Yeast Vaginitis - Treat the Symptoms or Diagnose by Culture?
By Frederick R. Jelovsek, M.D.,
With symptoms of vaginal burning and a white, curdy discharge, many women have learned to self-treat with non-prescription, over-the-counter anti fungal medications. They are wrong only 25% of the time.(1) In many instances though, this treatment may permanently cure the problem. But what happens when the symptoms quickly recur or when this is the fourth time in a year to get an infection?
At this point it is best to obtain a specimen of the vaginal discharge and send it for yeast culture. If it returns as Candida albicans or one of the other yeasts, this may represent a problem of resistant organisms and different therapies should be tried. If no yeast is cultured, that also is important in that it tells us to look for other uncommon causes of vaginitis such as physiologic discharge, allergic vaginitis, desquamative vaginitis, atrophic vaginitis or sometimes a vulvar irritation that is primary rather than being caused by a vaginal discharge.
In summary, any recurrent vaginitis (four or more in a year) should be cultured if it is thought to be a yeast vaginitis or if it is not clear from the microscopic wet prep what the organism is.
- Ferris DG, Dedle C, Litaker MS. Women's use of over-the- counter anti fungal pharmaceutical products for gynecologic symptoms. J Fam Pract 1996;42:595-600.
