Why did this patient and her partner repeatedly suffer yeast infection in spite of treatment?
It's often said there is nothing new under the sun. But just when you believe you've seen everything, something new and surprising turns up. So please don't teach your dog this patient's trick! It can give you more than you bargained for.
Studies show 75 per cent of women suffer at least one yeast infection during their lifetime and up to 50 per cent face repeated episodes. Anti-fungal vaginal medicine used to be available only by doctor's prescription. But in the mid-1990s, common medications such as Monistat and Canesten cream became over-the-counter items (OTC).
This resulted in huge sales. But millions of dollars may as well have been poured down the drain. Often the wrong OTC item was purchased to treat the disease, or in some cases no disease.
Dr. Daron Ferris, professor of obstetrics and gynecology at the Medical College of Georgia, headed a research team that studied 95 women with vaginal irritation. All the women believed a vaginal yeast infection was their problem and had purchased OTC medication.
Gynecologists carried out pelvic examinations and vaginal cultures to determine the diagnoses. The result? Only one-third of these patients had a yeast infection!
The others were suffering from a variety of other vaginal infections such as trichomonas, a common single-celled organism that causes discharge and irritation. Others were diagnosed with bacterial vaginosis due to the germ gardenerella. In 14 per cent of the women, doctors were unable to detect any vaginal infection at all!
Faced with so many errors in diagnosis, should yeast medication remain an OTC item? As has been aptly said, "He who treats himself has a fool for a patient."
But making it difficult for women to acquire this medication isn't the solution. Vaginal yeast infections are terribly itchy and need prompt treatment. And these days it takes too long to get a doctor's appointment.
Besides, even if a doctor's appointment is available, it doesn't always ensure the right diagnosis. The doctor may be rushed for time and fail to do a pelvic examination or a microscopic exam of vaginal discharge or a culture to pinpoint the diagnosis.
Fortunately, yeast infections are harmless. But a number of factors can trigger a sudden overgrowth of yeast. Antibiotics may kill disease-causing bacteria but can also kill good bacteria in the vagina that normally protect against yeast infection.
The hormonal changes of pregnancy can stimulate the growth of yeast. Women who have diabetes with increased amounts of sugar in the vagina are also more prone to develop this trouble.
But the patient who kept returning to the doctor's office complaining of intense irritation had none of these problems. She would be free of symptoms for several days during treatment. But as sure as night follows day, she would eventually return loaded with yeast. Despite taking showers rather than baths and using different medications, one failure followed another. As well, her partner who shared these recurrent infections was far from a happy camper.
A similar case frustrated me one time. Only after several failed attempts to rid my patient of yeast had I asked this question: "Do you have any animals and do they sleep with you?" She admitted she had a cat and yes, the cat often slept with her. So the cat was examined by a veterinarian and found to suffer from a vaginal yeast infection. Case solved.
My colleague, faced with repeated failure, decided to ask if his patient had an animal living with her. She replied she did have a small dog and the dog did, in fact, enjoy the comforts of her bed on many occasions. But that was nothing new.
It was only after intense probing that she finally admitted with embarrassment to teaching her dog a trick. Since she was away all day at work, she had taught the dog to urinate in the bathtub! The dog had a yeast infection!
Now that was something new under the sun! Please don't teach your dog this trick.
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