Monilia (vaginal infection)

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Download a PDF copy of the SHFPACT fact sheet Monilia here

MONILIA is a very common vaginal infection caused by a yeast called monilia, thrush or candida albicans. MONILIA IS NOT AN STI, nor is it dangerous - just a terrible nuisance which can keep coming back. Symptoms
Remember that symptoms may not be present at all, but can include:

  • vulval soreness , pain during intercourse;
  • vulval itching that can be mild or severe;
  • a white, yeasty smelling discharge (that looks like cottage cheese);  
  • redness or swelling of the vulva or foreskin;
  • stinging when you pass urine.

Monilia may also be present and cause no symptoms at all.

What causes a Monilia infection?
A MONILIA infection can occur when the normal bacteria of the vagina is upset. The vagina is normally mildly acidic and if the acid balance changes, yeasts from the bowel, or those which normally occur in the vagina, can multiply and cause the symptoms listed above.

Anyone can get MONILIA but you are more likely to get it if you are:

  • run down (eating badly, sleeping poorly, stressed, eg exams)
  • taking antibiotics or are on the Pill
  • pregnant
  • experiencing menopause
  • diabetic

Or you:

  • frequently use vaginal douches, or take bubble baths.
  • usually wear tight pants/jeans, panty hose.
  • You may be more likely to get it after intercourse with some men rather than others - some men have more alkaline semen, or Monilia may be present under the foreskin if uncircumcised.

Tests
It is recommended that you have a swab of the discharge taken for testing, to determine whether you have Monilia or some other infection (yellow, grey or very smelly discharge with no itch is more likely to be trichomonas, gardnerella or non-specific bacterial infection). It is possible to have more than one infection at the same time. If the problem recurs later, and the symptoms are exactly the same, it may not always be necessary to repeat the swab test but if anything is different from a previous attack, a swab should always be done.

Treatment

Treatments are available as vaginal creams or pessaries. Creams come with applicators, which should be filled and the cream inserted inside the vagina at night. The cream can also be used externally. Pessaries are large tablets or capsules, which can be inserted in the vagina with your finger or with an applicator. It is important to use the full course of cream or pessaries, even if you get your period.

Some common brands of vaginal treatment are: Nystatin, Monistat, Econazole, Pevaryl, Canesten.  Most of these products are available from the chemist without a doctor’s prescription.  Remember to ask for vaginal cream, as skin creams are also available. NB: These preparations may damage latex condoms & diaphragms.

Boric acid pessaries (prescription required) are sometimes helpful, especially if a swab shows candida non-albicans.  Sometimes, a course of oral medications such as nystatin, nizoral or diflucan is necessary in very resistant cases (prescription required). NB: These drugs must be avoided in pregnancy and breast feeding. They may interfere with the Oral Contraceptive Pill.

Self-Help Treatments
Vinegar or Lemon Juice (mild acids)
Use a solution of one part of these to 5 parts of water. You can soak a small tampon in the solution, squeeze it out slightly, then insert it in the vagina. Replace the tampon 4 to 6 hourly.

Herbal remedies
There are a wide variety, but their efficiency and safety are not necessarily medically proven. Usually available through alternative health shops:

  • A douche of 1/3 golden seal extract, 1/3 calendula extract, 1/3 white pond lily extract and a couple of drops of sandalwood oil. Make up 100ml. Use three times a day for 5 to 7 days, or possibly longer.
  • Calendula ointment applied externally can be soothing.
  • A mixture of thuja, golden seal, comfrey and crab apple, using 1 teaspoon in 1 cup of warm water twice a day as a douche.

What about sex?
Sexual intercourse is not advisable until treatment is completed because it will be uncomfortable and you can transfer the infection to your partner.

General Advice

  • Wear cotton rather than nylon underwear
  • Avoid tight jeans/pantyhose
  • Keep the genital area dry and well aired, as much as possible
  • Change out of wet swimwear as soon as possible
  • Wipe from front to back with toilet paper
  • Uncircumcised men should wash under the foreskin daily
  • Avoid bubble baths, heavily perfumed soaps, vaginal deodorants, deodorised panty shields
  • Avoid soap for washing your genital area
  • Improve your diet ie: less sugar and refined carbohydrates, adequate Vitamin B (yeast, liver, wheatgerm, yoghurt, whole grain cereals and green leafy vegetables) and Vitamin A (liver, butter, cheese, egg yolks, apricots, dark green vegetables) Sometimes yeast free diets help
  • Have enough rest and relaxation

Prevention of Recurrences
Acijel

Available from SHFPACT or Chemists. A mildly acidic jelly, inserted into the vagina with an applicator. It should be used for 5 to 7 nights.

Natural Yoghurt

Natural yoghurt containing acidophilus helps restore  normal conditions for the vagina. Insert the yoghurt either  with a plastic applicator (available from SHFPACT or chemist) or using a tampon with a cardboard applicator (push the tampon down inside the applicator, fill the tube with yoghurt, insert the tampon into the vagina pushing the yoghurt with it, and either leave or remove the tampon as you prefer). Use approximately 5mls for 5 to 7 nights. Cold yoghurt also feels very soothing on an itchy vulva.
Download a PDF copy of the SHFPACT fact sheet Monilia here

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