovaginal area, itching and tenderness, especially in the vagina, and complaints of burning and stinging during urination are symptoms that may occur with many vaginal infections. For this reason, the characteristics of the discharge from the vagina are generally taken into consideration for the diagnosis of vaginal infections. Healthy vaginal secretions are generally transparent or light-coloured, odorless, fluid in consistency and in a quantity that does not cause discomfort. However, microorganisms such as bacteria, fungi, viruses and parasites cause changes in the physiological properties of vaginal discharge. Infected vaginal secretions are usually yellow-green or gray in color, purulent in appearance, have a thicker consistency and have a foul odor. Fungal infection often causes white curds or cheesy discharge.

In addition to the clinical features of the disease, vaginal pH is evaluated and in suspicious cases, vaginal secretions are examined with 10% potassium hydroxide solution.

Vaginal Fungus Treatment

Vaginal fungus treatment must be applied to people with a definitive diagnosis and clinical findings, otherwise the healthy vaginal flora may be disrupted. Treatments that are terminated in a short time or not applied regularly cannot be successful, and these practices make the person more susceptible to the disease. Therefore, vaginal fungus treatment should be carried out under the supervision of a specialist physician from start to finish.

Treatment is planned according to the patient’s age, whether there is any underlying systemic disease, and the severity of fungal-related complaints. Considering the relationship between fungal infection and antibiotic use, antibiotic treatment is expected to be completed before fungal treatment.

Antifungal tablets that can be administered orally or intravaginally are preferred in treatment. Antifungal tablet treatment is performed by placing 1 tablet into the vagina before going to bed at night for 7 or 14 days to control the disease. It is important that the entire treatment plan is carried out by the physician in order to treat the disease effectively and prevent it from recurring and causing chronic vaginal fungus. While incorrect practices cause resistance to treatment and frequent recurrence of the disease, impaired vaginal pH also makes the person prone to other vaginal infections.

How to Prevent Vaginal Fungus?

In order to prevent vaginal fungal infection from developing, uncontrolled antibiotic use should first be prevented, and after antibiotic use, supplements should be taken to support the body’s deteriorating microbiota. Probiotics, which support the flora by preventing the proliferation of pathogenic microorganisms throughout the body, also strengthen the mucosal immune system and have a protective effect. To prevent the development of vaginal fungi, probiotic supplements containing lactobacilli can be used, especially during periods when the immune system is weakened.

To prevent vaginal fungus, genital hygiene habits must also be regulated. It is important that the person prefers cotton underwear as much as possible and does not use tight and non-breathable underwear. It is also necessary to avoid vaginal douching, which causes loss of healthy microorganisms.