Vulvovaginal Candidiasis

There is nothing more irritating than an irritated vulva.  Having sex, riding a bike, even just plain sitting- all of these are normally pleasurable activities that become distinctly unenjoyable when you have some form of vaginitis.

Just such irritation has been happening to me, albiet intermittently, for months.  When I saw my vaginal health professional, she diagnosed it almost immediately: a yeast infection, or vaginal thrush.  I was red in the vestibule (the external area near the vaginal opening) and the skin near there had sometimes even cracked open along a line and bled.  Apparently, this happens with some frequency in yeast infections.    She gave me double dose of fluconazole (trade name: Diflucan) because I had the infection for some time.  Great!, I thought.  This will be over very soon. 

To my surprise, I was back with the same symptoms in just a few weeks! This time she gave me three doses of fluconazole to take back to back.  Guess what? It still didn't work. 

I'm a scientist, so this time I decided to do a little independent research.  I wanted to make sure that I was being diagnosed accurately and did in fact have a yeast infection.  I consulted some medical materials and learned that I could easily do my own wet mount microscopy to look for the yeast.  Making a wet mount isn't very hard.  I just took a mucus sample from high in my vagina with a cotton swab, smeared it on a slide, and looked at it on the high magnification microscope I have access to. 

To be double sure, I also made a potassium hydroxide (KOH) wet mount.  The procedure was very similar, expect that first I made a 10% solution of KOH. Then I took the vaginal swab, dunked it in a small amount of the solution, and put some of that solution on the microscope slide. The idea behind this test is that the KOH dissolves all the skin cells and other stuff in the vaginal mucus, making the yeast easier to see. 

My scope goes up to 100x, but I could see the yeast easily even at a lower magnification.  Here is what it looked like: 

It is pretty distinct from the vaginal epithelium cells and bacteria, which looked like this: 

O.K., diagnosis confirmed.  It's definitely yeast that are causing my troubles.  But what to do?  I've already had several courses of fluconazole, no help there.  So I started doing a little internet research.  I found a few sites talking about alternative treatments for yeast infections:  herbs, essential oils like bergamot, and boric acid.  Boric acid?  did I read that right?

This is when I turn to my favorite site for looking for scientific research: PubMed. The first hit for 'boric acid candidiasis' turned up this paper: Boric Acid for recurrent vulvovaginal candidiasis: the clinical evidence, which lucky for me was a review of 14 pertinent studies that have been published to date  testing boric acid alone or in comparison to -azole drugs (fluconazole, clotrimazole, micronazole, you get the idea).   The range for cure rates in the 14 studies was between 40 and 100 %. About half of the studies that compared boric acid with an -azole drug found that boric acid was more effective. Unfortunately, 10% of women experienced negative side effects like vaginal burning sensation and redness.  Oh Hell, I thought.  I'm already there. 

After a bit more reading, I decided to try it out.  The boric acid has to be taken as a suppository, IT IS POISONOUS IF SWALLOWED.  Your health provider can prescribe it for you, but the drug must be compounded in a pharmacy or made into capsules yourself.   I went with the latter because, hey, it's be cheaper and somewhat cooler from the self-sufficiency point of view.  So I made myself capsules, each filled with 600mg of boric acid.  Locally, all I could get was granulated boric acid- it's sometimes sold in gardening stores - although I think the powdered form would have been slightly easier to dissolve for the body.  You can get the powdered form on Amazon here:  BORIC ACID POWDER HUMCO 6 OZ. This size is more than you'll ever need.  You'll also need some gelatin or vegetable capsules, (size 00) which I picked up from the health food store down the street because I wanted them now, but they are much cheaper here: Solaray - Empty Gel Caps 00, 100 capsules

The studies used a variety of treatment regimens, ranging from 600mg, once a day, for ten days up to 600mg, twice a day, for 14 days.  I decided to go with an intermediate dosage of 600mg, once a day, for 14 days.  I made exactly 14 capsules so that I would not try to change my regimen mid-treatment. I put them in a closed jar (you need to keep this stuff away from animals and children) on my night table so I could remember to put one in at bedtime.  Here is what the final product looked like:

As you can see, I'm on day nine of the treatment.  So far, the only side effect I've experienced has been a watery discharge in the morning. This happened to me on day three and day eight, but it was really no big deal.  Visually, things are looking a lot better.  My vestibule area has more of the light pink pearl-like sheen that I remember from before all this mess started. Everything feels a lot better,  too:  no itching at all since I started the treatment and sex actually felt good again!  I still have some residual soreness when I ride my bike, but it may just be that I have a crappy hard bike seat. :)

I'll post again when the treatment is completed and let you know if I'm cured!  Thanks for reading!