Many women self-misdiagnose yeast infection

Many women mistakenly believe they have a vaginal yeast infection and are doing themselves more harm than good by treating it on their own, researchers reported at the International Society for the study of Vulvovaginal Disease meeting.

The records of 153 new patients (aged 18-65 years) seen at a single vulvar and vaginal disease clinic were analyzed prospectively. All women had chronic or recurrent vaginal and vulvar symptoms.

Despite their belief that they had a vaginal yeast infection, only 26 percent of the women actually did. “Their symptoms didn’t correlate with the clinical evidence of a yeast infection, said the coinvestigator and assistant professor of obstetrics, gynecology and women’s health at St. Louis University School of Medicine. Women shouldn’t just run to the drugstore if they think they have a yeast infection. The optimal thing would be to be evaluated.

The sensitivity and specificity of wet mount and yeast culture were not affected by age or yeast infection type. There were no differences between women with positive and negative yeast cultures in terms of age or self-reported scores.

Seventy-five percent of women will experience one episode of vaginal/vulvar candidiasis in their lifetime; of these, 50 percent will have a recurrence.

With the many over-the-counter (OTC) antifungals and physicians’ willingness to treat symptoms over the phone, it may be time to consider limiting this practice when yeast infection is considered.

Initially, it was good that these antifungal medications were made available OTC, but it is actually becoming a bad thing. Now, women are running to the pharmacy whenever they have a problem, so it is really a disservice to women. They are seeing an increase in other types of candida which is resistant to the OTC antifungals. Candida glabrata is becoming more resistant and it is being fueled by overuse of OTC antifungals.

The women in the study reported itching and a vaginal discharge, which could also indicate inflammation, dry skin, or a sexually transmitted disease. In a significant number of cases the problem is dermatologic and thus cannot be treated with an antifungal medicine.