Category Archives: Yeast Infections and Women

Candida Yeast Infections Affect Women In Many Ways. They Can Have Vaginal Yeast Infections, Digestive Disorders, Skin Infections And Much More.

Vaginal Yeast Infection: Causes, Symptoms and Treatment

Vaginal yeast infection, also known as vaginal thrush, vaginal/vulvovaginal candidiasis (vvc) or candida vulvovaginitis is one of the most common yeast infections. Generally people think of vaginal yeast infection when they come across the term “yeast infection”. However, vaginal yeast infection is just one type of yeast infection and candida yeast can actually cause infections of different body parts – mouth, gut, skin, penis etc. You can discover more about these different types of infections here.

According to Centers for Disease Control and Prevention (CDC), it affects 75% of all adult women at least once in their life. Candida yeast is a normal inhabitant of the vagina – it lives there along with bacteria like lactobacilli; however, under certain conditions candida can multiply extensively causing it to overgrow.

Candida overgrowth leads to inflammation and classic symptoms of vaginal yeast infection. Vaginal yeast infection can sometimes become recurrent – when someone has a vaginal yeast infection at least 4 times in a year the infection is considered recurrent. It is estimated that about 5% of women in their reproductive years get recurrent vulvovaginal candidiasis.

This article will provide you detailed information on everything you need to know about vaginal yeast infections and help you make informed decisions regarding your treatment.

Causes and Risk Factors

To know how to manage, treat or even prevent vaginal yeast infections, we need to know why this infection happens in the first place. Why do some women get these infections very often while others never get it? What puts you at higher risk for getting these infections?

1) Weakened immune system: It is generally women with weakened immune system who get vaginal yeast infections. As a normal inhabitant of vagina, candida yeast does not cause any trouble because the local antibodies secreted by the vagina keep the population of candida in check. However, in women with weakened immune system, the body is not able to keep the growth of candida under control and candida overgrows causing infection.

So, when is it that your immune system becomes weak? If you have AIDS or diabetes, you are sure to have a weakened immune system. Apart from this, nutrient deficiency can cause you to have reduced immunity to pathogens. A review article published in 2005 by Cunningham-Rundles, McNeeley and Moon describes in details the mechanisms by which nutritional deficiency can cause lowered immunity. Vitamin A, beta-carotene, folic acid, vitamin B12, vitamin C, riboflavin, iron, zinc, and selenium affect our immunity and lack of these can cause decreased immunity and increased susceptibility to infections.

Related articles:

A 1986 study by Edman, Sobel and Taylor showed clearly that women with recurrent vaginal candida infection had significantly lower zinc levels in the blood. Deficiency of vitamin A also leads to lowered mucosal immunity and could be one of the reasons that can lead to vaginal candida infections. It is therefore important for you to assess if your nutritional intake is balanced and does provide you all the vitamins and minerals that you need for proper immune response.

The question that might bother you now is “I do not have any immunity weakening disease. How do I know if I have lowered immunity due to other reasons”? Look for the following signs:

  • a) You eat too much sugary stuff: Studies carried out in the 1970s by scientists invariably showed that consumption of sugar reduced immune function in different ways. For example, Sanchez and colleagues showed in 1973 that after consuming 100g sugar, the immune cells called phagocytes had very reduced function 1-2 hours after consumption. The effect lasted up to 5 hours after sugar intake.In 1982, Samaranayake and MacFarlane from Scotland showed that dietary carbohydrates had an effect on adherence of candida cells to our epithelial cells which line all our tissues and organs. They showed that when candida grew in the presence of certain carbohydrates, its ability to adhere to the epithelial cells was significantly increased. So eating sugary and starchy stuff can also make you more susceptible to vaginal candida infections – not only by reducing your immunity, but also by increasing the adherence of candida to the vaginal cells.
  • b) You have regular respiratory infections: According to American Academy of Allergy, Asthma and Immunology, too many infections (including respiratory infections) in a year can signal a lowered immune status.
  • c) You are chronically stressed: If so, you are more than likely to have a suppressed immune system. A meta-analysis of 300 research studies was done jointly by Segerstorm and Miller. This 2004 study showed convincingly that, under chronic stress, immunity afforded to us by both the immune cells and the antibodies is suppressed.
  • d) You do not drink enough water: If you do not drink enough water, you end up accumulating the toxins that would otherwise get flushed out of your body. These toxins affect your immune system in a negative way.

2) Antibiotic usage: Frequent antibiotic usage decreases the vaginal microflora, especially lactobacilli. The normal vaginal microflora is protective against candida overgrowth. Once this normal flora gets disturbed by antibiotics, it makes you susceptible to candida infection. Xu and colleagues did a study in 2008 that showed clearly that use of even short courses of antibiotics increased both the vaginal colonization and symptomatic vaginal candida infection. A 2009 Indian study of over a thousand women by Ahmad and Khan found that 44.8% of antibiotic users had vaginal candida infection as compared to only 12.9% of non-users. Read our comprehensive article on antibiotics and yeast infection connection to learn more.

3) Uncontrolled diabetes: Another one of the major risk factors is poorly controlled diabetes. It can also result in chronic or recurring vulvovaginal candida infections. A study by Leon and colleagues which was published in 2002 showed that people with type I diabetes (insulin dependent) are three times more likely to have excessive candida as compared to those with type 2 diabetes (not insulin dependent). Watch this video by Eric Bakker to learn about candida and diabetes connection.

4) Estrogen excess: It has been shown clearly that estrogen helps candida grow in environments that would otherwise be bad for it. For example, a research study by Zhang and colleagues published in 2000 showed that when candida was exposed to estrogen, it grew better and could even survive unfavourable conditions such as temperatures as high as 48oC.

There is also another way by which estrogen aids establishment of candida infection. Spanish researcher Relloso and colleagues published data in 2012 which showed that increased estrogen during ovulation and period following it impairs the immune response against candida. Additionally, studies done back in 1989 on vaginal epithelial cells by Kalo-Klein and Witkin had already showed that estrogen and progesterone inhibited the cellular immune response against candida.

It is difficult to point at a single factor that leads to candida infection – some people who do have estrogen excess do not get candida infection. This points towards a combination of factors that could be at work when a person gets a candida infection. In a recent 2016 article, Wang and colleagues described their research work in mice showing that a combination of estrogen and immunosuppressive agents like steroids are ideal for candida to establish itself in the vaginal mucosa. Thus, if you have excess estrogen while you are having immunosuppressive agents (or a lowered immunity due to any other reason), you will be more likely to get vaginal candida infection.

You may have estrogen excess in following conditions:

  • a) Use of oral contraceptives: Almost all oral contraceptives are a combination of synthetic estrogens and progestins. Thus, they add a constant level of excess estrogen. There are many studies that show that use of oral contraceptives is linked with an increased risk for vaginal candida infections. For example, a 2009 Indian study on over a thousand women by Ahmad and Khan found that 57.5% of oral contraceptive users had vaginal candida infection as compared to only 11.8% of non-users. However, there are some studies that do not find any such link. Although this link is controversial, oral contraceptives do increase your estrogen levels on a regular basis and, combined with other factors, could put you at higher risk for vaginal candida infections.
  • b) Hormone replacement therapy (HRT): Postmenopausal women have a decrease in hormone secretion and are at risk for developing conditions such as osteoporosis, diabetes, heart disease etc. To counter this, they may be placed on HRT. However, women receiving hormone replacement therapy have a higher risk of developing vaginal candida infections as has been shown by many researchers. Dennerstein and Ellis showed with their study on postmenopausal women in 2001 that there is a significant relationship between use of estrogen and candida infection. They found that this was because estrogen stimulated maturation of epithelium which led to production of glycogen. Glycogen acts as an attractive substrate for growth of candida.
  • c) Pregnancy: During pregnancy a woman produces more estrogen than she produced in her whole life when not pregnant!! Pregnancy seems to increase both the level of colonization of vagina by candida as well as the risk for symptomatic candida infection as has been seen from scientific research. Ahmad and Khan’s study on over a thousand women in 2009 found pregnancy to be a strong risk factor for vaginal candida infection with 76% of pregnant women having the infection as compared to only 31% of nonpregnant women. The increase in risk of getting vaginal candida infection is due to the increase of sex hormones (which includes estrogen) in pregnancy – especially in the last trimester where the estrogen levels peak.

5) Immunosuppression: Suppression of immunity either due to a disease (like HIV), or use of immunosuppressive drugs (like corticosteroids used as anti-inflammatory drugs, immunosuppressant given during organ transplant or to treat autoimmune disease) can put you at a higher risk for vaginal candida infection. It reduces the person’s ability to fight infections as well as reduces the protection of vaginal tissues by antibodies.

6) Use of intrauterine devices (IUDs): Use of IUDs for contraception increases your risk of getting vaginal candida infection. Demirezen and colleagues from Turkey showed in 2005 that prolonged use of IUD can predispose a woman to vaginal candida infection. They also proposed that IUDs may reduce lactobacilli in vagina and thus also increase the risk for candida growth. Additionally, Demirezen and colleagues found that IUDs destroy cervical mucus which acts as a barrier against infections.

That candida is able to form biofilm on IUDs was shown by Auler and colleagues from Brazil in 2010. They studied women using IUDs who had vaginal candidiasis and concluded that biofilm on IUDs is an important risk factor for vaginal candida infection.

7) Use of Spermicides/condoms: Several research studies have found use of spermicides-condoms associated with a higher risk for vaginal candida infections. McGroarty and colleagues from Canada reported in 1990 that this association is due to the spermicidal compound nonoxynol-9 (N9) which increases the adhesion of candida to the cells. In 1999, Watts and colleagues showed that N9 also had a negative effect on the normal flora of the vagina. As the normal flora keeps candida population in check, any alteration in this is likely to promote candida growth.

Other suggested reasons include allergy to latex, sensitivity of vaginal cells to condom and small traumas to the vagina which all could potentially promote the growth of candida. Consult with your doctor in this case.

8) Poor personal hygiene: A 2009 Indian study by Ahmad and Khan found that 36.5% of women with poor genital hygiene had vaginal candida infection as compared to only 15.6% of women with good genital hygiene. Poor personal hygiene can make you more susceptible to candida infections by increasing the numbers of candida in the vagina. Improper intimate hygiene practices (like wiping back to front) can also allow candida from the gut to colonize the vagina and is likely a major source of candida.

9) Orogenital sex: Receptive oral sex has been found to be one of the risk factors for getting vaginal candidiasis. One-half to one-third of the population has candida in their mouths. Reed and colleagues showed with their research in 2009 that candida can indeed be transmitted from mouth to the vagina. They also showed that orogenital sex is associated with increased incidence of vaginal candida infection. They proposed that saliva may also promote adherence and growth of candida in the vagina by providing moisture and also acting as an irritant or by changing the immune response.

10) Clothing habits and hygiene: Using tight and poorly ventilated clothes or using synthetic underwear increases your risk for getting vaginal candidiasis. This is likely because such clothing increase moisture and temperature levels in the vaginal area, thereby promoting growth of candida. Neves and colleagues have also suggested in a 2005 study  that synthetic underwear could cause allergic reactions that change the vaginal environment leading to vaginal candida infections.

Signs & Symptoms

Signs and symptoms of vaginal candidiasis are not totally specific to this condition – similar symptoms can be seen in conditions other than vaginal candidiasis. Presence of candida in the vagina also does not point towards vaginal candidiasis as many women with candida colonizing their vagina remain asymptomatic.

Some of the symptoms that a woman with vaginal candidiasis will have are:

• Vaginal and vulvar itching, intense itching that can drive them crazy
• Redness in the vaginal and vulvar area (sort of rashes)
• Painful urination (this is a biggie)
• Painful sexual intercourse (this could also be UTI)
• Discharge that is generally thick cottage-cheese like, and that does not have any strong odour

You can access a table that gives an overview of different conditions that have similar symptoms, here.

One must be extremely cautious when self-diagnosing. A 2002 study by American scientists from D. G. Ferris’ laboratory found that only one-third of the women were able to correctly diagnose themselves. A wrong self-diagnosis is generally accompanied by the wrong use of over-the-counter antifungal agents. This does not solve the woman’s issues with infection, in fact it delays treatment and also can lead to development of antibiotic resistant types of candida.

If you have any of these symptoms and suspect that you have vaginal candidiasis, your best option is to visit your health care provider and ascertain using lab tests if what you have is indeed candida infection.

Tests & Diagnosis Available

When you suspect that you have vaginal candidiasis it is important to get correct diagnosis.

You may use an at-home screening kit (like Vagisil screening kit or Monistat vaginal health test) to test for the cause of your infection. Keep in mind that this is only an assessment test and cannot identify specific cause of the infection and cannot be used to self-medicate.

The kits basically check for the pH (acidity) of your vagina. They come with two individually wrapped wands with a pH paper attached to one of the ends. A normal vagina has a pH between 4 and 4.5. If your vaginal pH is above this pH, the cause could be due to bacteria, trichomonas, or if you are post-menopausal it could also be due to atrophic vaginitis. If on the other hand, the pH is between 4 and 4.5, you could have vaginal candidiasis or irritant vaginitis.

After you have conducted the screening, you will need to see your doctor to make a confirmatory professional diagnosis of the specific cause of your problem.

A professional diagnostic lab will carry out the following tests to determine the cause of your infection:

a) Microbiological tests: The discharge will be checked for presence of candida. A wet preparation of the discharge (saline and 10% KOH) or Gram stain will be checked under the microscope for presence of candida in abnormally large numbers. In women where the microscopy is negative for candida, cultures of candida will be done. Cultures are also used to identify the specific type of candida and whether the infection is caused by unusual nonalbicans candida species like candida glabrata. Sometimes antibiotic sensitivity test will also be carried out to decide on the best treatment.

b) Biochemical tests: KOH whiff test is done to test for bacterial vaginosis. This test is negative for candida infections. A few drops of potassium hydroxide solution are added to a vaginal discharge sample and is then checked for a strong fishy odour. If such an odour is present, it indicates bacterial vaginosis and sometimes may indicate trichomonas infection.

Treatment – How To Treat The Issue

Sometimes vaginal thrush will go away on its own and will not need treatment – it depends on how much your body is able to fight the infection on its own and how strong your immune system is. Vaginal candidiasis generally needs to be treated because an uncomplicated vaginal candida infection can become complicated and severe if left untreated. Additionally, there is a risk that you will pass on the candida to your sexual partner. Development of bacterial vaginosis or urinary tract infection is another complication that you may face if you leave your infection untreated.

Let us look at the treatment options that are routinely used to treat vaginal candida infections, their benefits and problems, and also some natural treatment that you could use instead of the pharmaceutical treatments.

Pharmaceutical treatment:

Vaginal candidiasis is classified into two types and the pharmaceutical treatment is based on the type:

  • Uncomplicated vaginal candidiasis: When the vaginal candidiasis occurs infrequently, in a woman who does not have a compromised immune system due to diseases like AIDS or diabetes, and produces only mild to moderate symptoms. This type of candidiasis is caused by Candida albicans.
  • Complicated vaginal candidiasis: When vaginal candidiasis is recurrent or severe or which occurs in women with diabetes, AIDS or immunosuppressive therapy. Cases involving nonalbicans candida are also classified as complicated vaginal candidiasis.

For uncomplicated candida infection, short-course ointments (one application for 1 to 3 days) are usually given. Ointments for external and intra-vaginal application containing antifungal azole compounds or nystatin are both available over-the-counter, but azole ointments have been deemed to be more effective than nystatin. Additionally, suppositories containing these compounds are also available.

Azole drugs include clotrimazole, miconazole, tioconazole, butoconazole and terconazole. Orally, fluconazole or itraconazole is usually given in a single dose – however oral therapy is avoided during pregnancy or lactation. According to CDC, 80-90% patients who complete this therapy experience relief from symptoms and culture tests for candida are negative after therapy.

For complicated vaginal candidiasis, it is important to know exactly what species of yeast is causing the infection. Every episode of recurrent vaginal candidiasis caused by Candida albicans can generally be treated with short duration treatment with oral or topical azoles. However, sometimes longer term treatment is given to control the fungus and is followed by a 6 month long maintenance dose of oral fluconazole.

About 50% of women on maintenance therapy develop the infection again when the treatment is stopped. Therefore episodic treatment is preferred over maintenance therapy. Conventional therapies are not as effective against nonalbicans candida such as Candida glabrata, and tests need to be done to confirm the activity of drugs against them.

The commonly used azole drugs act on the enzyme that is involved in the final step of making ergosterol which is a key component of the fungal membrane. Lack of ergosterol causes the cell membrane to not form properly and leads to killing or growth inhibition of the fungal cell.

Azole drugs that are used for candida infections are of two types: imidazole based and triazole based. Imidazole based drugs are for topical use while the triazole based drugs are available for oral use. However, there can be severe issues with oral intake of these drugs (itraconazole may cause heart failure and fluconazole can lead to acute liver injury) and so these should be avoided as much as possible. Here is a table that gives you an overview of the azole drugs used for treating candida infections, including the side-effects and warnings.

Azole drug Type Trade names Form available Side-effects Warnings
Clotrimazole Imidazole Canesten
Lotrimin
Gyne-Lotrimin
Mycelex
Cream, lotion, powder, solution for skin, lozenges, vaginal tablets and cream itching, burning, irritation, redness, swelling, stomach pain, fever, foul smelling discharge (vaginal product), upset stomach or vomiting (lozenges) N/A
Itraconazole Triazole Onmel
Sporanox
Oral (Used generally for systemic infections) diarrhea,constipation, gas/bloating, heartburn, unpleasant , sore/bleeding gums, headache, dizziness, sweating, muscle pain or weakness, joint pain, decreased sexual desire or ability, nervousness, depression, runny nose/ other cold symptoms, fever, hair loss
Serious: blurred vision or double vision, ringing in the ears, inability to control urination or urinating more than usual
May cause heart failure
Tioconazole Imidazole Trosyd Topical (external and internal ointments) Mild vaginal burning, irritation, or itching
Serious:Rash, Hives, Itching, difficulty breathing, tightness in the chest, swelling of the mouth, face, lips, or tongue, fever or chills, foul smelling vaginal discharge, nausea, severe or prolonged vaginal burning, irritation, or itching, stomach pain, vomiting
N/A
Butoconazole Imidazole Femstat Gynazole Vaginal cream burning, irritation, stomach pain, fever, foul smelling discharge N/A
Flucanazole Triazole Diflucan Oral or intravenous headache, dizziness, diarrhea, stomach pain, heartburn, change in taste

Serious: nausea/vomiting, extreme tiredness, unusual bruising or bleeding, loss of appetite, pain in the upper right part of the stomach, yellowing of the skin or eyes, flu like symptoms, dark urine, pale stools, seizures, rash, blistering or peeling skin, hives, itching, swelling of the face, throat, tongue, lips, eyes, hands, feet, ankles, or lower legs, difficulty breathing or swallowing

May cause acute Liver injury
Miconazole Imidazole Monistat
Fungoid
Zeasorb
Micatin
Topical (External and Internal creams; pessaries) increased burning, itching, or irritation of the skin or vagina, stomach pain, fever, foul-smelling vaginal discharge N/A

Natural Treatment:

Considering the number of side-effects that the pharmaceutical drugs have, rising drug resistance of candida to these drugs, and the recurrence of infection post-treatment, natural holistic treatment of these infections is your best option. What I mean by holistic treatment is the treatment of the person as whole – externally as well as internally – and not just symptoms of a particular part of your body. Why internally, you ask? It is because you need to strengthen up your system internally – regain the balance of normal bacterial flora, regenerate your mucous membranes and immunity of these membranes, and boost your general immunity as well. This would allow you to fight the external infection and get rid of it for good!

A good natural and holistic treatment includes diet, lifestyle and natural medicines that take care of your infection without creating any side-effects that further debilitate your body.

  • Diet

You need to follow a good, well balanced diet that provides you all the essential macro- and micro-nutrients. Like I have described earlier in this article, a deficiency of micronutrients can severely weaken your immune system. Deficiencies of zinc and vitamin A can specifically reduce your immunity against candida.

Your diet should be balanced even in terms of carbohydrates – stop or reduce the intake of sugar and other refined carbohydrates in your food. Eating large amounts of sugary and starchy food can make you more susceptible to candida infections – we have also discussed this earlier in this article.

You need to have a good source of protein (lean meat, milk, nuts, lentils), good fats (avocados, extra virgin coconut oil, extra virgin olive oil, cold pressed sesame seed oil, flax seeds, flax seed oil etc.) to keep your hormones in balance and to provide well-functioning membranes to the cells, carbohydrates and other macronutrients (brown rice, unrefined wheat flour, grains, vegetables and fruits), a good source of lactobacilli and other good bacteria (yoghurt, kefir, and other fermented food and dairy products). Make sure that you have a varied diet – choose a variety of vegetable, fruits, nuts etc. Try and choose organic produce when you can – this way you avoid pesticides, antibiotics, growth hormones etc. in your diet.

  • Lifestyle

You need to stop taking alcohol completely. Alcohol has far reaching impact on our immunity and our nutrition. A woman taking alcohol sustains more tissue damage from alcohol than a man does. A 1996 study by Eriksson and colleagues from Finland found that acetaldehyde increase on taking alcohol is higher in women and even more so during the high estrogen phases of the menstrual cycle. So if you want to keep your vaginal candida infection at bay, it is important that you stay away from alcohol. You can read more about the link between alcohol and candida here.

A stressful lifestyle is candida’s best friend! If you have a situation that is constantly stressful, you need to make changes to get out of that situation. If a job is too stressful, change jobs; work on a stressful relationship; if you are a chronic worrier – stop worrying and meditate; exercise in moderate amounts – exercise reduces stress; drink plenty of water – remove the toxins you accumulate in excess because of stress; and prioritize your sleep – sleep is a stress-buster. If stress does not allow you to calm down and sleep, try a warm bath and some calming herbal teas before you go to bed. Warm milk before sleep also helps you sleep better.

Stay away from antibiotics – both antibacterial and antifungal. These disrupt the balance of your natural microflora. Do not use NSAIDs (Non-steroidal anti-inflammatory drugs) and corticosteroids as much as you can as these suppress your immune system. Of course, these drugs can be life-saving in certain instances – so I am not telling you to avoid them under the most pressing circumstances, but am telling you to change your mindset about solving every issue with a single pill. Prevention is better than cure – so work towards developing a good immunity. This way you will avoid getting infections and thus avoid antibiotic usage. Do not jump for a pill with every single issue. No issue is solved completely until you tackle the underlying cause – and same is true with candida infection.
You need to make these long term lifestyle changes and you will find yourself healthier, with more energy and free of candida infections.

  • Natural medicines

There are good natural antifungal options available when it comes to treatment of vaginal candida infection. Tea-tree oil is a natural antifungal agent. A 2006 study by Mondello and colleagues from Italy found that a component of tea-tree oil is effective against candida that was resistant to azole antifungals! A cream or suppositories containing tea-tree oil will therefore be effective against your vaginal candidiasis. Additionally, coconut oil has antifungal properties as well. You can read about the antifungal/anti-candida properties of coconut oil here. It is a good idea to include it in your diet as well as use it for vaginal application. You can also use natural baths to help ease the itching and pain from the infection. A detailed article on natural anti-candida baths can be found here.

You can also try the range of CanXida products created by Eric Bakker ND after years of research and experience with candida infections. CanXida Remove is an oral alternative to azole drugs. It provides many anti-candida benefits without any serious side effects. It provides relief from itching, burning and discharge related with vaginal candida infection. It has 12 most clinically proven herbal medicines and nutrients of highest quality – Garlic, caprylic acid, undecylenic acid, Betain HCL, Grapefruit seed extract, Black walnut hull extract, Pau D’arco extract, Neem extract, Clove extract, Berberine HCL, Biotin and oregano oil. These compounds attack candida in different ways and kill candida without allowing candida to develop resistance. CanXida Restore can be supplemented to your treatment with CanXida Remove to restore your natural enzymatic and normal-flora balance thereby supporting your candida treatment. CanXida will give you best results when complemented with a well-balanced candida diet and lifestyle changes.

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Prevention

Prevention is always better than cure. What strategies can you adopt to avoid getting vaginal candidiasis in the first place? Look at the risk factors – see if you fall into any of the higher risk scenarios. If so, make an effort to lower your risk. If you are pregnant or are immunocompromised, put extra effort into lowering your risk of developing vaginal candidiasis.

In general:

  • Maintain good personal/intimate hygiene. Do not douch if you do (unless its douching protocol discussed in our other articles) – douching changes the natural ecosystem of the vagina and allows candida to establish itself.
  • Always use cotton underpants as you need proper aeration of the area and avoid moisture build up. Damp and improperly aerated areas promote the growth of candida
  • Work towards building a good immune system. Eat a healthy, well balanced diet. Get your vitamins as much as you can through natural sources as it is much easier for the body to use vitamins in natural form. Include a daily dose of sunshine if you can – if you live in a region where sunshine is scarce, make sure that you boost your vitamin D levels through supplements.
  • Try and avoid corticosteroids where you can as these suppress your immunity. If you develop a good immunity, you will rarely get into situations where you need to use corticosteroids.
  • Avoid overuse of antibiotics. You can read more about antibiotics and how they promote candida growth here.
  • Get enough sleep. Sleep heals the body and repairs it. Lack of sleep also increases cortisol levels which can trigger candida infections through different mechanisms. Read more about cortisol and candida link here.
  • Drink enough water to flush out toxins that could harm your immunity.
  • Avoid alcohol like plague. Alcohol has far reaching impact on our body, reduces our immunity and makes us more susceptible to candida infections. You can read more about alcohol and candida connection here.
  • Avoid stress. it suppresses your immune system. If you cannot avoid stress, learn to handle stress. Meditate; A 2016 American study by Black and Slavich analysed 20 random controlled trials involving more than 1600 participants found evidence that mindfulness meditation can positively affect our immune system by causing decrease in inflammation, increase in cell based immunity and also increase in enzyme activity that protects against aging of cells. Including meditation into your lifestyle, whether or not you are chronically stressed, will help boost your immunity not only against candida, but also against many other infections. Make sure watch our three part Candida and Stress connection video series Part 1, Part 2, Part 3.

Is yogurt good for it?

Yes, it is beneficial to take yogurt orally as well as for application to sooth the itching and pain and to restore the natural normal flora of the vagina. However, a good probiotic enzyme is recommended which is more potent try canXida restore.

Can you get vaginal yeast while breastfeeding or during pregnancy?

Yes, you can.

I have white bumps can that be because of the infection?

It can be because of the yeast infection, but it could also be due to blocked follicle (folliculitis), or due to a viral infection.

Can I smell bad down there?

If you smell bad down there, you likely have a bacterial infection and not yeast infection.

Can it cause sores?

Yes, complicated yeast infections can result in fissures and sores.

Can it cause swelling? Or is swelling a symptom?

Yes, it is.

What are some good home remedies for vaginal yeast infection?

Tea-tree oil based creams, coconut oil, yogurt, natural herbal baths are some good home remedies and you can also use CanXida Cream which contains all of those ingredients plus more.

Is rash a symptom?

Yes, it is.

What is the difference between vaginal yeast infection discharge and normal discharge?

Normal discharge can be clear or cloudy white and may appear yellowish when dry on clothing. It can also be thin and stringy. The color and consistency of normal discharge will vary depending on the ovulation cycle. Vaginal yeast discharge appears thick, white, clumpy and cottage cheese-like. There is also an increase in the amount of discharge.

Should one treat vaginal yeast with only local treatment or should I also take some pill?

It depends on the severity of your infection. If you have an uncomplicated yeast infection and your immune system is not in a decent working condition, local topical treatment could be enough. However, with more complicated and recurring cases, it is advisable to take an oral pill like CanXida Remove and use CanXida Cream with it locally.

Is coconut oil useful to rub down there?

Yes, coconut oil has antifungal properties. So a good quality coconut oil can be useful.

Can you possibly get the vaginal yeast after having sex?

Yes. If your sexual partner has candida and you have a weakened immune system due to any reason, you may contract vaginal yeast after having sex. You can also get the infection from improperly cleaned sex-toys which run the risk of having candida biofilms on them. Excessive sex can also lead to the infection by causing small lacerations in the vagina that promote the growth of candida. Additionally, oral receptive sex also has the potential of giving you vaginal candida infection as one-third to one-half the population has candida in their mouth as their normal flora.

Is Bath Good or Bad for Yeast Infection?

Yes, baths are recommended for controlling the symptoms of yeast infection like itching, burning, swelling and pain. No remedy works fast enough to relieve these annoying symptoms; so while one waits for the effects of any medication (natural or otherwise) against the infection, one can use different types of baths for instant relief from symptoms. Baths are not the same as douching. While in douching, the vagina is washed internally, baths only wash the vagina externally. Douches are definitely not recommended for yeast infections as they are likely to increase them (unless you follow our douching protocol here). Baths on the other hand can provide instant symptomatic relief and some reduction in the yeast infection. Baths can be taken in a normal bath-tub filled only to cover the pelvic region, or in sitz-baths that are specially designed shallow baths. Baths should be warm, not hot or cold.

Good baths

Good baths are baths that take care of the following issues:

  • They maintain the acidity of the vagina
  • They do not kill off natural vaginal bacteria
  • They do not have potentially harmful side-effects for you or, in case of pregnancy, to the baby
  • They do not kill the sperm if you are wanting to become pregnant

Bad baths

Bad baths will, on the other hand, have some or all of the issues that good baths manage to take care of.

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Benefits of baths

  • Can quickly relieve the symptoms of yeast infection like itching and burning
  • Some products added to the baths may reduce the yeast infection

Side effects of baths

Some compounds added to the bath have sperm-killing activity. Although baths are not internal, you should be careful with these if you want to become pregnant.

Follow instructions when using any of the baths. Inappropriate use can cause damage to your own tissues and not be really useful in controlling candida either (as injured tissues are more prone to candida proliferating and growing.

Some products added to the baths may kill the useful bacteria and increase your yeast infection.

Some products used in the baths may have a strong dependence on the concentration at which they are used and can be harmful when used at sub-optimal concentrations.

Is apple cider vinegar bath a good option?

Apple cider vinegar (ACV) was tested in 2008 in full-denture wearers to check its activity against Candida. The study carried out by a group from Brazil. They found that keeping the dentures overnight in 10% solution of ACV reduced the number of candida in the oral cavity. However, it was unable to get rid of it completely. Another study published in 2015 by another group of scientists from Brazil has shown that different concentrations of ACV kill different types of Candida. ACV also reduced the ability of Candida to adhere to the dentures – perhaps this effect could be similar to adherence to the mucous membranes. The candida inhibiting activity of ACV could therefore also be helpful in case of vaginal candida infections. This study also considered 4% malic acid in ACV to be the active component against candida. Therefore, only undistilled, unfiltered ACV is likely to have significant inhibitory effect on candida. It will be important to note that if apple cider vinegar has been produced from apple cider that has undergone malolactic fermentation (a type of fermentation used to remove the sourness in ciders and wines) will have much lower levels of malic acid, and may not be as effective as anti-candida agent. Additionally and additively, the acidity of vinegar (which is similar to the acidity of a healthy vagina) could be responsible for inhibiting the growth of candida. Please note: you should never use undiluted ACV for baths; always use the dilutions recommended by your health-shop/natural health practitioner.

Is distilled vinegar good yeast infection bath?

As described above, maleic acid in ACV has been considered the active component against candida. Distilled vinegar, which is made from fermentation of distilled alcohol, lacks malic acid. It has acetic acid as its main component. Even distilled ACV is not likely to have the same impact against candida as ACV. While scientists from Lithuania found in 2014 that acetic acid was very active in killing candida, they also found that it killed a lot of the mammalian cells as well. Thus, use of strong, undiluted acetic acid can also be detrimental to your own tissues. Vinegars (of any type) should therefore always be used at the prescribed doses in the prescribed manner.

This may sound weird but a friend of mine told me that red wine vinegar helped her. What do you think?

Grapes have a high content of malic acid. But wines, most often than not, undergo a process of conversion of malic acid to lactic acid to reduce sourness. Vinegar made from such wines will be lacking in malic acid which is active against candida. In 2003, a study conducted by Spanish scientists on different types of vinegars found that wine vinegars were lower in malic acid content and there was absolutely no malic acid in red wine vinegars fermented without wood. Thus, it is likely that the effectivity of red wine vinegar against candida will depend on the quality of wine and the processes used to make the wine itself.

I have heard Aveeno oatmeal bath for yeast infection is good. Is that true?

Yes. Aveeno oatmeal is colloidal oatmeal. It has been used for centuries to relieve itch and irritation from dry skin due to winter, lengthy showers or harsh soaps. Researchers from Skin Research Center of Johnson & Johnson in USA found in 2008 that Avenanthramides, which are present in oats are potent anti-inflammatory agents and these give the anti-irritation capacity to oats. In 2012, researchers from Johnson & Johnson Santé Beauté France together with a dermatologist also from France showed from data collected in 10 countries that colloidal oatmeal is a safe and effective ingredient in personal care products and has low propensity to cause allergies. The anti-irritation, anti-itch property of oatmeal is utilized by Aveeno oatmeal bath to provide relief from symptoms of yeast infection.

Is baking soda bath good?

The study by Lithuanian scientists published in 2014 also tested the effect of baking soda on stopping the growth of candida. They found that baking soda at a certain concentration did cause killing of candida cells. If the concentration of baking soda was reduced, it actually promoted the change of oval form of candida to the hyphal/fibrous forms which are actually more infective. On the other hand, they also found that baking soda at concentrations that killed candida also killed mammalian cells in a big way.

You also need to remember that baking soda will increase the vaginal pH. This also will make the yeast happier and make them grow more.

Hence, we would suggest an extremely careful use of baking soda baths as not doing so can actually be injurious to your own tissues or may even increase your issues with yeast infections.

Are baking soda baths safe for diaper rash or during pregnancy?

Baking soda baths have been recommended for treating diaper rash. However, it is important to point out that indiscriminate use of anything that seems very household and innocuous may not really be safe. A case study presented in 1981 by doctors from USA showed that indiscriminate use of baking soda for treating diaper rash caused the 4 month old baby to suffer from hypokalemic metabolic alkalosis (excess bicarbonate in the blood causing it to become alkaline). Baking soda was absorbed by the baby through its skin causing the disorder.

Transfer of bicarbonates across placenta is slow as is described in a recent article by researchers from University of Toronto. This would mean that if you use sodium bicarbonate baths and absorb the bicarbonate through your skin, the fetus will not immediately get affected. However, as mentioned earlier, indiscriminate use of anything can be dangerous.

What types of bath salts can I use?

Bath salts of any kind are not recommended for candida infections. Bath salts contain salt, Epsom salt and baking soda, all of which by themselves can change the natural bacterial balance of the vagina through both their alkalinizing action as well as anti-bacterial action and thereby increase your yeast infection problems.

Is Kosher salt different and does it help?

Kosher salt is only different from normal salt in that it lacks any additives and is different with respect to its crystals. Chemically it is otherwise the same. It is therefore unlikely to help.

Do you recommend Epsom salt baths for yeast infection?

Epsom salts have been shown to reduce inflammation caused by endotoxins.

Is bleach bath ok?

Bleach can be chlorine based or peroxide based. Chlorine based bleach have strong anti-bacterial properties in addition to anti-fungal activity. If you use bleach in your bath, it will kill both the good and the bad bacteria and fungi, leading to imbalance in the vaginal microflora. This can actually cause yeast to come back with a vengeance.

What do you think about hydrogen peroxide bath?

We will be answering the question in another article make sure to check back.

I have heard a lot of great things about boric acid bath. Is it good?

A study from India, published in 2006, showed that diabetic women who had infection with certain species of candida responded better to boric acid vaginal suppositories as compared to the anti-fungal fluconazole. A recent study (2015) by scientists from USA shows that boric acid inhibits the invasive growth of candida by destabilizing its invasive hyphal/filamentous form. It has been described, in 2011 by another group of researchers from Greece, to be a safe alternative when conventional treatment fails. However, adverse effects caused by boric acid include vaginal burning sensation, water discharge during treatment and vaginal redness.

Since 2010, Boric acid is on the high concern list and declared to be toxic to reproduction with potential to impair fertility and cause harm to the unborn child by European chemicals agency. While you will find arguments against this mentioning no human studies having been carried out, there are studies from 1977 and 2006 that have showed that vaginal treatment (in the form of vaginal tablets) with boric acid increases the risk for congenital defects in human babies by 2.6-2.7 fold. However, another study from 1998 does mention that topical vaginal application is unlikely to cause any damage as the absorption of boric acid is limited unless the skin or vaginal epithelium is severely damaged. But think about this: you have vaginal infection where candida has already damaged your tissues to some extent, to which is added injury to the tissues from constant itching, how undamaged would the vaginal tissue be? We therefore recommend you to use boric acid baths with extreme caution – especially if you are in the reproductive period of your life and would like to have a healthy child.

Is borax bath a good option?

Borax is a salt of boric acid. Since 2010, borax has also been added to substance of very high concern candidate list and has been declared to be toxic to reproduction by the European Chemicals agency. It has the potential to impair fertility and to cause harm to the unborn child. Our recommendations on borax bath will therefore be similar to those for boric acid.

What do you think about buttermilk bath?

There is not much data out there for us to say anything. Keep an eye on our youtube channel for answer to this question in future.

I heard that in India they do milk bath. Can that help give yeast infection relief?

There is no data to back that up.

What is your take on coconut oil bath?

Coconut oil is a great for candida yeast infection. Here is a video we did on the topic on our youtube channel.

I heard that in many countries essential oils are used as bath. Is that true and does it work?

What do you think about lemon bath?

While in the past there have been contradicting reports on the use of lemon essential oils, a research group from Poland published an article in 2014 showing that different commercial lemon essential oils had different activity against Candida growth. They showed that if the essential oils from lemon were higher in their content of oxygenated monoterpenes, their antifugal effects were higher. They also showed that a particular ratio of the two different kinds of oxygenated monoterpenes could be important to stop the growth of Candida strains that are more resistant to lemon essential oils. According to these scientists, use of lemon essential oils to treat candidiasis is an interesting solution due to their documented safety.

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Isn’t tea tree oil a good solution for yeast infection relief?

Australian tea tree oil is a great solution.

What is garlic bath?

While I have never heard about the garlic bath for yeast infection. Garlic itself is a great antifungal you can take for candida.

Can baths prevent yeast infection as well?

Yes, some baths may be able to prevent yeast infection. For example, ACV bath may be helpful in restoring the vaginal pH, thereby preventing yeast growth.

I tried lavender bath once and it helped. Do you think it can also help prevent?

If it helped you then continue, we don’t have any data at this stage.

Vaginal Yeast Infection Cleansing

I regularly receive emails from women all over the world about vaginal yeast infection cleansing. A vaginal yeast infection is more common than you may think, millions of women is America have an annoying yeast infection, and many have a recurring problem. Have you seen my may You Tube videos about these kinds of yeast infections?

If you have a vaginal yeast infection and are in an intimate relationship it is best that you take precautions with your partner, it is easy to transmit a yeast infection between males and females, but also between females. I’ve seen countless cases of women who infected their male or female partners, and also plenty of males who kept reinfecting their partners too. You will need to be especially vigilant and careful with hygiene, make sure that both people in the relationship observe a very high level of personal hygiene. While a Candida yeast infection is not a serious sexually transmitted disease like gonorrhea, chlamydia or syphilis, it can easily be transmitted from one person to another.

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I want you to know one very important thing about curing this problem – you simply MUST treat this problem both internally, as well as externally. Follow my Candida Crusher Diet, in my book you will find an incredible amount of information on what to eat, and on what to avoid. Chapter 5 of Candida Crusher book outlines a great summary of the best vaginal yeast infection treatments, and here is some information from that summary:

Using A Vaginal Applicator To Cure A Candida Yeast Infection

There are different types of applicators you can get. Some women prefer a smaller, soft silicone device that is available, others may like to use a turkey baster. It all depends on what you feel comfortable using. Using an applicator is not that difficult, do observe hygiene and ensure the applicator is inserted as far as possible without applying too much force. Here are eight points to consider when using an applicator:

  1. Wash your hands.
  2. Draw sufficient yogurt (or douche mixture) into the applicator.
  3. Lie on your back, draw your knees up a little and spread them apart.
  4. Gently insert the applicator with the tablet in front into the vagina as far as possible, do NOT use force.
  5. Depress the plunger so that the yogurt (or douche mixture) is released.
  6. Withdraw the applicator.
  7. Clean both parts of the applicator thoroughly with soap and boiled, lukewarm water (if not disposable).
  8. Wash your hands.

The Yogurt Douche Method

Yogurt has been used for centuries as a vaginal treatment, is is soothing, cooling and rich in lactic acid. A lactic acid rich product allows proliferation of lactobacillus species to thrive, and discourages yeasts from growing. It is especially nice to use if your vagina is burning or stinging. Be patient, give it time to work.

You will require up to two tablespoons of room temperature yogurt and an applicator. The technique is very simple; you just pull out the plunger (or squeeze the bulb if you use a baster) and fill with sufficient yoghurt, then gently insert the tip into the vagina and squeeze the contents gently inside. Get yourself in a comfortable position you normally would if you were going to do a douche.

Make sure you use a good quality and preferably organic yogurt, and please avoid those commercial supermarket types of yogurt that are full of sugars and fruits. You will want a plain acidophilus yogurt without ANY sugars, so do read the label carefully.

Do not rinse the vagina afterwards, just rinse the outside gently and pat dry. You will want to wear a maxi pad generally to minimize any possible leakage, and most women will do this before bed and leave in overnight.

In the morning you will want to have a good wash in the shower or bath naturally and preferably wear a mini pad that day to prevent any residual leakage.

The three basic treatment options for the yogurt douche are:

  • Use pure natural organic low fat plain yoghurt.
  • Use a mixture of purified water and yogurt to thin the mix.
  • Use the whey liquid – most powerful way (the liquid on top of the yogurt)

Yogurt Tampon Treatments

Some women will use a tampon they have rolled in yogurt, but after recommending this form of treatment for some time, I don’t find the yogurt tampon as effective as the tea tree oil tampon, which is what I now recommend. To make a tea tree oil tampon work the most effectively, use the pure oil or use the water-soluble form of tea tree and make a strong solution of five parts of water and one part of water-soluble tea tree oil, soak the tampon and leave overnight.

The strongest tampon treatment is when you use grapefruit seed extract (GSE). Try this for very stubborn vaginal thrush: Soak a tampon in 1 tablespoon vegetable oil like organic sunflower oil and add from 5 – 10 drops of GSE, make sure you mix the vegetable oil and GSE very well. Insert the tampon and leave overnight. Repeat for 3-4 nights. This is one of the most effective local vaginal thrush treatments you can do, try it, you will be surprised. I‘ve seen it shift even impossible cases. Start with the water-soluble tea tree oil tampon treatment first for 3-4 days; if it fails then try the GSE or alternate treatments.

Vaginal Pessary Recipe:

A tea tree oil tampon will clear up many vaginal fungal problems, sometimes even within a day or two.

To make a vaginal pessary you will need:

  • 1 tampon
  • Several drops of tea tree oil.

Remove tampon from its wrapper and pour a few drops of tea tree oil across the top and sides. Insert the tampon, as you would do during your periods. As when you have your period, change the tampon after a few hours.

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Some women may be sensitive to pure tea tree oil, although I have not found this to be the case in 90% of women. Try a drop on the inside of your wrist first. If you don’t want to use the pure oil, soak a tampon in a tablespoon of warm water to which you have added ¼ teaspoon of the water-soluble tea tree oil, and you can use a one part water-soluble tea tree oil to five parts of water if you wish.

Vaginal Suppository Treatments with Boric Acid

Some people get concerned when I talk about an acid when it comes to vaginal treatment, thinking that it will burn and cause a lot of pain, but this is untrue. It is important to remember that vinegar and lemon juice are kinds acid too and are equally safe to use.

Boric acid is a safe and non-toxic white crystalline powder that has anti-fungal and anti-bacterial qualities and is available without a prescription. It is has many different applications and is a very effective insecticide as well, mix it with oil and it will attract ants and roaches that will die after eating it. A good remedy for oral thrush in infants is the homeopathic remedy Borax 6 c.

Boric Acid Vaginal Suppository Treatment is particularly effective for stubborn and resistant cases of vaginal yeast infection when used in conjunction with the two phase Build and Kill stages you just read before.

How to Make Boric Acid Vaginal Suppositories

It is definitely simple to have your own boric acid suppositories, basically buy some 00 gelatin capsules and fill them with boric acid, around 500 to 600 mg. You can buy boric acid along with the gelatin or cellulose two-piece capsules through your pharmacy (drug store) or a decent health-food shop.

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Make a lot of them up at once because they will keep for a very long time if stored dry and cool for at least a year. When you store them, place them in a container (use an old vitamin container) and drop in a sachet or two of those little packets of silicon which will help to keep your caps free of moisture and potentially harden up over time. Don’t keep in the refrigerator.

Treatment Method

Insert one capsule at bedtime for a seven to ten day period. Alternate with lactobacillus acidophilus treatment in the day and boric acid at night. For recurring and stubborn cases treat for 30 days straight and after the month treat two days out of seven for even up to one year. Best results in the impossible cases are when you alternate this treatment with the GSE treatment, AND use the two-phase protocol outlined above. Treat even during your period, but stop on the few days when your flow is the heaviest.

Caution: Stay away from such treatments (as given) if you are pregnant, please consult with your physician. Make sure to keep boric acid away from kids.

Fantastic Aromatherapy Treatments for Vaginal Thrush

According to one Salvatore Battaglia, who wrote the textbook widely regarded as one of the world’s best books on the subject of aromatherapy, (The Complete Guide to Aromatherapy, The Perfect Potion, 1995) the best essentials oils to for a yeast infection are German chamomile, geranium, lavender, lemongrass, myrrh, petit grain, tea tree and thyme.

Aromatherapy Treatment

The treatment Salvatore recommends is baths and local applications of essential oils. The oils mentioned above have been selected because of their antiseptic, antifungal and immune-stimulating properties. A sitz bath is very effective for vaginal irritation; 2-3 drops of the essential oil should be added to the bidet or large bowl of warm water and used twice daily if symptoms persist.

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The Aromatherapy Douche for Itching And Soreness

Valerie Ann Worwood (The Fragrant Pharmacy. MacMillan, London, 1990) recommends a douche using whole milk yogurt containing live acidophilus cultures.

  • German chamomile 5 drops
  • Lavender oil 5 drops
  • Tea tree oil 5 drops

Add the above oils to a 100-gram carton of fresh yogurt. The yogurt combined with the essential oils has the dual action of antibiotic and antifungal properties. Use Valerie’s method if there is a considerable amount of soreness and incessant itching. Use either an applicator for inserting pessaries or a tampon applicator.

Another way of using yogurt is by diluting it with warm spring water until you have made a thin fluid. Then the essential oils are added and this mixture is used in a douche, washing the vaginal tract twice daily.

The Tea Tree Oil Douche

Tea tree oil is one of the best natural medicines you will ever use with a yeast infection, but please be sure to get the Australian Tea Tree Oil. I have recommended Tea Tree Oil for over twenty years for yeast infections and am never disappointed with the fantastic feedback I routinely get from patients. The best maple syrup comes from Canada and the best Tea Tree Oil comes from Australia.

Get the pure oil for stubborn skin areas, especially on the feet and toes as well as toe nails. It is totally safe to use on nails, and unlike thyme or oregano oil, there is little risk in this oil causing any burning sensations.

Place about 300mls tepid water into a shallow bowl, add 1 teaspoon water miscible (water-soluble) Tea Tree Oil and mix well. Fill a douche bag with the tea tree solution and apply as required to the vagina. The tea tree oil is anti-inflammatory but also an effective anti-fungal.

Tea Tree Oil Vaginal Pessary and Douche Combo – Even Better

Australian Tea Tree Oil is one of the best things you can use when you have a vaginal yeast infection, it’s just one of those medicines that works consistently time and again.

A Tea Tree Oil douche has been used and recommended by alternative medicine doctors for over 50 years now for vaginal yeast infections, literally since the discovery of the remarkable natural antifungal.

Use from eight to ten drops of the pure Australian Tea Tree Oil in 500 milliliters (or 1 pint) of tepid purified or distilled water. Douching in between pessary applications seems to be the best solution in ridding your vagina from the discomfort including the burning and incessant itching of a candida vaginal yeast infection.

Try Water-Soluble Tea Tree Oil

For women who want to use Tea Tree Oil in a douche will need to get the water-soluble Tea Tree Oil, you can use the pure oil or you can get a water-soluble Tea Tree Oil, see what works best for you. I have known several people over the years that have successfully treated their own cracked heels, tinea, athlete’s feet with a warm foot spa, and including in the water plenty of water-soluble tea tree oil.

Those of us who use essential oils and know them well will tell you that apart from oregano oil, tea tree essential oil is the best anti-fungal used straight on stubborn areas of skin, jock itch, fungal nails. Use the Tea Tree Oil as spot skin, scalp or nail treatment, and use the water-soluble tea tree oil for when you want to do a douche or wash areas of skin in general.

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Tea tree oil can be applied directly to candida skin problems (especially the toes or with athletes foot) or add to bath water. The water-soluble Tea Tree Oil is perfect for candida yeast infected patients; use a small amount (about 1/4 – 1/2 teaspoon to 1 cup of tepid water) as a douche or to wash the skin, feet or other areas of the body. This is the one time I do recommend that you use a tampon – make up a solution of water soluble Tea Tree Oil and water (you can try a weak solution first, like ¼ teaspoon of the water soluble oil to 1 cup of tepid water) and if all is well go stronger, such as 1 teaspoon of the water soluble oil to a quarter cup of the water. I know some women who use the Tea Tree essential oil neat on a tampon, but I do not recommend this for you until you gain sufficient experience with Tea Tree Oil and understand how it affects you in different ways. I believe that Tea Tree Oil is possibly the best product to use vaginally, besides oregano oil or fresh garlic. Try the probiotic & whey douche and alternate with the Tea Tree Oil douche. You will be quite surprised.