The yeast pandemic: Why women are suffering in silence

An itch. A burning sensation. An uncomfortable discharge. An unannounced visitor, whose presence assaults your otherwise calm life. It is a vaginal yeast infection and it is here to stay.

The infection usually causes a strange feeling. When it starts, most people do not know how to deal with it. So, they choose silence. It recurs. Silence, again. What most people do not realise is that the silence is costly. It is a ticking time bomb and when it finally goes off, the damage will have already been done.

“A yeast infection almost cost me my marriage,” Benta Owako tells HealthyNation. “It is one of the most embarrassing things. I was itchy and scratching made things worse. My private parts were swelling and turning red and I was in pain. Sex was painful and I lost interest, but I could not tell my husband why,” she recalls.

When she had the infection the first time, Benta’s husband accused her of having multiple sexual partners. Sadly, she also did not know what caused the infection. Her explanation fell on deaf ears. She was infected several times, but chose to keep it to herself.
When she noticed her husband was not supportive and would demand for sex despite her being in pain, she gave in because she did not want to lose her marriage.

Benta finally had enough and opened up to a friend who advised her to see a gynaecologist. Luckily, the gynaecologist managed to identify the trigger. There was a pattern. The infection would happen days before and after her menses.

She was given drugs to take at the start of and after her menses to stabilise her hormones. “People suffer due to lack of knowledge. I wish I knew the infection was treatable, I would not have suffered in silence. After that episode, I always encourage young girls to speak up when they are going through something, so that they can get help as fast as possible,” she adds.

Faith Mwilu (not her real name) believes she had her first yeast infection in high school. At the time, she was about 15 and did not understand what was happening. She thought her body was preparing her for teenage life. “I remember feeling very weird and embarrassed about it. I had a discharge and irritation ‘down there’ and I felt very uneasy. On most occasions, I would rush to the toilet to ease the itching,” she tells HealthyNation.

Abstain from sex

Faith did not tell anyone about it and was not treated. “I did not go to hospital because I was in school. I could not go to the school nurse because I was afraid of what she would say.  I thought I was dirty,” she says.

She waited until schools were closed. Confiding in her mother only added to her woes as she was hostile.

She asked Faith to explain what caused the infection. At the back of her mind, Faith knew her mother was hinting at sex. “But sex had never crossed my mind when I was in school,” says the 23-year-old.

Her mother scolded her and she was never treated. To her relief, the infection went away without medication.

Her joy was short-lived because the infection showed up again last year. She started getting recurrent yeast infections and urinary tract infections,  especially after her period. “At first I would just wait for the infection to disappear on its own,” explains Faith.

Faith had heard about home remedies for yeast infections and decided to try them. She would shower as often as possible and sleep without underwear and take yoghurt. These did not help. The infections became recurrent after sex. “I decided to keep track of the infections and I realised they mostly showed up after I had sex,” she says.

Faith chose to abstain from sex, a move that paid off. The infections stopped. “I decided to finally tell a friend about it and she advised me to go to hospital. My friends and I are very open about reproductive health, they are not judgemental and this helped,” says Faith.

Faith mustered up the courage to go to a clinic near her home. “The doctor prescribed some medication that consisted of probiotics and some other tablets and within a week, the infection had cleared,” she recalls. “It has been five months without an infection.”

In 2019, Marion Awour’s (not her real name) top Google searches were “what causes vaginal itching”, “is it normal to have an unusual discharge”, “why do I feel pain when urinating” and “what causes pain when having sex”.

The most common result for her searches - a yeast infection. She had never heard of a yeast infection before, but based on her symptoms, her suspicions were right. A hospital visit confirmed the diagnosis.

“I used to itch three days after ‘seeing’ my partner. The area would swell and after almost a week, everything would go back to normal. I would even forget that episode and move on with my life,” she explains. “Until the next time.”

Being a university student who needed to attend classes, the irritation was a nightmare.

“Due to the discharge, I had to change my underwear every time to make my life easier. Sometimes I would wear a pad the whole day,” she adds.

The three represent thousands of women who are suffering in silence because of a yeast infection. Some have even stopped their sex life because of the pain, especially when their partners are not supportive.

For Marion, sharing her predicament with her partner was not an option. The breakup that followed thereafter did not help. The infections persisted. “I talked to my friends and they advised me to buy Clozole B and apply it around the affected area. I did so and it worked wonders,” she says.

“I still had a smelly, cheese-like discharge but no pain. As months went by, things got worse. I started bleeding. I would find blood stains, which was alarming,” she says.

Marion was traumatised.

Abuse of antibiotics

In December last year, she turned to home remedies, such as taking guava leaves, but that did not help. She had not told any of her family members yet. One time she remembers feeling very tired and dizzy and had to be taken to a local clinic.

“I told the doctor everything. He asked me if I had unprotected sex and I said ‘yes’ . The discharge samples were taken to the laboratory and the results were positive for a yeast infection,” she explains.  “I was given Clotrimazole. After I finished the drugs, I still had abnormal discharge.”

Marion found a gynaecologist on Facebook. “He told me to buy Fluconazole and it was very effective. I bought eight tablets and after the third day of taking the medication, I was okay until today,” she says.

Faith says she has heard a lot of myths around yeast infections, the most popular being that it is a sexually transmitted disease. She advises girls and women to seek help should they experience any symptoms. She says it helps to have someone to confide in.

According to the World Health Organization, about 75 per cent of women will experience a vaginal yeast infection some time in their life. Up to 45 per cent of those women will have repeat yeast infections.

Explaining a yeast infection, Dr John Ong’ech says it is very common and not necessarily sexually transmitted. The infection can be caused by frequent use and abuse of antibiotics. Family planning methods, especially a coil, can also trigger an infection.

Immune system disorders may cause yeast to grow uncontrollably in your body and usage of douching products, including soaps and vaginal sprays, automatically changes the balance of bacteria in your vagina, says Dr Ong’ech.

The overuse of antifungals can also increase the chances of resistance, which keeps the yeast coming back. “I know some women can get a yeast infecrtion from their partners because they can be carriers, but it is not one of the major causes of infection,” he says.

He says 90 per cent of his patients have yeast infections, especially pregnant women. “This is common among women and it should not worry you. But you should get treated,” he says, adding that men can also get penile candidiasis, but it is not common.

According to him, the infection happens when the balance of yeast and bacteria in the vagina is tampered with, allowing fungus known as candida to multiply. When it multiplies, it becomes powerful and causes itching or a burning sensation and sometimes a discharge.

Depending on when and how it presents, the infection can either be mild, moderate or severe for those who have had it for long.
He advises women to seek medical attention whenever they suspect they have a yeast infection before it gets complicated.

Treatment will include the use of long-course vaginal therapy (treatment with a cream, ointment, tablet or suppository for two weeks) or multi-dose oral formulations.

The expert warns against use of traditional herbs, including garlic, and douching to treat yeast. He says there are no studies to support the claim that garlic has anti-fungal properties, and since a yeast infection is fungal, he advises on medication.

Garlic, he says, has chemicals that automatically alter the PH of the vagina. Using it can cause more harm than good and lead to diseases, including cancer in the future.

Ensure hygiene

“Garlic contains bacteria, which is very dangerous because the area is very sensitive. Use of perfumed oil can also be dangerous. The vagina has a way of cleaning itself. It is a ‘perfect’ environment for botulism bacteria to grow, which can be life-threatening. When you develop any symptoms, see a doctor,” he says.

Botulism, a condition caused by Clostridium botulinum bacteria, can be offset when a person eats food containing toxins because it has not been properly canned, preserved or cooked.

On why an infection can recur, Dr Paul Mitei, a gynaecologist in Western region, explains that it is common and does not mean that one is dirty.

“The infection can return even after treatment may be because a partner is a carrier and he is not treated and may be when one is using medication that alters the hormones in the body,” says Dr Mitei.

To prevent further recurrence, Dr Mitei advises women to choose good underwear, recommending cotton. “Sleeping without underwear can also help reduce the infection,” he adds.

Having good hygiene can also prevent one from a yeast infection. “Wash the area well with a clean towel, avoid using perfumed soaps, and once you are done showering, dry the genital area gently but thoroughly to remove any excess moisture,” he says.

It is also recommended that after visiting the washroom, one should wipe from front to back. Doing the opposite encourages the spread of yeast or bacteria in the anus, urinary tract, or vagina. It is also advisable to change pads or tampons after four hours to prevent vaginal infections.

Dr Mitei warns against staying in a swimsuit for a long time since it keeps the area warm and wet and this fosters the spread of yeast.