NUNM students have many opportunities to explore topics, research and areas of practice that interest them. From broad elective choices to research study participation and self study, our students choose the doctor they want to become. Rachel Peterson, naturopathic doctoral student, shares her research and perspectives on the healing candida or a yeast infection with natural medicine.
Often referred to as a “yeast infection,” vulvovaginal candidiasis (VVC) affects an estimated 75% of all women at least once in their lifetime. 45% of women with candida have multiple outbreaks, and between 5% to 8% have a recurrent condition, with four or more outbreaks in just one year. As these statistics demonstrate, vulvovaginal candidiasis is both common and incredibly prevalent. In this article, we will review exactly what candida is, how it affects a woman’s body, and how to promote health to clear candida naturally.
Vulvovaginal candidiasis (VVC) occurs when the balance between beneficial bacteria and potentially harmful bacteria in the vagina becomes unbalanced. The vagina houses an estimated 50 different bacterial organisms that maintain an optimal pH between 3.5 to 4.5 for defense against pathogens. Candida albicans (Candida) is one of the main species of yeast present in the vagina and is predominantly kept under control by the beneficial bacterial species lactobacillus. In a healthy vagina, lactobacillus accounts for about 90% of the vaginal population, and produces lactic acid and hydrogen peroxide, both of which create an acidic, protective environment. Imbalances occur when lifestyle and environmental factors decrease our lactobacillus population, allowing candida to proliferate excessively. Oral birth control pills, spermicides, lubricants, antibiotics, and synthetic underwear are common contributors to a bacterial imbalance. If you struggle with frequent VVC infections or want to prevent an infection, checking your medicine cabinet or personal care products for possible contributors may be a good place to start.
Candida has become a major buzzword in the health-conscious community, as articles and books covering the condition seem to be everywhere these days. With a dramatic surge in mainstream exposure, it is important to read and analyze these articles critically. There is a great deal of controversy about how candida spreads and how deeply it can affect an individual’s overall health. Some alternative practitioners diagnose women with “systemic candida,” describing a candida overgrowth that has traveled into the blood stream and spread throughout the whole body, causing a myriad of symptoms including headaches, fatigue, poor digestion, and skin conditions to name a few. Conventional medicine calls this condition “systemic candidiasis,” but this rare condition truly only occurs in patients with significant immune compromise (for example: those patients who are on immune suppressants after organ transplant or conditions like HIV). The seriousness of systemic candidiasis should be noted, as this condition correlates with other diseases and infections of the heart, lungs, and central nervous system. When some alternative practitioners refer to systemic candida, they are most likely misusing the name of the pathology and actually referring to an imbalanced microbiome and not to candida in the blood stream. Regardless of whether you see a naturopathic doctor or a conventional physician, it is important to avoid mislabeled diagnoses.
For a suspected case of VVC, it is important to seek physician support. With easily accessed, over-the-counter, conventional treatments, many women misdiagnose and mistreat themselves, or fail to address an underlying condition. Diabetes, Cushing’s disease, Addison’s disease, hypothyroidism and hyperthyroidism, leukemia, and pregnancy are all examples of conditions that may cause recurrent yeast infections. Most women with VVC experience itching and discomfort. Additional symptoms include inflammation and swelling of the vagina and vulva, pain during urination and intercourse, and thick vaginal discharges that resembles cottage cheese. Symptom relief may occurs with the flushing of menstruation.
Given the pervasiveness of VVC, taking a holistic approach to not only support alleviation of symptoms but to try and understand the root cause of the manifestation of symptoms seems both prudent and necessary. In addition to alleviating symptoms, treatment focuses on balancing the vaginal ecology and pH, strengthening the immune system, and decreasing inflammation. To balance the vaginal microbiome, we must also restore the gut microbiome through diet. Connecting the two, a 1977 study found that all female participants with recurrent VVC had candida present in the stool, while those without VVC did not. Although more research is necessary to establish the connection, the link between gut and vaginal bacteria could be vital for many patients. Diet affects our immunity, hormonal balance, and vaginal ecosystem, which sets the foundation for further prevention and treatment of disease. Specifically in targeting candida overgrowth, it is important to avoid dietary sugars, simple carbohydrates, and alcohol, which not only decrease our immunity but also allows Candida to thrive.
As a nutritional supplement, lactobacillus can help compensate for the deficit that occurs during a candida overgrowth. Research remains inconclusive, but there are studies that indicate the efficacy of supplementation. One study demonstrated the role of lactobacilli as important immune modulators and showed that women with more lactobacilli are less likely to contract VVC, as well as bacterial vaginosis. Lactobacillus can be ingested in many forms: orally as a probiotic, in probiotic foods like yogurt, or intravaginally. One study on women with HIV compared intravaginal lactobacillus acidophilus to conventional anti-fungal tablets and demonstrated both treatments had the same efficacy. As with all probiotic capsules and foods, it is important to analyze the labels and make sure they contain high-quality lactobacillus acidophilus, without added sugars that can exacerbate the issue.
Women’s health expert and naturopathic physician, Tori Hudson, ND, states that boric acid vaginal suppositories are the most effective natural treatment for VVC. One study demonstrated boric acid to have a 98% cure rate on patients who were unaffected from conventional antifungal agents. In addition to the positive research, boric acid is inexpensive and accessible. Dr. Hudson recommends 600 mg vaginal suppositories twice a day for 3-7 days with acute infections, and for 2-4 weeks for chronic infections. It can also be used preventatively, for 4 days per month during menses for several months.
There are many other natural remedies for vulvovaginal candidiasis, but the key element in this discussion is to think about, and treat, the whole body when faced with a candida infection. Naturopathic physicians help support patients in discovering the innate healing properties of their bodies, strengthening their immune systems, supporting the colonization of beneficial bacteria, and working with diet, lifestyle and natural supplements to prevent and treat vulvovaginal candidiasis. Working together holistically and also individually, with each unique patient in front of us, can help encourage lasting results.
- Hudson T. Women’s Encyclopedia of Natural Medicine. New York, NY: McGraw Hill; 2008.
- Gates D, Schatz L. The Body Ecology Diet: Recovering Your Health and Rebuilding Your Immunity. Carlsbad, CA: Hay House; 2011.
- Brown D. Probiotics: Key Players in Female Genitourinary Tract Health. Naturopathic Doctor News and Review. https://ndnr.com/womens-health/probiotics-key-players-in-female-genitourinary-tract-health/. Published December 3, 2018. Accessed February 27, 2019.
- Vaginal Yeast Infections: Symptoms, Causes, Risk Factors, Care, Treatments. WebMD. https://www.webmd.com/women/guide/understanding-vaginal-yeast-infection-basics#1. Accessed February 27, 2019.
- Miles MR, Olsen L., Rogers A. Recurrent vaginal candidiasis. Importance of an intestinal reservoir. JAMA. 1977; 238 (17): 1836-37. https://www-ncbi-nlm-nih-gov.nunm.idm.oclc.org/pubmed/?term=Recurrent+vaginal+candidiasis.++Importance+of+an+intestinal+reservoir
- Mitchell C, Fredricks D, Agnew K, Hitti J. Hydrogen peroxide-producing lactobacilli are associated with lower levels of vaginal interleukin-1β, independent of bacterial vaginosis. Sex Transm Dis. 2015; 42(7): 358-63. doi: 10.1097/OLQ.0000000000000298.
- Williams AB, Yu C, Tashima K, Burgess J, Danvers K. Evaluation of two self-care treatments for prevention of vaginal candidiasis in women with HIV. J Assoc Nurses AIDS Care. 2001; 12 (4): 51-57. doi: 10.1016/S1055-3290(06)60216-1.
- Jovanovic R, Congema E, Nguyen H. Antifungal against versus boric acid for treating chronic mycotic vulvovaginitis. Journal of Reproductive Medicine. 1991; 36 (8): 593-97. https://www.ncbi.nlm.nih.gov/pubmed/1941801.
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