Discontinuing YI Treatment

[mameshibarun.livejournal.com]

Hi Superstars! This is a throwaway account... I'm a regular around here but I'd like to keep my anonymity intact for this question, forgive me :)

Anyway, I come with yet another yeast infection question. I did a google search, checked out the vulvapedia, and looked through the VP tags and didn't see anything that really addressed my question well... I apologize if I am just terrible at searching and feel free to point me to the correct post if I missed something!

So I had a series of "yeast infections" when I lived in Japan a couple years ago that were kind of a pain in the rear. The first one was definitely a YI - intense itchiness, clumpy discharge, bread-like smell, and as it was my first one ever, I went to the gyno and had it confirmed. Also, in Japan you can't get OTC treatment for them, so I returned to him every time I had any kind of symptoms, in order to get medication. Now the thing is, I had these issues several times a year, and he just assumed it was the same infection re-appearing. Usually it was just a case of itchiness and increased discharge, not necessarily clumpy, just an increase, and a change in smell, though not usually bread-like. And I admit there was a bit of a language barrier so I never really had a full grasp on what was going on during my visits; usually he would just take a look and confirm it on a visual inspection, though he did do a culture swab more than once. And the thing is, those swabs showed no yeast!  Which makes me suspicious if it was really a YI after that first initial one.

I ended up treating each bout of itchiness/ increase in discharge (just regular discharge, not clumpy or anything) with the YI treatment he gave to me (when he did give it to me, the times he did a swab and saw no yeast he just sent me home), and then when I came back to the US last year had another "flare up" that I went in to Planned Parenthood for. The nurse there examined me and said it looked like a YI, but when she did a wet mount there was no yeast there. So I basically didn't do anything but just wait it out.

In the spring I had another bout with it, and this time just self-medicated with monistat, the 7-day cream. Which burned like blazes, but when I finished it the symptoms were gone. Whether that was due to the medication or not, I don't know.

So now here I am and once again I've got an intermittent, mildly itchy vulva, increase in (non-clumpy) discharge, and kind of a peculiar smell. It's not yeast or bread-like, but just, not my usual. I went in to PP again, actually for an unrelated reason, I wanted to start HBC and also got a screening for chlamydia and ghonorrea (haven't gotten the results yet), as I've been with a few new partners recently, and I asked about the increased discharge and itching. She said it just sounded like a YI... the STI tests are done with a urine sample so there was no reason for me to get undressed/ on the table. There was no physical exam.

So I went out and got some of the 7-day treatment again and just started it 2 days ago. But after researching a bit on vulvapedia, I'm skeptical it's actually a YI and thinking it might be something more along the lines of Cytolytic Vaginosis or perhaps BV.

Here's the question: First, does that sound like a YI to you? And if not, will it be bad if I stop the YI treatment after 2 days? Everybody always says you're supposed to finish the full course of any medication to avoid creating drug-resistant strains, but if I don't actually have a YI, do I still need to finish it? Or can I stop it and try something else? I'm currently without health insurance, so avoiding another office visit would be preferred as I have to pay for it myself and I'm not exactly rolling in cash at the moment. Of course, I am definitely willing to go if trying to tackle this myself is an unwise/ risky decision.

Thanks guys! This is such a wonderful community :)

Comments

[acharmedlife.livejournal.com]

I'm in a similar situation.
I've been getting yeast infections every month since May. At first, canesten worked. Then I tried diflucan, and it worked. But now, I've had a yeast infection for THREE MONTHS that hasn't been responding to treatment.
I have the symptoms you do - itchy, red and raw vagina, increased, thick discharge, and a different scent. However, the swabs the doctor has taken always come back negative for yeast.
For me personally, I have no STIs. It is so confounding and so incredibly uncomfortable. At this point, I have been raw for so long that my vagina is swelling :(

In the end, the doc prescribed me a 3-month supply of diflucan to take in the third week of my cycle, which is when the symptoms are worst. Here's hoping it works.

You could do the usual things like take probiotics and eat lots of yogurt. Just finish the treatment anyway and see if it does anything.

[helpme11111.livejournal.com]

does this mean that yeast infections can come back negative even when you have them? I've had some situations which sound like yours and the OPs (itchy, red, sore, increased discharge but not particularly thick or yeasty, and for me no smell) which have also come up negative for yeast. Eventually I end up in too much discomfort, and I use monistat, and it goes away. I didn't know whether I was actually harming myself to use unnecessary medication but it works so well, I can't be too concerned.

[archangelbeth]

If it works, then I can't think that there's not something there.

On the other hand, it might be worth trying boric acid, or something else to just try to re-balance what's up? (Or test pH first; some people can get overly acid vaginas and, rarely, an overgrowth of the normally-friendly lactobacilli! Baking soda douching works for that, I believe.)

[helpme11111.livejournal.com]

I have asked about pH and was told that it was normal by a nurse who said that would come out as Vaginitis. I don't put a lot of stock in what she said as I left that doctor for other similar, misinformation issues.

I have a little bit of an aversion to the boric acid thing, only because you have to create it yourself... And I know that it's probably less "dangerous" (i can't think of the right word—overmedicational?) than using monistat.

The hardest thing for me is that I'm not SURE what's going on—it happens after sex but not all the time, doesn't discriminate by type of condom or condom at all or the type of sex, I'm negative for everything as is my partner. I've tested positive for gardnirella before and then tested again to show I finally kicked it, so if it was bv I assume I would know by the test.

originally i thought maybe sex was giving me little tears that itched as they healed, but I've had incredibly vigorous sex with no issues, and very gentle short sex with huge problems. So my only guess is mild yeast aggravated by sex, which does not show up on tests and which will sometimes disappear on it's own. I can't think of what else it could be!

I also have celiac and know intestinal issues can cause YIs...

[polylizzy.livejournal.com]

are you using a lube like astroglide

they have sugars in them, sugar in a vag can lead to infections.

I had cyclic YI's when I was married, I would get it just before my period EVERY MONTH.

after my divorce they totally went away. no more sex, no more lube, no more infections.

I also find that rinsing my vag area (all of it, creases fully front to back) with a hand held shower every day when I have my period and any time i itch down there at all seems to help. I can make sure I dont have any soap residue in there that ran down my crack during washing. it also rinses off any residue from feminine care products.

dunno if thats the problem but it might help?

[helpme11111.livejournal.com]

no lube, and i fully utilize my hand-held shower....

I do think it's the cyclic nature, mine is just after my period, but it comes and goes. It's a mystery!

[mameshibarun.livejournal.com]

one of the nurses at PP suggested I try Rephresh douches. She made a point of saying regular douching was a bad idea, but this brand apparently helps to fix the pH level in the vagina or something. I haven't tried it yet though... was thinking I might give it a go after finishing the 7-day cream treatment?

[mameshibarun.livejournal.com]

oh! also, while perusing the vulvepedia entry on yeast infections, I ran across this (http://www.encognitive.com/node/6031) article that states:

"Cytolytic vaginosis(CV) is the current term for a condition of lactobacilli overgrowth. It is a little recognized but common cause of cyclic vulvovaginal complaints in women of reproductive age. CV is often misdiagnosed as candidiasis and most women have tried many antifungal medications both conventional and alternative, with little or no relief.....[researches] observed that the symptoms of CV were similar to Candida vaginitis, but when viewed under a microscope, there were differences."

Which had me wondering if what I had really WAS a YI or perhaps something else masquerading as one...

[archangelbeth]

Not impossible! That's why I was suggesting the pH test, because lactobacilli loves acidity, so if you had high-acid pH, it might suggest you had CV.

I'd consider holding off on the RePhresh douching until you did a pH test -- though there are, at least in Target, little vaginal pH testing kits that have the thing on a kind of plastic wand so you don't have to futz with little paper strips. (Though paper strips are probably cheaper.) I suspect Rephresh would tend to acidify the vagina (since that's the usual direction that it needs to go), but that wouldn't make over-enthusiastic lactobacilli any calmer.

If it's not over-acid, then I've heard some people say the RePhresh stuff -- not being full of chemicals -- is useful. You might also consider apple cider vinegar, diluted to 3% (or whatever your body can stand). (There's a study that suggests it doesn't mess with lactobacilli, but does mess with BV bacteria and yeast.)

Crossing fingers!

[acharmedlife.livejournal.com]

Yeast can come back negative. If yeast infection treatment works, then use that. If it looks like a duck and quacks like a duck... it might be a duck.

It is common for women to get cyclical infections that recur during a certain time of the month and such.

[helpme11111.livejournal.com]

For me it usually comes after sex but not all the time. Does not discriminate as to a condom, a type of condom, or the type of sex. I'm negative for everything they test for except a skin biopsy, which it hasn't come to yet, and with the same partner who's negative for everything. That's what makes me think it's a yeastie which is aggravated by sex...but a month ago it happened and went away on it's own. The only other vaginal infection i have had is recurring gardnirella, but that test always came out positive and treatment worked and it wasn't a reaction to sex, and the itching was much different. Survey says...yeast? I think it is stronger after my period, which makes sense.

[make-me-stay.livejournal.com]

I can't really say whether it might be something other than a YI, but I can throw in my own experience - I had persistent YIs this year, following a long-term course of antibiotics. OTC treatments would work for about a week, but it would always come back. Like you, I started worrying about whether it was something else (or something more serious).

Persistent vaginal YIs can be an indication of an imbalance in your gut, not just in your vagina/vulva. So OTC treatments for YI will only be a bandaid solution, if that's the case and you're not treating the overall imbalance. My doctor said I should try a candida diet for a while - limit as much as possible yeast, sugar, processed foods for about 6 weeks - in order to get rid of the yeast overgrowth in my guts. I found it tricky to begin with, but it really did help - there's heaps of info/recipes online if you google "candida diet".

Good luck :)

[mameshibarun.livejournal.com]

I have actually had to cut certain things out of my diet (bread, especially) for what I thought was unrelated intestinal stuff. perhaps you're on to something though, it makes sense they would be related!

[dorasolo.livejournal.com]

I had the same problem in college, but it turns out that mine was an allergy to spermicide on condoms. Any chance you're allergic to something? I would have itchiness, an almost metallic odor, but no clumpy or white discharge.

[mameshibarun.livejournal.com]

hmmm... that's an interesting thought. I haven't noticed it being associated with any particular thing, but then again I haven't been paying attention to that either! I would guess in my case it would be more of a clothing or food related illness though, as I haven't been sexually active during all of my bouts with it