Vulvovaginal candidiasis

This is one of the most common genital infections and is caused by Candida albicans in around 80–92 per cent of cases. Other non-albican species like C. tropicalis, C. glabrata, C. krusei and C. parapsilosis can also cause similar symptoms, although sometimes more severe and recurrent. C. albicans is a diploid fungus and is a common commensal in the gut flora. It is important to confirm the diagnosis with a perineal and/or vaginal swab. Conditions such as contact dermatitis, allergic reactions and non-specific vaginal infections can present in a similar manner. Testing can be done with a Gram stain or wet film examination and direct plating on to fungal media. Further testing to type the species may be required in recurrent or very severe cases as some species such as C. krusei can be resistant to some of the imidazoles, such as fluconazole.

Pregnancy, high-dose combined oral contraceptive pill, immunosuppresion, broad spectrum antibiotics, diabetes mellitus, hormone replacement therapy and HIV-infected women have a higher predisposition to develop vulvovaginal candidiasis.

Up to 30–40 per cent of asymptomatic women may have C. albicans grown on a vaginal swab. These women do not need treatment even if they are pregnant. There is no evidence of any adverse effects in pregnancy to either the mother or the baby if treated with topical imidazoles. However, the oral imidazoles are contraindicated in pregnancy.

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Women should be advised to avoid using any soaps, perfumes and synthetic underwear. The high-dose o estrogen combined oral contraceptive pill should be changed to a lower-dose pill. If there are persistent or recurrent symptoms, consideration should be given to change to a progesterone-only contraception. Check blood sugars to rule out undiagnosed diabetes mellitus and if present good glycaemic control should be the aim. Avoid recurrent courses of broad spectrum antibiotics. The treatment of vulvovaginal candidiasis can be based on whether the infection is uncomplicated, complicated or severe and recurrent.

Azoles/imidazoles are the mainstay of the treatment. They can either be used either as a local topical application (pessaries/creams) or oral preparations. There are several types of imidazoles with similar efficacy with a cure rate of over 80 per cent. The treatment is usually based on the preference of the physician, local availability and costs. The common imidazoles are clotrimazole, econazole and miconazole. Other antifungals, such as nystatin cream or pessary, can also be used. The medication can be taken as a single pessary treatment or a course of pessaries for a few days at a lower dose. The commonly prescribed medication is clotrimazole, which can be taken as single 500 mg pessary or a course of a 100 mg pessary over 6 days. Oral imidazoles, such as fluconazole, are given as a single dose at 150 mg or itraconazole 200 mg twice a day for 1 day. However, these are contraindicated in pregnancy.

There is no evidence to treat the asymptomatic male partner.

Benefiting from sex

It is not loosely said that sex could be the key to a very healthy and a successful love relationship. Leaving aside the graver risks and complications that could arise- with proper precautions, a regular run at physical intimacy could benefit you in ways more than one.

Enabling a sound and rhythmic beating of the heart

Proper, controlled sex could help you monitor your heart rate. The oestrogen and testosterone balance is invariably linked to matters of the heart. According to an expert, low levels of either could cause heart complications, even osteoporosis.

A deviant yet effective form of exercise

Your regular cardio and push-ups are very practical measures to keep your body fit. What most people are unaware of, is the fact that even sex could help shed off that unwanted fat. The activity should help you lose up to 5 calories per minute: imagine how many you would end up losing by the end of a month!

Pulling down the abnormally high blood pressure

Recent studies have promoted this fact: sexual intercourse brings about an increase in the heart rate. It could very well lead to lowering of systolic blood pressure, it suggests.

Enabling better bladder control among women

Vaginal penetration acts as a lubricant to the pelvic muscles; the constant contractions bring efficacy to the vaginal muscles, making them proficient in controlling urinary output. A strong pelvic floor is necessary to avoid incontinence and sex seems to be a practical way of doing so.

Sometimes, the core of a relationship tipping down the cliff is sex, or the lack of it. The most emotionally compatible couples eventually suffer distress because they are sexually mismatched. A depressive phase experienced by one of the partners affects the sex life and consequently, the overall relationship. Health complications or even something as trivial as shyness could affect the couple and their bedroom intimacies.

The best approach to these problems is to educate yourself with regards to the deficiencies which you face. Communicating every issue related to it, whether petty or serious, is extremely crucial. For all you know, a dissatisfying quickie could ruin the rest of your day. If one of the partners is a shyster, it is important for the person to read as much about physical intimacy so that they open up to it gradually.

Finally, we must consider this: sexual intimacy will benefit you as mentioned above, provided you carry out safe measures to practice the same. Before you make a move to the sheets, ensure that a routinely health check up is arranged for. That apart, you must not give up on other health boosters such as a balanced diet, a proper exercise regime, and most important of all, a good night’s sleep. Also, in order to enhance the libido appropriately, it would be ideal to make sex a part of your proper routine: that way, none of your daily activities are altered. To conclude with, do consider the status of your health and your partner’s before you go all the way; this should benefit both in the way that most complications are avoided or minimized.