By the colloquial term vaginal mycosis (synonyms: vaginal mycosis, vaginal mycosis, vaginal soor, soorvaginitis or also soorkolpitis) one understands an infectious disease of the female vagina by a fungus from the genus Candida (mostly Candida albicans). It is estimated that about three quarters of all women get such a fungal infection at least once in their lives. This makes the vaginal mycosis one of the most common venereal diseases, but fortunately it is usually easily treatable and heals without permanent damage.
In most cases a vaginal mycosis is caused by the yeast fungus Candida albicans, more rarely by other fungi of the same genus. Candida albicans is found on the mucous membrane of the vagina in a large number of women and is therefore also part of the natural vaginal flora in some healthy individuals. Under normal conditions, however, these fungi cannot spread.
This is because the vaginal environment is very specific. The natural vaginal flora is mainly characterized by an acidic pH value (normally between 4.0 and 4.5). This is mainly caused by the lactobacilli (lactic acid bacteria) and makes it difficult for fungi and other pathogens to settle and multiply in the vagina.
If this flora is correct and the woman’s immune system is functioning properly, it is very unlikely that she will develop vaginal mycosis. However, there are some factors that can weaken the immune system. These include various underlying diseases, for example congenital immune defects, cancer diabetes mellitus AIDS or the use of broad-spectrum antibiotics and other drugs such as cortisone.
In addition to disorders of the immune system, changes in the healthy vaginal environment can also promote the development of a vaginal fungal infection. Such fluctuations in the pH value can be caused, among other things, by hormonal changes such as pregnancy, menstruation, menopause, puberty, stress when taking the contraceptive pill, incorrect intimate hygiene (especially the excessive use of vaginal irrigation or intimate sprays throws the vaginal environment out of balance), certain contraceptive products (e.g. spermicidal creams, foam suppositories) or lubricants. In addition, external influences such as sexual intercourse (if the partner is infected), incorrect behaviour after bowel movements (one should always wipe backwards from the vagina to prevent germs from the intestines from reaching the vagina), sharing linen or towels, visiting public facilities such as swimming pools or saunas, wearing clothes that are too tight and impermeable to air (garments made of synthetic materials are particularly dangerous) can also cause the appearance of vaginal mycosis.
Under normal conditions, however, these fungi cannot spread. This is due to the fact that there is a very specific environment in the vagina. The natural vaginal flora is mainly characterized by an acidic pH value (normally between 4.0 and 4.5).
This is mainly caused by the lactobacilli (lactic acid bacteria) and makes it difficult for fungi and other pathogens to settle and multiply in the vagina. If this flora is correct and the woman’s immune system is functioning properly, it is very unlikely that she will develop vaginal mycosis. However, there are some factors that can weaken the immune system.
These include various underlying diseases, for example, or the use of broad-spectrum antibiotics and other medications such as cortisone. In addition to disturbances of the immune system, changes in the healthy vaginal environment can also favour the development of a vaginal fungal infection. Such fluctuations of the pH-value can be caused by hormonal changes such as .
- Congenital immunodeficiencies,
- Cancer
- Diabetes mellitus
- AIDS
- Pregnancy,
- During menstruation,
- In the menopause,
- In puberty
- When taking the contraceptive pill
- Stress
- Incorrect intimate hygiene (especially the excessive use of vaginal rinses or intimate sprays brings the vaginal environment out of balance)
- Certain contraceptive preparations (e.g. spermicidal creams, foam suppositories) or lubricants.
- Sexual intercourse (if the partner is infected),
- Wrong behaviour after bowel movement (one should always wipe backwards from the vagina to prevent germs from the intestine from reaching the vagina)
- Shared use of linen or towels,
- Visiting public facilities such as swimming pools or saunas
- Too tight-fitting, air-impermeable clothing (garments made of synthetic materials are particularly dangerous) cause the appearance of vaginal mycosis.
A fungal infection in the body often occurs when the immune system is weakened. In most cases, the mouth, esophagus and genital area, as well as the vagina, are affected. Diseases such as diabetes, cancer or HIV can trigger a weakened immune system.
But also pregnancy or a previous therapy with an antibiotic can cause vaginal mycosis. The antibiotic destroys the lactic acid bacteria of the vaginal flora. These bacteria build up a protective layer in the mucous membrane and are responsible for maintaining the vaginal environment.
The antibiotic also destroys the protective layer and makes it easier for fungi to multiply quickly in a warm and moist vaginal environment. The longer an antibiotic is taken, the more likely it is that a vaginal fungus will develop. In most cases the fungus can be treated well with a vaginal mycosis remedy and will not reappear after discontinuing the antibiotic.
A reason for the first or general occurrence of vaginal mycosis can be the taking of the contraceptive pill. Taking the pill supplies the body with hormones. The increase in hormones, especially with estrogen-containing pills, causes a change in the vaginal environment similar to that which occurs during pregnancy.
The fungi typically found in the vaginal flora multiply under high estrogen levels. The infection can easily be treated with an antifungal agent. If the fungus does not disappear or reappears despite treatment, the doctor should consider changing the pill or a lower dosage.
There are several signs and symptoms that can indicate and make it likely that the vagina is infected with a fungus. The most common and disturbing symptom is severe itching. Itching occurs mainly in the area of the labia and/or at the entrance to the vagina.
The fungus can affect both the external and internal female genitals. Other common signs are a burning sensation when urinating and pain during or after sexual intercourse. The discharge is also usually altered.
Typical is an increased, white-yellowish and crumbly discharge. Usually odorless, however. In addition, the mucosa on the vagina may have white deposits.
Not all signs and symptoms need to occur equally or simultaneously. If there is no relief of the symptoms despite therapy, a doctor should be consulted for clarification. The main symptom of vaginal mycosis is often massive itching, which is sometimes restricted to the inside of the vagina, but usually affects the entire primary external sex organ (the pubic or vulva).
This is also the area where a burning sensation can occur. The infected skin is often reddened and/or swollen, which is a sign of an existing inflammation. Another characteristic feature is an outflow from the vagina (fluorine vaginalis), which is usually crumbly, whitish and odorless.
White deposits on the mucous membrane are also possible, which cannot be removed. Sometimes there are more serious skin defects (e.g. pustules or eczema), which can even spread to the thighs. Because the affected areas look like sore, some patients may experience additional pain when urinating or during sexual intercourse.
Another characteristic feature is an outflow from the vagina (fluor vaginalis), which is usually crumbly, whitish and odorless. White deposits on the mucous membrane are also possible, which cannot be wiped off. Sometimes there are more serious skin defects (e.g. pustules or eczema), which can even spread to the thighs.
Because the affected areas look like sore, some patients may experience additional pain when urinating or during sexual intercourse.A symptom of vaginal mycosis (vaginal candidiasis) can be a change in the discharge (fluorine vaginalis). This may be more and differ in color and consistency from normal. As a rule, however, the vaginal mycosis discharge is odorless.
In most cases the effluent is yellowish-white in color and has a crumbly consistency. Many patients then describe the effluent as “cottage cheese-like”. The odor of the effluent does not usually change in the case of vaginal mycosis (vaginal candidiasis).
However, if a foul-smelling discharge is noticeable, it should be examined by a gynecologist. This can be an indication of a bacterial infection, which must be treated with medication by a doctor in any case. Here you will find detailed information on the topic: Vaginal dischargeAnother symptom of vaginal mycosis (vaginal candidosis) can be pain.
Many patients describe above all strong burning sensation. There may also be pain when urinating, similar to that of an inflammation of the urinary tract. During a fungal infection, pain during sexual intercourse is also often noticeable.
In order not to infect the partner, sexual intercourse should be waited until the vaginal fungus has healed. A vaginal mycosis almost always causes severe itching. Mostly it itches before redness and swelling of the vagina occur.
However, a vaginal mycosis can also be detected without causing disturbing symptoms. Then the fungus colonizes the vaginal flora only in small quantities. The yeast fungus does not always cause symptoms like itching, burning or pain.
This is because fungi and bacteria belong to the normal vaginal flora and are not dangerous. They can also occur naturally in the mouth and digestive tract. Excessive intimate hygiene or a weakened immune system in chronic diseases or medication can lead to an imbalance in the vaginal flora.
Due to the warm and humid environment, fungi multiply and can cause discomfort. People who suffer from a disease that weakens the immune system are more likely to be infected with a fungus. Also the intake of certain medicines can lead to it.
If the partner has a fungus in the genital area, a condom should be used to prevent transmission. In addition, towels and underwear should be changed regularly and washed hot, because the fungus can settle there and cause repeated infection. It is also possible to get a fungal infection after staying too long in a swimming pool.
This is because the chlorine attacks the vaginal flora and promotes fungal growth. Since vaginal mycosis is not a venereal disease and is caused by the body itself, it is rarely contagious and is hardly ever transmitted through sexual intercourse. The fungus can multiply best in a moist and warm environment, such as in the vagina.
Since the male member is rather dry and more in contact with air, the fungus has little opportunity to reproduce and settle there. Therefore, it very rarely comes to an infection with a fungus, which is then colloquially called penis fungus. Often, however, the fungal infection in men goes unnoticed and runs without symptoms.
The fungal infection of the vagina is not a sexually transmitted disease and therefore, strictly speaking, cannot be transmitted. The fungus is caused by a disturbance of the vaginal flora. Through a change in the environment, the fungus has the possibility to multiply.
The cause of the changed vaginal milieu can have various reasons. A weakened immune system due to diseases such as diabetes, infections or stress, but also some medications, especially antibiotics, can be responsible. Another common reason is excessive intimate hygiene.
Too frequent cleaning in addition with soap, shower gel or spray can irritate and confuse the vaginal environment. It is better to cleanse the vagina daily with normal, lukewarm water. Furthermore, an incorrect wiping technique in the toilet can cause a smear infection and thus promote a fungal infection.
To prevent a renewed infection, underwear should be washed regularly with a high temperature to reliably kill the fungal spores. For a diagnosis of vaginal mycosis, it is very important to take a detailed medical history (anamnesis).The physician asks here the female patients exactly In addition he seizes all possibly existing Grundleiden and further possible risk factors for vaginal mycosis, thus for example also whether the woman is at present in a hormonal conversion phase. This is followed by a physical examination.
During this examination, a fungal infection through the reddened, swollen vaginal mucosa and the crumbly, white coating is noticeable. However, in order to find out which exact pathogen is responsible for the vaginal mycosis in a particular case, it is necessary to take a smear from the mucous membrane. This means that the gynecologist (gynecologist) takes a little vaginal secretion with a cotton swab.
This smear is prepared and then placed under the microscope where it is examined for the presence of fungal spores (recognizable by fungal threads or shoot cells). In addition, part of the sample is sent to the laboratory, where a fungal culture can be grown on certain culture media. This is sometimes particularly important because bacterial infections of the vagina or labia can often be accompanied by symptoms very similar to those of a fungal infection and it is also not uncommon for mixed infections to occur.
In the case of bartholinitis, for example, glands in the labia minora become inflamed by a bacterial infection, which can lead to similar symptoms. However, since bacterial infections must be treated differently, a differentiation of these pathogens is absolutely necessary!
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Vaginal mycosis is especially noticeable by strong itching.
In addition, it can cause pain when urinating or burning. Furthermore, a strong reddening in the genital area is often observed. In addition to a fungal infection with the species Candida albicans, bacteria or other pathogens may also be responsible for these symptoms.
To find out whether it is really a vaginal fungus, there are self-tests (pH test strips) that can be used at home. The test is available from various manufacturers in pharmacies without a prescription. The self-tests measure the pH value of the vagina.
Normally, the vaginal environment is in the acidic pH range. This is necessary to maintain the bacterial balance of the vaginal flora. The test changes color in case of a pH change.
Depending on the manufacturer, this means an infection with a fungus or bacteria. More reliable, however, is the diagnosis by a gynecologist. This should be consulted if treatment with a cream has not been successful.
The treatment of vaginal mycosis is in most cases relatively simple and can often be done by the patient herself at home. Special anti-fungal agents, so-called antimycotics, are almost always used. Frequently used agents are, for example, nystatin or imidazole (including miconazole or clotrimazole).
Such drugs are available in the form of creams, ointments or vaginal suppositories. They are available in pharmacies without a doctor’s prescription. Nevertheless, it is important to always follow the instructions on the package insert exactly and to consult a doctor if anything is unclear.
It is essential that the treatment is always carried out locally at first. The creams and ointments should be introduced into the vagina with the help of a specific applicator and also applied to the labia and, as a precaution, to the anus in order to really reach all the fungal spores present. This procedure should be repeated about once or twice a day.
The vaginal tablets (suppositories) can be inserted into the vagina either with an applicator or with a finger. This method is not recommended during menstruation, as the active ingredient can be flushed out of the body by the escaping blood without first taking effect. With regular treatment, the symptoms improve after only a few days.
However, depending on the active substance, the therapy must be carried out consistently for one to six days (depending on the dosage and type of preparation, see package insert!) and not discontinued at the first signs of improvement, as otherwise individual fungal spores may survive and lead to a renewed infection. Only if therapy is unsuccessful or the infections recur repeatedly, systemic treatment with orally administered drugs is indicated.For the treatment of vaginal mycosis, there are Canesten® preparations that can be purchased over the counter from pharmacies.
Canesten® is a combination therapy. It contains one tablet and one cream. The tablet is inserted into the vagina where it is supposed to work for 72 hours to fight the fungus.
It is recommended to take the tablet in the evening before sleeping. The cream is applied to the outer genital area. The cream should be applied 1-3 times a day for at least 1, preferably 2 weeks to successfully treat the fungus.
Both the tablet and the cream contain the active ingredient clotrimazole. This is usually well tolerated. The advantage of Canesten is only a single application of the tablet for the treatment of the vaginal fungus.
For the treatment of vaginal mycosis there is a preparation of the brand Vagisan®. This can be purchased over-the-counter in pharmacies. Vagisan® Myko Kombi is a 1-day therapy for vaginal mycosis.
It contains a suppository and a cream. The suppository is inserted into the vagina where it fights the fungus. It is recommended to use the suppository in the evening.
The cream is used to treat the external genital area. To treat itching and pain, the cream should be applied thinly 2 times a day for at least a week. Both the cream and suppository contain the antifungal agent Clotrimazole.
An alternative to antimycotics in the treatment of vaginal mycosis are the so-called antiseptics. These contain the active ingredient povidone-iodine and are also available in different dosage forms (creams, tablets, solutions and suppositories). They are used particularly when the infection is only mildly severe and/or is only in its early stages.
It is important to note that this method of treatment should not be used if a patient has a thyroid gland disease, as the iodine supplied can lead to serious complications in such a case. There are different treatment options to treat the vaginal mycosis. Anti-fungal agents, also called antimycotics, are used for therapy.
Antimycotics are available as suppositories, creams and tablets. Mostly a combination of cream and suppositories is recommended. The cream is used for the external area and the suppository is inserted into the vagina.
To treat vaginal mycosis successfully, the cream must contain an active ingredient against yeast fungi. These active ingredients include clotrimazole, miconazole and nystatin. During pregnancy a doctor should be consulted before applying a cream.
The anti-fungal agents can be purchased over the counter from a pharmacy. The partner should also be treated in case of recurring infections in order to avoid a renewed infection through sexual intercourse. Home remedies such as natural yoghurt or buttermilk (which are to be applied to the vaginal mucosa), Döderlein preparations or lactic acid bacilli are still widely used to treat vaginal mycosis.
However, the benefits of these forms of therapy are highly controversial and it is assumed that the desired effect, if at all, can only be achieved in the short term. In the meantime, the co-treatment of a partner in the context of a fungal infection of the vagina is no longer generally recommended. In individual cases, however, when the infections recur very frequently, there is still a tendency to treat the partner with antimycotics as well in order to reduce the risk of mutual re-infection.
It is just as important, especially in the presence of a vaginal fungal infection, to change and wash underwear and towels/washcloths regularly in order to avoid reinfection with your own germs. In addition, it is of course always important to treat a possible underlying disease appropriately in order to get a vaginal fungus under control permanently. You should always consult a doctor if there is any uncertainty about the diagnosis, if you are pregnant at the same time, if the symptoms do not improve even after three days of consistent therapy or if the fungal infections recur frequently.
