Candida & Women's Health

What is Candida?

Candida is a type of fungi with a budding growth pattern that gives it the classification of a yeast. There are hundreds of candida species that exist, although the main culprit in causing yeast infections is the Candida albicans strain, which accounts for approximately 75% of all candida or yeast infections. From early infancy onwards, candida yeast is a normal part of our microflora which is present throughout the body and can be predominantly located on the skin, in the lumen of the digestive tract and along the linings of mucous membranes, which can be found in the oral cavity, urinary tract and in genital areas. Candida causes no harm being part of our natural microbiome, however it becomes a health concern when certain changes to our body's environment occur, creating an imbalance of microbiota which may favour the growth of candida and encourage an overgrowth of yeast, referred to as ‘candidiasis’ or more commonly known as a ‘yeast infection’.

Essentially, candidiasis is a fungal/yeast infection which is caused by the overgrowth of Candida albicans and can present internally, externally or in severe cases, can progress to an invasive form of candidiasis which is referred to as ‘candidemia’. Candidemia is a systemic candida infection of the bloodstream which can secondarily affect internal organs such as the heart, kidney, brain and bones.

Symptoms of Candida

Candidiasis has an array of symptoms which range from mild to moderate, however this may present very differently depending on the type of yeast infection acquired and the location site of the body. Some of the most commonly known types of candida yeast infections are described below:

• Oral candidiasis also commonly known as oral thrush may appear on mucosal surfaces of the mouth such as the tongue, palate, inner cheeks, gums and may even spread to the oesophagus. Symptoms of oral thrush include white coloured patches that resemble a curd-like texture with an underlying surface area of redness and inflammation. These patches can be scraped off and may sometimes be painful and bleed slightly. Externally, this may also appear on the outer corners of the lips where there is a warm or moist area and the skin becomes cracked, red and inflamed. Contributing factors include having poor oral hygiene and there is increased risk with dentures.
• A genital yeast infection also known as thrush may occur in both males and females, however the prevalence rate is much higher in women with approximately 75% of females experiencing vaginal thrush in their lifetime. Recurrent vaginal yeast infections which occur 4 or more times within a year is a condition known as ‘Recurrent Vulvovaginal Candidiasis’ (RVVC), affecting around 5% of the Symptoms of vaginal thrush include; itching, soreness, redness, inflammation, irritation, localised rash, a burning discomfort especially during urination or during sexual intercourse and abnormal vaginal discharge which may be watery or more commonly has a thick, cottage-cheese like appearance and generally does not have a strong odour.
  
  Males who experience genital thrush will present with similar symptoms, they are generally less severe due to our reproductive structure. Poorly managed yeast infections may contribute to candida-related Urinary Tract Infections (UTI) and therefore it is important to ensure good hygiene practices are emphasised and avoid over-cleansing or douching. Keep mindful that the infection may be spread through sexual intercourse, so ensure you're always practicing safe sex. If the condition is recurrent, it is best suggested to visit your health professional as the symptoms may be similar to Bacterial Vaginosis (BV) or Sexually Transmitted Infections (STI) and will require a different course of treatment. Routine pap smears are also encouraged for women.

• Cutaneous candidiasis is a yeast infection of the skin and is commonly known as an external fungal infection. It can appear anywhere on the skin but is most prone to areas which are warm, moist or creased areas including the skinfolds (armpits, groin area, inner elbows and knees) and scalp. The symptoms of cutaneous candidiasis include redness, itching, a visible rash, flaking white patches which may scale or shed, weeping skin and occasional small pustules. Areas in-between the toes and fingers are also quite susceptible to infection which may even appear on the nails, commonly known as athlete’s foot, tinea, onychomycosis or fungal nail infection. Skin fungal infections are a prime example of how environmental changes may directly trigger a microbiota imbalance making it prone to infection; naturally occurring candida protects us against pathogens, however alterations to temperature, moisture and acidity (pH) impact the living conditions of this fungus, resulting in a thriving environment for overgrowth. Factors to consider in this condition are products applied topically including soaps, cleansers, lotions etc., changing out of wet or sweaty clothing as soon as possible, avoid restrictive clothing and opting for cotton.

Due to the nature of the infections onset, it is considered to be an opportunistic condition as the disorder will arise as a result of alterations to our biochemical environment and will occur primarily in those individuals who have a compromised state of health or with existing reduced immune defence mechanisms. Research surrounding the relationship between genders and yeast growth intensity have displayed that there is a significantly higher prevalence occurring in women compared to men, and most frequently in the younger age groups. Additionally, women with higher oestrogen levels such as in pregnancy and/or breastfeeding or when taking medications such as the Oral Contraceptive Pill (OCP) and hormone therapy have an increased risk of acquiring candidiasis. Populations who have an increased susceptibility also include newborns, infants, the elderly, hospitalised patients and those who are overweight. Other individuals who are at a higher risk of developing candidiasis include those with unmanaged diabetes due to the relation with blood sugar balance, people with high stress levels due to the impact on digestive and immune systems, people who frequently use antibiotics due to the disruption of internal flora and there is a strong correlation between candida overgrowth and people with conditions causing immunosuppression, such as HIV or AIDS. Dietary factors largely contribute towards the development of yeast overgrowth as food groups including sugars, refined carbohydrates, lactose containing dairy products and alcoholic beverages may have a direct impact on our internal homeostasis, promoting the growth of candida yeasts.

Symptom Management

The symptom management has similar treatment protocols for the various presentations of candidiasis as they generally arise from the same underlying causes. Recommendations will be specific for individuals once taking into consideration their personal factors such as dietary intake, lifestyle, genetic, current or previous medical conditions, topical products and external environment.  In addition to the dietary and lifestyle factors mentioned, some natural suggestions may also include: foods and beverages which are rich in prebiotics and probiotics will provide beneficial bacteria to nourish the microbiota; garlic has anti-fungal properties and coconut oil is rich in caprylic acid and lauric acid which when applied topically is beneficial to skin health maintenance.