Bacterial Vaginosis

Chronic Yeast Infections: What Causes Them & Natural Treatment Options

Pelvic Floor Doctor
Medically Reviewed By Dr. Amanda Olson, DPT, PRPC

Introduction

Yeast infections are very common; as many as 75% of women (people with vaginas) will have a yeast infection sometime in their life (Sobel, 1997). Yeast infections are also more common during pregnancy, though this generally does not pose a risk to the pregnant person or their child (Pawlaczyk et al, 2006).

It’s generally easy to treat a yeast infection; however, yeast infections that happen multiple times a year can be difficult and distressing to manage. What might be causing your chronic yeast infections, and how can you treat them naturally?

Let’s review your options.

What is a Yeast Infection?

A yeast infection is one cause of vaginitis: inflammation or irritation of the vagina. Yeast infections are typically caused by a bacteria called candida, typically the variant candida albicans.

Symptoms usually include itching, burning, pain, and redness of the vagina, as well as abnormal discharge.

Vaginitis can also be caused by other infections, including the sexually transmitted infection trichomoniasis. If you’re not sure which one you have, you or your doctor can check your vaginal discharge.

A thick and lumpy discharge (sometimes compared to cottage cheese) can indicate a yeast infection, while yellow or green discharge with an unpleasant smell may indicate trichomoniasis (Spence & Melville, 2007).

That said, a self-diagnosis is rarely enough to determine the cause of your vaginal irritation. If you are experiencing vaginal pain, itching, or discomfort, or if you have irregular discharge, please contact your doctor.

Why Do I Have Chronic Yeast Infections?

Chronic yeast infections (or in medical terms, recurrent vulvovaginal candidiasis) are defined as 3-4 medically diagnosed yeast infections in a given year.

While most yeast infection patients report their chronic yeast infections go away after 1-2 years, others find that their condition lasts 4-5 years--or in some rare cases, decades (Sobel, 2016).

One review of 8 articles covering 17,365 patients found that chronic yeast infections occur in 3-4% of the global population (Denning et al, 2018).

We are not sure what causes chronic yeast infections. However, risk factors include diabetes (or other glucose intolerance), lifestyle, and hormonal treatments such as the birth control bill or post-menopausal HRT.

Natural Treatment for Chronic Yeast Infections

There is still much we don’t know about the cause or treatment of chronic yeast infections. While more research is needed to prove natural treatments for yeast infections, there is some evidence that shows a relationship between certain lifestyle changes and the decrease of chronic yeast infections.

Decreasing Glucose

One of the risk factors of developing yeast infections, chronic or not, is either type 1 or type 2 diabetes. This is partly due to the negative effect of diabetes on the immune system, but it’s also partly due to the role sugar plays in managing vaginal bacteria.

The bacteria that causes most yeast infections, candida, thrives when blood sugar and glycogen levels are high (Mohammed et al, 2021).

Perhaps because of this relationship, a 2011 survey of 51 patients with chronic yeast infections reported that some patients have seen a substantial improvement in the frequency of their yeast infections when they managed the level of glucose in their diet (Donders et al, 2011).

While this evidence is anecdotal, reducing your glucose intake is generally a safe and positive step in managing your physical and mental health, and may be necessary in managing or preventing diabetes.

To this end, the American Diabetes Association recommends reducing or eliminating refined sugar, white bread, and sugary cereals, and replacing starchy vegetables like corn and potatoes with non-starchy vegetables like lettuce, broccoli, and green beans.

Exercise can also be an important factor in reducing your blood sugar and managing or preventing diabetes.

Hormones

There may be a link between estrogen, a sex hormone typically found in females, and chronic yeast infections. Studies have found that postmenopausal patients taking hormone replacement therapy (HRT) are significantly more at risk of chronic yeast infections than participants of a similar age who were not taking HRT (Fischer & Bradford, 2011).

Other studies have reported that estrogen fosters the development of the bacteria that cause yeast infections (Fidel, Cutright, Steele, 2000).

Estrogen is often found in the birth control pill. The Donders study also mentioned that some chronic yeast infection patients have seen improvements when they stopped taking the birth control pill (2011).

If you’re taking estrogen through HRT or through an oral contraceptive, you may want to talk to your doctor or OB/GYN about the associated risks and potential alternatives.

Boric Acid

You might also look to a supplement, boric acid, to help manage your chronic yeast infections. Boric acid is an antifungal and antiviral supplement that has been used in the treatment of vaginal infections for over 100 years. One review of 14 studies of boric acid found that it was an effective, safe, and affordable tool in managing recurrent vulvovaginal candidiasis.

The study noted that it is probably safe during the second and third trimester of pregnancy, though had some risks in the first trimester. (Iavazzo et al, 2011). If you are planning to use boric acid long-term in managing your chronic yeast infections, talk to your doctor first.

Therapy

Therapy is unlikely to cure your chronic yeast infections. However, having chronic yeast infections can be emotionally (and financially!) taxing. It is painful, sometimes embarrassing, and can make having sex difficult.

If your chronic yeast infections are causing you emotional distress, you should be able to talk to someone about it--whether that is a therapist or your normal support system. Plus, decreasing the stress in your life may make you less susceptible to infections.

Conclusion

Chronic yeast infections can be painful and unpleasant and can disrupt the normal flow of your life.

You can reduce your risk of developing recurrent yeast infections by making lifestyle changes like diet and exercise, by talking to your doctor about your method of contraception, or by taking a supplement such as boric acid.

Therapy can also help you decrease stress in your life and help empower you to manage your physical and mental health.

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By Dr. Amanda Olson,DPT, PRPC

 

References

  1. Sobel, J. D. (1997). Vaginitis. New England Journal of Medicine, 337(26), 1896-1903. https://doi.org/10.1056/NEJM199712253372607
  2. Pawlaczyk, M., Friebe, Z., Pawlaczky, M. T., Sowinska-Przepiera, E., & Wlosinska, J. (2006). The effect of treatment for vaginal yeast infection on the prevalence of bacterial vaginosis in early pregnancy. Acta Dermatovenerologica Croatica, 14(1), 0-0. https://pubmed.ncbi.nlm.nih.gov/16603098/
  3. Spence, D., & Melville, C. (2007). Vaginal discharge. BMJ (Clinical research ed.), 335(7630), 1147–1151. https://doi.org/10.1136/bmj.39378.633287.80
  4. Sobel, J. D. (2016). Recurrent vulvovaginal candidiasis. American journal of obstetrics and gynecology, 214(1), 15-21. https://doi.org/10.1016/j.ajog.2015.06.067
  5. Denning, D. W., Kneale, M., Sobel, J. D., & Rautemaa-Richardson, R. (2018). Global burden of recurrent vulvovaginal candidiasis: a systematic review. The Lancet Infectious Diseases, 18(11), e339-e347. https://doi.org/10.1016/S1473-3099(18)30103-8
  6. Mohammed, L., Jha, G., Malasevskaia, I., Goud, H. K., & Hassan, A. (2021). The Interplay Between Sugar and Yeast Infections: Do Diabetics Have a Greater Predisposition to Develop Oral and Vulvovaginal Candidiasis?. Cureus, 13(2). https://doi.org/10.7759/cureus.13407
  7. Donders, G. G., Mertens, I., Bellen, G., & Pelckmans, S. (2011). Self‐elimination of risk factors for recurrent vaginal candidosis. Mycoses, 54(1), 39-45. https://doi.org/10.1111/j.1439-0507.2009.01754.x
  8. American Diabetes Association. (n.d.). Understanding Carbs. ADA. Retrieved February 23, 2021, from https://www.diabetes.org/nutrition/understanding-carbs
  9. Fischer, G., & Bradford, J. (2011). Vulvovaginal candidiasis in postmenopausal women: the role of hormone replacement therapy. Journal of lower genital tract disease, 15(4), 263-267. https://doi.org/10.1097/LGT.0b013e3182241f1a
  10. Fidel, P. L., Cutright, J., & Steele, C. (2000). Effects of reproductive hormones on experimental vaginal candidiasis. Infection and immunity, 68(2), 651-657. https://doi.org/10.1128/iai.68.2.651-657.2000
  11. Iavazzo, C., Gkegkes, I. D., Zarkada, I. M., & Falagas, M. E. (2011). Boric acid for recurrent vulvovaginal candidiasis: the clinical evidence. Journal of Women's Health, 20(8), 1245-1255. https://doi.org/10.1089/jwh.2010.2708