I’ve binge-watched The Bold Type three times now (I’m a manic binge-watcher). You can credit my passion for the show to my obsession with Jane’s profession as a writer at a women’s (and women-led ) magazine (something I’ve successfully manifested for myself) — and for how real the show is. I recall Jane dealing with a vaginal yeast infection following a ‘vagay-cial’? Her situation piqued my curiosity. While a vagay-cial was the culprit for Jane, are there any other factors that can cause vaginal yeast infections? I did some research and noticed a few studies drawing links to lingerie and monsoons as potential triggers. And, hey, these are things most of us love — so if they’re secretly sabotaging us, we have a right to know!
And that’s why I roped in Dr Anagha Chhatrapati, Consultant, Gynaecology at Global Hospital, Parel, Mumbai and Dr Divya Vora, Obstetrician and Gynaecologist, MBBS, DGO to talk to me more about this type of infection; whether these triggers are legitimate; and what we can do to manage it effectively.
Rains And Sexy Lingerie: How 2 Things We Love Most Might Be Plotting Against Us
What are yeast infections, and why do they affect the vagina? Do they affect the vulva as well?
Dr Divya breaks it down for us like this, “The vaginal flora is characterised by the healthy bacteria that live inside the vagina. The normal vaginal flora is dominated by various lactobacillus species. Lactobacilli help keep our vagina healthy by producing lactic acid, hydrogen peroxide, and other substances that inhibit the growth of yeast and other unwanted organisms. They maintain the vagina at a healthy pH. When this vaginal pH reduces for various reasons, the chances of developing vaginal, as well as vulva infections, become high. A yeast infection or candidiasis is an infection caused by a fungus called candida — which naturally occurs in small amounts on the skin as well as the mucosal surfaces inside the mouth, respiratory tract, intestines, and vagina. Candida — especially C. Albicans — overgrowth in the vagina is commonly called a vaginal yeast infection, vaginal candidiasis, or vaginitis. If the fungus grows on the vulva, it is identified as a vulva yeast infection and is less common than the vaginal one. In most cases, it occurs with the vaginal infection.”
Dr Anagha explains what triggers these infections, and how they manifest, “A healthy vagina has a balanced mix of naturally present fungi and bacteria. When this balance gets upset due to various reasons — such as illness, antibiotics, impaired immunity, uncontrolled diabetes, or even sexual activity — there could be an overgrowth of a yeast called Candida Albicans. This can cause an infection. It is typically characterised by profuse curdy-white discharge and intense itching in the perineum. It affects the vagina, the vulva or the opening of the vagina, and the inner thighs as well.”
What are some signs and symptoms you’ve developed one?
“Depending on the severity of the infection, you might experience burning during intercourse or urination, itching in the vagina and vulva, and vaginal discharge. In severe cases, you might notice profuse curdy-white discharge with excoriation and bleeding due to epithelial damage. Secondary bacterial infections can lead to foul smell as well,” says Dr Anagha.
Dr Divya adds to this insight, “This infection starts off as an urge to itch like it’s the only thing to do in the world! You might experience redness, swelling, and thick and curdy-white discharge. On examination, the condition of your vaginal walls and the type of discharge will help confirm the diagnosis further.”
Does the likelihood of developing one increase during the monsoons? Why?
Dr Divya confirms my suspicion, “Yes, unfortunately, it does! Fungi and bacteria love moisture, and they have their own little party going on down there because of how warm and moist the environment is. During monsoons, the likelihood of you getting drenched is high, and wearing clothes that are wet, and are touching your privates for a long time becomes an invitation for bacteria and infection to infest. This makes you susceptible to contracting an infection.”
What are some precautions you’d suggest we exercise during monsoons to avoid having to deal with this situation?
Dr Anagha put together a list of do’s and don’ts for us to follow:
- Wear loose-fitting, dry, cotton-based undergarments.
- Change out of damp or wet clothes as soon as possible.
- Include immunity-boosters in your diet such as probiotics like curds. Even foods rich in vitamin C — such as citrus fruits and amla, help.
- Avoid consuming foods rich in refined carbohydrates.
And Dr Divya helps up with another set of tips, “Regardless of whether it’s summer, monsoon, or winter, it is always advisable to wash your vulva with water, and pat it dry with a clean, soft cloth/ tissue after urinating, Remember — clean from front to back, always! Cleaning from the back to the front introduces more organisms into your vagina from the anus, and you don’t want that! Change your underwear at least twice a day. Make sure you change your pads/tampons every 6 hours — and menstrual cups every 8 hours. Wear airy and loose-fitting clothes, and avoid tight, non-breathable clothes — especially during monsoons. Avoid the lacy /silky/satiny underwear. They tend to cause more harm than fun! Use breathable, cotton-based underwear. And lastly, keep yourself hydrated, and follow a balanced diet supplemented by prebiotics and probiotics!”
How do you treat such an infection?
“Depending on the severity and type, these are treated with oral antifungal medicines, antifungal creams or vaginal suppositories. Sometimes, we also add a course of probiotics to improve the natural vaginal flora,” explains Dr Divya.
Dr Anagha says that the use of a local vaginal pessary or suppository containing antibiotics and antifungal medications for 7 nights is sufficient. She suggests avoiding intercourse during menstruation. If intercourse happens, wash your genitals with water, and
insert the pessary afterwards. Keep it overnight. Simultaneous treatment of the sexual partner is essential to avoid recurrence.
Does lingerie have anything to do with whether we develop such infections or not? How do we prevent this from happening?
Dr Divya gives us a much-needed reality check. She says, “This might really hurt but that sexy thong isn’t so sexy after all! A poor-fitting thong can shift, finding itself on the inside of your labia majora or your butt-cheeks. Ouch! Poor-fitting and synthetic underwear can be especially irritating when worn for long periods of time, and friction from walking or movement can make the inflammation worse. This friction against your delicate bits can cause chafing, sores, and eventually lead to opportunistic infections. Preventing this is easy! Stick to airy, breathable materials like cotton and pick comfortable underwear. Materials like satin, silk, lace and polyester have a reputation for increasing irritation as well as the chances of infection! Once in a while, go ahead and wear that lacy G-string. Just make sure you have it removed soon!”
Any other factors that can cause such an infection — apart from weather and clothing?
Here are some triggers as explained to me by the experts:
- Yeast infections are most common during pregnancy and menopause due to the drastic hormonal changes which, in turn, change the vaginal pH.
- Diabetes is a major risk factor for recurrent vaginal infections (diabetes leads to increased sugar in body secretions making them favourable breeding grounds for yeast infections) and so is any immunocompromised state.
- Use of scented and harsh soaps, intimate washes and lubricants or condoms and sex toys that don’t suit you, could be a major cause.
- An unhealthy lifestyle and poor dietary habits play a huge role in hampering immunity and causing recurrent infections.
- Antibiotics given for the treatment of other diseases can kill the protective vaginal lactobacilli. This alters the vaginal pH and leads to candidiasis.
- Sexual activity with an infected partner can trigger it, and indulging in oral sex can lead to fungal infections.
- Excessive hygiene practices like vaginal douching and washing with corrosive soapy solutions can kill the protective lactobacilli and disrupt vaginal mucosa.
- Immunosuppression due to HIV AIDS, cancer chemotherapy or steroid treatment leads to recurrent vaginal candidiasis
While we love monsoons and pretty, lacy lingerie, it’s advisable to love them in healthy, well-balanced amounts. If you think you’re experiencing any of the aforementioned symptoms, consult a gynaecologist immediately instead of waiting for it to turn into something severe.
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