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Fellow Listmembers--

There seems to be some misinformation and controversy about yeast infections.
 As I occasionally do, I'm going to stick my professional neck out--

Yeast infections are generally caused by a small organism called Candida.
This is not the same type of yeast used for baking or brewing.  Yeast
infections are medically referred to as "vulvovaginal candidiasis," or just
"candidiasis."  While vaginal yeast infections are the most well known
manifestation, yeast infections can occur in the throat/mouth (called
"thrush"), as well as other areas of the body--particularly in HIV or other
severely immunocompromised individuals.

Most women will have one or more yeast infections in their lifetimes.  A
small percentage--approximately 5%--will experience recurrent (or chronic)
yeast infections.  The specific risk factors for yeast
infections--particularly those that are chronic--are still being investigated
by the medical community.  However, many studies agree that the following
contribute to yeast infections:

1) AIDS or other immunocompromised status
-This includes the use of steroid therapy (i.e. prednisone)
2) Long-term antibiotic use
3) Diabetes
4) Frequent cunnilingus (female receiving oral sex)
5) Use of oral contraceptives (still under investigation!)
6) Pregnancy
7) Obesity
8) Excessive genital moisture (due to bathing suits, etc.)

Some also theorize that sex during menstruation, early age of first sexual
experience, and potential genital abrasion during intercourse are additional
factors.  Causes such as tight clothing and abnormal vaginal flora (which
means that you don't have enough of the "good" bacteria to protect you) have
been largely discredited.  Thus far probiotics have also not shown strong
evidence of preventing yeast infections, although I don't imagine that it
hurts to take them, particularly if you have other intestinal problems.

The use of oral therapies such as Diflucan have made the treatment of
candidiasis less invasive and uncomfortable.  However, it is important for
women who experience vaginal discharge or discomfort to seek a physician's
diagnosis at least once, so that they can learn to properly recognize a yeast
infection.  And I should add that while many over-the-counter creams and
suppositories are effective (and less time-consuming than seeing a doc!),
self-treatment is not always the best answer.  Occasionally, women experience
species of Candida (there are multiple species that cause infection) that are
resistant to the cream therapies.  In such cases, oral therapy is usually the
best option.  A physician should really decide.

I have not read any convincing evidence to show that a diet rich in or devoid
of certain food groups will prevent or treat yeast infections.  In fact, only
in the cases of diabetics have glucose levels (i.e. sugar) significantly
effected yeast growth.  Essentially, while yeast do need sugar and nutrients
to grow, eating a piece of cake does not mean that your vaginal yeast
population will suddenly exlode.

Many newly-diagnosed Celiacs may be immunocompromised, and many "veteran"
Celiacs may have other health conditions that effect their immune system and
metabolism.  In fact, yeast infections and Celiac Sprue would be an
interesting study!  For now, it is important to consult a health professional
if you think that you have a persistent yeast infection.  Particularly in HIV
or cancer patients, yeast infections can prove to be a serious and
debilitating condition.

As I've said before, I realize that a lot of you are hurting and frustrated
with the medical community.  However, please be cautious with medical advice
that you receive from "unofficial" sources.  The old expression "take it with
a grain of salt" comes to mind.  This listserv is wonderful for swapping
recipes, ideas, and sharing experiences, but it is not a substitute for
proper medical care.

In health,
Jessica M.
Research Microbiologist
University of Wisconsin-Madison

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