Dear Dr Mitchell,
Each time my husband and I get intimate I get a yeast infection, so much so that I think I'm allergic to him. We will both get treated, and I will be fine as long as we're not intimate, then bam, an infection again! My husband refuses to use condoms because of his religion, so short of divorcing him, what can I do to ease these troubles?
Recurrent yeast infection is a common problem in women. A yeast infection is caused by a fungus and in most cases, this is Candida albicans. It usually presents with itching in the vagina or vulva. The associated vaginal discharge tends to be white, thick, clumpy, or curdy looking and sticks to the walls of the vagina. In some cases, the discharge can be greenish yellow. The condition can sometimes be confused with bacterial vaginosis. The distinct difference between the two infections is that there is a fishy, pungent odour with bacterial vaginosis (also called Gardnerella vaginalis). The discharge also looks different. It tends to be greyish-white and is watery.
Trichomonas vaginalis is a sexually transmitted infection that can also be confused with a yeast infection. This usually presents with a greenish-yellow discharge and a characteristic fishy odour.
Candida infection (yeast), bacterial vaginosis, and trichomonas infection all present with itching in the vagina. In vaginal and vulval candida infection there is sometimes swelling of the vulva with blisters, resulting in severe discomfort.
There are some conditions that will tend to cause an increased tendency to recurrent yeast infections. The use of antibiotics, steroids, pregnancy, diabetes mellitus, and a suppressed immune system can all set the stage for frequent yeast infections. Women who are on the oral contraceptive pill can also have more frequent yeast infections. Suppression of the immune system may be due to infection with the human immunodeficiency virus (HIV). However, a well-controlled person who takes the antiretroviral treatment will tend to have a fairly good state of health without the recurrent infections. Poorly controlled diabetic patients will also tend to get recurrent yeast infections.
The fact that you are both treated and the problem tends to be recurrent after sexual activity needs to be dealt with seriously. Your husband needs proper evaluation. He should get a complete investigation with a swab, urine analysis, blood sugar test, and screening for all the major sexually transmitted infections, including HIV. You should also get a vaginal swab done to ensure that you are being diagnosed and treated for the correct problem. It is also important for you to do a blood sugar, HIV test, and screening for the other major sexually transmitted infections.
The treatment for a yeast infection is completely different from the treatment for trichomonas and bacterial vaginosis. Failure to properly diagnose and treat the correct infection can result in frustration.
You should practise hanging your underwear in the sun since this helps to destroy any fungal infection in the underwear. The use of female condoms can help to reduce contact and would decrease your risk of transmission of infections from your husband, especially if he does not want to use the male condom. You need to be sure that he does not have another partner since this can be the source of a recurrent infection, especially since he is opposed to the use of condoms. You should have this conversation with him.
It is extremely important to reduce your risk of major sexually transmitted infections and cervical cancer caused by the human papillomavirus (HPV). Consult your doctor and get a complete investigation done for the both of you. You should also do your Pap smear regularly to screen for cervical cancer. The vaccine for prevention of HPV infection and cervical cancer is widely available, so you should get this to reduce your risk. It is usually given in three doses over six months.
Leaving your husband might not be the way to go. Proper evaluation, treatment, and counselling will definitely resolve the issues so you can both be happy with each other.
Dr Sharmaine Mitchell is an obstetrician and gynaecologist. Send questions via e-mail to email@example.com ; write to All Woman, 40-42 1/2 Beechwood Avenue, Kingston 5; or fax to 876-968-2025. All responses are published. Dr Mitchell cannot provide personal responses.
The contents of this article are for informational purposes only, and must not be relied upon as an alternative to medical advice or treatment from your own doctor.