Chronic, Cyclical Candida Infections: What Causes it and How to Treat it
What is Candida?
Vulvovaginal candidiasis, more commonly referred to as a yeast infection, is an overgrowth of a type of yeast called Candida in the vaginal tract. Approximately 75% of women will have at least one yeast infection during their life.1 Of those women, one in six will also experience recurrent episodes at least four or more per year.1 Yeast infections can be caused by several types of Candida species, but the majority are due to Candida Albicans.
What are the symptoms of a yeast infection?
The most common symptom women experience is vaginal itching, burning and/or discomfort. A classic sign of a yeast infection is a thick ‘cottage-cheese-like’ discharge. Although less common, women may also notice vulvar swelling and experience pain during intercourse and urination.2
There are several diet and lifestyle factors that contribute to the overgrowth of Candida. One theory is that the digestive tract, specifically your intestines, are an initial source of Candida.2 It then migrates and colonizes in the vagina. Functional medicine understands the importance of treating the gut and focusing on digestive health for preventing recurrent infections. Male partners can also have Candida, but are often asymptomatic.2 If you have been diagnosed with a yeast infection, it is important that you talk to your partner as they may require treatment.
The Candida-Estrogen Link
Candida species require estrogenized tissue in order to replicate, meaning high levels of estrogen can escalate infections. Yeast infections are more common in women of reproductive age than in postmenopausal women due to declining estrogen.3 In women with high levels of circulating estrogen, recurrent cyclical yeast infections are most likely to occur right before and after menses. This is when estrogen is at its peak, and can trigger an underlying yeast infection.3
There are several risk factors that increase your chances of developing a yeast infections. Some of the most common risks are listed below:
- Uncontrolled diabetes
- Oral contraceptive pill (especially higher dose brands)
- Antibiotics use
- Vaginal irritants
- Corticosteroid use
Conventional treatment options for Candida often have a high rate of relapse and kill both the ‘good’ and ‘bad’ bacteria in your body. Oral antifungals may cause gastrointestinal side effects in up to 15% of people, and can also be toxic to the liver.4 Further, overprescription of antifungals is creating resistance to treatment for several strains of Candida species.5
As an alternative, there are several natural treatment options that help cure and prevent future infections.
Probiotics- Research has demonstrated that taking a high dose probiotic both orally and vaginally for at least one month can help eradicate yeast infections. Two strains of lactobacillus, L. rhamnosus GR-1 and L. fermentum, seem to be the most effective.6 Book an appointment with your Naturopathic Doctor to determine if a probiotic is right for you.
Boric acid- Boric acid suppositories are another natural treatment option, but are NOT safe to use during pregnancy. If you are currently trying to conceive or are pregnant, I recommend you avoid these suppositories.
In addition to taking a probiotic, the following lifestyle changes are key for preventing recurrence and speeding up recovery from a current infection.
- Avoid tight fitting clothing, wear loose pants or long skirts
- Choose cotton, rather than a synthetic type underwear, to prevent moisture build up and allow better airflow
- Reduce your consumption of simple sugars such as fruit juices, sodas, baked goods and products containing white sugar or white flour7
- Do not use vaginal perfumes, moisturizers or douches as these are known to irritate the vagina
- Murina F, Graziottin A, Felice R, Radici G, Di Francesco The Recurrent Vulvovaginal Candidiasis:Proposal of a Personalized Therapeutic Protocol. ISRN Obstet Gynecol. 2011, 2011:1-4.
- Ramsay, A, Astill N, Shankland G, Winter A. Practical Management of Recurrent Vulvovaginal Candidiasis. Trends in Urology Gynaecology & Sexual Health. 2009, 14(6):18–22.
- Beckmann C, Herbert W, Laube D, Ling F, Smith Obstetrics and gynecology: 7th Edition. Lippincott; 2014.
- American Family Physician. Treatment of Recurrent Vulvovaginal Candidiasis. http://www.aafp.org/afp/2000/0601/p3306.html Published 2000.
- Whaley SG, Berkow EL, Rybak JM, Nishimoto AT, Barker KS, Rogers PD. Azole Antifungal Resistance in Candida albicans and Emerging Non-albicans Candida Frontiers in Microbiology. 2016;7:2173. doi:10.3389/fmicb.2016.02173.
- Reid G, Charbonneau D, Erb J, Kochanowski B, Beuerman D, Poehner R, Bruce A. Oral use of Lactobacillus rhamnosus GR-1 and L. fermentum RC-14 significantly alters vaginal flora: randomized, placebo-controlled trial in 64 healthy women. FEMS Immunology and Medical Microbiology. 2003, 35:131-134.
- Reed B. Risk Factors for Vulvovaginal Candidiasis. OBstetrics & Gynecology Survey. 1992, 7(8):551-560.