Candidacies
or commonly called thrush is a very common infection in women. It is
particularly bad during pregnancy. This
happens
because women have high levels of oestrogen hormone which destroys the vaginal lining
cells and besides this high levels of hormone progesterone interferes with the
ability of the protective cells ( neutrophils) to fight candida. This can start
fairly early during pregnancy and can go on throughout her pregnancy. She should always see her care taker, confirm
the diagnosis and make sure there are no other infections. There are two common
antifungal drugs (DRUGS WHICH ACT ON CANDIDA) which are very useful and can be
obtained without a prescription. These do not harm the foetus, but there are
some which are not so safe. (FLUCONAZOLE). These can also be obtained easily. These
can cause a miscarriage. This treatment can be in the form of vaginal suppositories
or vaginal cream. In the first instant treatment is given for seven days and if
it reoccurs for two weeks or more the infection can be really bad. Always have
a medical input in your treatment.
Postmenopausal
women
The
other group of women who need attention about candidacies are, post menopausal.
Postmenopausal women do not suffer candidacies as they have run out of
oestrogens. They only get it if they are on HRT or are diabetic. In this situation
always examine the patient, if she complains of vaginal symptoms of itching,
discharge, pain on intercourse, dysurea, even bleeding.
There
can be many different problems. They often get another infection called
anaerobic vaginosis which causes very foul smelly discharge and itching, the
discharge is predominant, as opposed to thrush where itching is maddening. I
have come
across
two postmenopausal women who kept on using anti thrush creams, neither they nor
her primary care giver bothered to look at them. They both had a Carcinoma of
the vulva which is usually occurs in menopausal women.
Other
groups which suffer are Diabetics and obese women. Please do not keep focussing
on one problem that is Candidacies. Do some tests, are there any other
infections or any other problems. Always exclude diabetes in women with
persistent
thrush.
As practitioners
never order treatment without proper history and examination, if as care taker
we follow this rule, we will not miss the serious issues.
