Many medical students are taught simple sayings to help them make the most accurate diagnosis possible. One such saying that comes to mind is “all that wheezes is not asthma” – meaning that just because a patient is wheezing when you listen to the lungs with a stethoscope, it does not mean they have asthma. There are many other conditions that cause wheezing; everything from heart failure (probably the most common cause of wheezing) to aspirating a foreign substance such as a toy part or even a tumor. The saying is important because it reminds doctors to be thorough in their evaluation and not to be fooled.
I propose another saying that should be heeded by women and doctors alike, “all that itches IS NOT yeast”. Most women will have at least one vaginal yeast infection at some point in their lives and will remember all too well the severe itching and discharge. Often the yeast infection followed a course of antibiotics allowing the yeast to overgrow and “set up house” so to speak. However itching outside the vagina (an area called the vulva) is more commonly caused by problems other than a yeast infection – everything from allergies, to dry vagina from lack of estrogen and even other bacterial infections.
According to Susan Hoffstetter of the Saint Louis University School of Medicine who recently analyzed the records of more than 150 new patients who thought they had yeast infections only 26 percent actually did have yeast. She warns that women should not be so quick to pick up the over the counter yeast treatment but rather get appointments with their health care practitioners to be evaluated first.
The good news for women who think they may have a yeast infection is that there are simple things you can do to help you decide whether to pick up the phone and make an appointment with your doctor. If you are experiencing vaginal symptoms such as itching and a discharge you can buy a simple over-the-counter self-test kit to help you determine whether the infection may be yeast or possibly something else.
Yeast infections typically don’t affect the usually low or acidic pH of the vagina fluids. The pH of the vaginal fluid with other infections such as bacterial vaginosis (also called BV) and trichomoniasis (commonly referred to as trich) typically is much higher or more basic. So a simple and reliable test of the pH is available for you to use at home. If your pH is low and therefore normal, you could safely try one of the many effective yeast medications that can be purchased without a prescription. If your pH tests abnormal and high you can be sure it is worth your time making an appointment to get the correct diagnosis and best treatment.
Bottom line for all women however is that if your symptoms don’t go away with over-the-counter treatment for yeast infection, it is well worth your time making an appointment to find out exactly what is wrong. Post-menopausal women with low estrogen may benefit from a vaginal hormone cream; other women may find they are allergic to something they are using and would be helped by avoiding all perfumed hygiene products and switch to hypoallergenic baby wipes. Other women may need to be treated for BV, trich or other infections.
To your health!