Robert Filice, M.D. - Dr. Bob's Newsletter
Chronic Yeast Vaginitis
Most women are familiar with the common vaginal yeast infection which produces a whitish discharge, often with external genital redness, burning, itching, and irritation. In some women this disorder can become chronic or frequently recurrent. Within the over-the-counter and prescription drug business this disorder produces a lot of sales of a lot of different products.

Women with this problem may have one or more predisposing factors which include excessive sugar intake, the excessive use of wine or beer, use of the oral contraceptive pill, frequent antibiotic exposure, or a tendency to diabetes and its resulting higher blood sugar levels. Some women with recurrent vaginitis also have a systemic problem with Candida, and thus will require systemic therapy for complete eradication of this problem. Sugar feeds the organism responsible for the most common type of vaginal yeast infection, Candida albicans. It is true that even appropriate pharmacologic treatment of Candida vaginitis will fail in the long term when predisposing factors have not been eliminated. It is also true that Candida is not the only organism that causes vaginitis, so a drug failure could suggest mis-diagnosis. Lately one Diflucan tablet has become the favored drug approach to this problem, but Diflucan also fails sometimes.

Just before Diflucan came on the market, a study appeared in the journal Reproductive Medicine (1991) which compared a fungal vaginal cream with inserted boric acid suppositories. Those women who failed to respond to the antifungal agents did respond to the boric acid in 98% of all cases. There are many different products out there for vaginal yeast infections, but the most effective of them all, and the least expensive over-all seems to be boric acid capsules. They work because they acidify the vaginal secretions, making them inhospitable for yeast and other organism over-growth. The protocol for use is to moisten one capsule (from a compounding pharmacist) and insert vaginally twice daily for two weeks. This course may be repeated once more if symptoms do not completely resolve after the first time. Women with severely irritated vulvar tissue may need to first wipe on some external vitamin E oil to protect that area from possible leakage of boric acid out of the vagina. If that is not done, there may be a temporary burning sensation. Boric acid is probably all you need to know about treating vaginal yeast infections. But remember, if you have a recurrent problem, then some other factors are probably working against you. See your natural medicine doctor for help.

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