You may have had vulvovaginal yeast infections in the past, especially during pregnancy or within a couple years postpartum. However, in peri- and menopausal women, it’s not uncommon to see reinfection regularly as frequent as everyday, even with the help of oral medication and vaginal suppository.

If you’ve stumbled across this article, chances are that you’re out of your wits trying to find answers to your recurrent yeast infection. You’re not alone. Now, I’m guessing that you’ve tried everything under the sun. Your doctor had prescribed a 6-month weekly dose of fluconazole, you’ve checked your fasting glucose level, you’ve eliminated sugar and dairy from your diet, you’ve tried the anti-candida diet, you’re taking probiotics (and not taking unnecessary antibiotics), you’re washing your perineum without soap, you’re wearing breathable undergarment and pants, you’re avoiding certain brand of panty liners, and you’ve done all that you can to reduce stress and improve sleep. I am so sorry that you had to endure this.!

Drug-resistant candida species have been on the rise in the last few years1. Family doctors and OBGYN alike have been challenged by the tenacity of candidiasis. In most cases, antifungal medication, either oral or topical, is an effective treatment but only while patient is taking it. Such medication does not appear to be curative in recurrent cases and the adverse effects eventually outweigh the benefit. Therefore, antifungal medication hasn’t been the answer to recurrent vaginal yeast infection.

The cause of recurrent yeast infection is most commonly Candida species, but the reason why some women get it again and again is still unclear. I suspect that it is due to a combination of factors typically not examined together when studies are conducted. In naturopathic language, health is assessed on the whole, considering the manifestation of a disease as a result of all physiological systems interacting with each other.

A new perspective has been suggested in January 2020 that rather than a weakened immune system of the host, it is the overreaction of the host’s immune system to Candida species that perpetuates the symptoms classic to vaginal yeast infection2 which are soreness, frequent odourless discharge, itching, burning, pin-point bleeding, and cottage-cheese like discharge.

In my clinical experience, I have found recurrent yeast infection to be associated with hormonal changes, and the street goes both ways: yeast overgrowth can disrupt hormone, possibly speeding up the onset of perimenopause, and conversely, hormone fluctuation as in the case of peri-menopause, can perpetuate yeast overgrowth since yeast is always present in our normal, healthy, microflora.

Another perspective that I’d like to offer is that in this normal microflora of ours, we can have something called biofilm – a cohesive community of microbes that form the protective matrix for yeast. Have you ever seen the slime on a mushroom in the wild? That slime is biofilm and it protects the top surface of the mushroom. We have it in our body too. That slime, or biofilm is found in our gut, bloodstream, and surface of teeth. Yeast is a very smart and sneaky organism. It has two forms: budding and spore. When there’s plenty of nutrients, the yeast thrives in the budding form; when nutrient is deficient or that a threat is present, as in the case of an antifungal medication, the yeast reverts to its spore form. That spore form can stay dormant in the biofilm shielded from the effect of antifungals, and when the effect of antifungal medication subsides, or that you’ve stopped taking antifungals, the spore comes out of biofilm and becomes the budding form again, which propagates yeast growth and therefore, infection.

Nasty, isn’t it?!

My success in treating any type of recurrent yeast infection happens when I support hormone fluctuation in peri-menopause while also disrupting the biofilm.

To balance hormones, I always first support the adrenals as we know that the adrenals function is most important for any hormone balance. We can achieve this by using an adaptogen coupled with estrogen metabolism support. For example,

Rhodiola + Ashwaganda + DIM

To crack open biofilms so that spores can be removed, I use

Serrapeptase + Black cumin3 + DMSA + N-Acetylcysteine

Depending on the patient’s health status, I may suggest supportive therapies to help the body remove biofilm fragments:

Chicory
Turmeric
Dandelion

It goes without saying, healthy sleep patterns, stress management, and a balanced diet low on sugar are part of the game when attacking recurrent yeast infection.

Again, you’re not alone. Speak to your healthcare provider now that you have this piece of information with you to bring to your next doctor’s appointment. Best of luck and as always, Talk to Dr.Kait now if you have any questions.

Stay safe,
Dr. Kait Chang

References
1. Sobel JD, Sobel R. Current Treatment Options for Vulvovaginal Candidiasis Caused by Azole-Resistant Candida Species. Expert Opinion of Pharmacotherapy. 2018 Jun; 19(9).
Microorganisms. 2020 Jan 21;8(2). pii: E144. doi: 10.3390/microorganisms8020144.
2. Rosati et al. Recurrent Vulvovaginal Candidiasis: An Immunological Perpective.
Microorganisms. 2020 Jan; 8(2).
3. Rusda et al. A therapeutic effect of Nigella sativa extract on female Wistar rats vulvovaginal candidiasis model. Med Glas. 2020 Aug; 17(2).

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