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- Wed Dec 29, 2004 3:38 pm
I am a 23 year-old-female. I started getting yeast infection periodically starting from 17 years old. I was treated for vaginal infections several times since then. In july 2003 I had an abortion, after which the doctor prescribed me the birth-control pills (Ovcon35). In october I overdosed these pills and had a breakthrough period. After a week break I started taking Ovcon35 again. On Dec.16 vaginal itching, burning and had chunky white discharge. I used a 1-day yeast-treating cream. On dec. 18 I had periods again (for the 2nd time this month, 1st time was on dec. 1-5). Today is dec. 29, but the bleeding does not stop. In fact the discharge became very dark, olmost black. I am very scared, what can it be connected to? Is it the pills, or I might have an infection? I regularly have sex without using the condoms. I will really appreciate a professional reply.
| Dr. Tamer Fouad
- Wed Jan 04, 2006 5:24 pm
Vulvovaginal candidiasis is the second most common cause of vaginitis in the United States and the most common cause in Europe. An estimated 75 percent of women have vulvovaginal candidiasis at some time in life, and approximately 5 percent of women have recurrent episodes.[2,3-5] Candida albicans is the infecting agent in 80 to 90 percent of patients.[6,7] Recently, the frequency of non-albicans species (e.g., Candida glabrata) has increased, possibly secondary to greater use of over-the-counter antifungal products.
Studies have shown that the risk of vulvovaginal candidiasis (yeast infection) is increased in women who use oral contraceptive pills, a diaphragm and spermicide, or an IUD.[8,9,10]
Other risk factors include young age at first intercourse, intercourse more than four times per month and receptive oral sex.[3,5,11,12,13]
The risk of vulvovaginal candidiasis is also increased in some women who have diabetes, are pregnant or are taking antibiotics.[3,11,14]
Regarding the recurrence of yeast infection. First, evaluation of the causative organisms and any risk factors for recurrence will be required.
The optimal treatment for recurrent vulvovaginal candidiasis has not yet been defined
In vitro studies have shown that imidazole antifungal agents such as miconazole and clotrimazole are not as effective against nonC. albicans fungi. C. tropicalis and C. glabrata are 10 times less sensitive to miconazole than is C. albicans.
Terconazole vaginal cream (Terazol) is the agent of choice when infection with a species other than C. albicans is suspected. The potent interference of this agent with the cytochrome P450 isoenzymes makes C. tropicalis and C. glabrata more susceptible to treatment.
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