This fungus, whose name originates from two Latin words meaning “white”, is particularly troublesome for women, where it can cause vaginal thrush. What is it that makes Candida so persistent? Which factors promote the occurrence of the Candida infection (candidiasis) and how can we prevent or treat it? Obstetrician-gynaecologist Dr Panagiotis Xeromeritis answers our questions.
The word “candidiasis” might sound strange, but unfortunately many common complaints are caused by this organism. Of the 81 species of the genus Candida, the species Candida albicans is the one responsible for most infections. So let’s learn a little more about this strange yeast that lives in our bodies and occasionally makes its presence known in annoying ways…
► Getting to know Candida
“The Candida fungus lives parasitically in 80% of people without causing any problems. It is mostly found in the intestinal tract, especially the large intestine, where it constitutes part of the natural intestinal flora. This flora is the result of an ecological balance between lactobacilli and other micro-organisms, such as Candida. The intestinal flora also produces the perineal and vaginal flora in women”, explains Dr Panagiotis Xeromeritis.
Simply put, this yeast lives happily in our body without causing any problems since it is normally kept under control by the immune system and the natural microflora in the intestinal tract. So, when does Candida turn hostile?
“When the balance in the intestinal and vaginal flora is disturbed”, says Dr Xeromeritis, and explains: “If the lactobacilli are reduced in number, then other organisms, such as Candida, multiply. The normal flora (like lactobacilli) produces amino acids, vitamins (B and K) and antibiotics which protect the mucous membrane, killing dangerous bacteria or altering the pH of the vagina so that these cannot survive. When the balance between useful and harmful organisms is disturbed, the yeasts multiply. This results in what we call ‘candidiasis’, i.e. Candida infection”.
► Disturbed by…
There are many factors which can upset the balance in the vaginal flora:
- Use of antibiotics. Antibiotics reduce the number of lactobacilli in a woman’s intestine and vagina.
- Modern diets, which are rich in carbohydrates and sugar - excellent “foods” for Candida.
- Immunosuppression, i.e. a lowering of the body’s defences (fatigue, cortisone treatment, other infections).
- Diabetes mellitus.
- Changes in the vaginal conditions (antiseptic washes, use of antibiotics, menstruation) which make the environment hostile to the useful microbes and favourable to Candida.
- High humidity and temperature (in the summer for example) also help in the proliferation of the fungus.
► Vaginal thrush
Many women suffer from fungal vaginitis, especially during the summer; this is associated with characteristic thick whitish vaginal secretions accompanied by itching, burning and irritation.
According to the U.S. Centers for Disease Control, up to 90% of women will present candidiasis at least once in their lifetime. Some 40-50% will present two or more episodes, and 15-25% will suffer from recurrent infections. For the most part, fungal vaginitis is caused by excessive growth of Candida albicans, which is normally present in the vagina along with other organisms (mostly lactobacilli), forming the natural vaginal flora. Any reduction in the population of lactobacilli will result in a change in the pH (the “acidity”) of the vagina to less acidic conditions, which are suitable for Candida proliferation.
What can cause this reduction in lactobacilli? Many factors can reduce their population and disturb the sensitive balance of the vaginal flora. Such factors are elevated temperature and humidity, particularly during the summer months, from frequent swimming in the sea or in swimming pools; prolonged wearing of wet bathing suits; tight clothes and underwear made from synthetic fabrics; frequent sexual activity; use of antibiotics; use of contraceptives etc.
► Diagnosis and treatment
“In most cases, the treatment of candidiasis is simple and requires special medication. The duration of the treatment depends on the affected organ: for example, nail infections require much longer treatment than fungal vaginitis”, notes the expert. Products that can restore the natural intestinal flora (prebiotics) are important in reducing the rate of relapse, especially for candidiasis of the gastric tract and the genitals. Also, the unnecessary use of antibiotics should be avoided, because these also destroy a large portion of the useful bacteria.
Many experts believe that special diets can provide relief from the symptoms of an infection. This intestinal yeast needs carbohydrates to “feed” and multiply. Therefore, by eliminating processed hydrocarbons, sugar and foods with high yeast content (Roquefort cheese) or high water content (bread), we can help our body fight off the “unwelcome guest” more effectively.
In addition, Dr Xeromeritis stresses the importance of a general improvement of our immune system with vitamins and trace elements, through a diet rich in vegetables, fruits and cereals.
Relapses are a common problem for women with candidiasis. If these are very frequent, the doctor might request some additional tests, such as for diabetes, since undiagnosed diabetes might be responsible for them.
“The key to preventing candidiasis is the balance in the intestinal flora and a strong immune system. The right diet, along with suitable dietary supplements such as prebiotics and trace elements which fortify the immune system, contribute to the prevention of fungal infections. These dietary supplements become necessary when antibiotics are taken. Furthermore, a medical examination as soon as the first symptoms appear, and the use of the right antifungal treatment –even as a prophylaxis in some cases– can prevent relapses”.
who is who
Dr Panagiotis Xeromeritis is an obstetrician-surgeon gynaecologist. He was born in Athens in 1976 and completed his studies in medicine and obstetrics-gynaecology at the Université Catholique de Louvain, Belgium. He has received awards starting as early as primary school and has authored many scientific papers, published in Greek and international scientific journals.
As part of his obstetrics-gynaecology training at the Université Catholique de Louvain, under the direction of Professor J. DONNEZ, he was trained in endoscopic gynaecological surgery (laparoscopy - hysteroscopy), in high-risk pregnancy monitoring and in prenatal testing. From 2008 he has maintained a private practice in Thessalonica.
7, G. Lassani str., Thessalonica, tel. +302310231691, www.gynaikologos.org