Yeast infections, bacterial vaginosis and cytolytic vaginosis are the most common vaginal infections we treat here in our Toronto clinic.
We also treat common STDs such as trichomoniasis, herpes and HPV, and abnormal growths such as cervical dysplasia, fibroids and endometriosis.
Although we haven’t had a chance to get all of our practitioners on video to talk about these issues, our excellent team of naturopathic doctors sees a lot of them and has a proven track record of treating them using a natural approach.
Below, a couple of our naturopaths talk about a few of the issues they see the most, although if you have another vaginal issue, we certainly have experience with that, too…
Yeast Infections – Dr. Kate Whimster, Naturopathic Doctor
- Yeast infection symptoms. The presence of yeast in the vaginal area is normal. But if there’s a lot, or if it keeps recurring and you have itching, burning, discharge, sometimes pain, then naturopathic medicine can intervene to take care of it.
- Conventional vs naturopathic medicine. Over-the-counter medications such as creams that treat the yeast infection can often get rid of it, but it always comes back, whereas naturopathic medicine fixes the imbalance that’s causing the infection in the first place. Also, conventional doctors often treat cytolytic vaginosis as a yeast infection, but they need to be treated differently because they’re entirely different organisms.
- Short-term yeast infection treatment. We look at the root yeast infection causes and treat them. Low-sugar diet with very few starches, perhaps a temporary candida diet. There are a lot of anti-fungal herbs you can take, getting more sleep doing some hygienic stuff like wearing cotton underwear, not wearing underwear at night when you sleep – that kind of thing for some people can make a big difference. Suppositories that are anti-fungal will get rid of the yeast, and oral probiotics will replenish the normal bacteria.
- Long-term treatments. Correcting a hormonal imbalance is often necessary. Sometimes the immune system is an issue. And sometimes it’s neither of those things – it’s just that the vaginal environment has been sort of compromised so much that it can’t really get back on track. So depending on how what’s going on with the person, I’ll treat the underlying cause and usually like within a few months, you can have like a huge resolution of yeast.
Yeast Infections – Dr. Tehseen Meghji, Naturopathic Doctor
- Diagnosis. It’s generally not advisable to diagnose it yourself – it can be easily confused with other conditions such as bacterial vaginosis or a sexually transmitted infection, as well as other bacterial origins, so it’s really important, specifically for recurrent candida infections or yeast infections to make sure that you’re diagnosing it correctly.
- What to do at home. At home you can follow a low sugar diet, because sugar feeds yeast, so that’s one of the main things to be aware of when you have yeast infections. Also avoid wearing things that are synthetic origin – so making sure that you’re wearing cotton underwear and favoring unfragrant soaps and pads over tampons – natural cotton pads are better.
- What a naturopathic doctor can do. There’s much more that you can do botanically, with different botanical herbs. There are a bunch of suppositories that can be helpful in treating acute conditions. And probiotics are something I definitely will always recommend, but it’s important they’re getting the right type of probiotics.
- Using Monostat. The good thing about naturopathic approaches compared to something over the counter like Monostat is that the natural therapies actually work against the resistant strains and they don’t have many side effects.
Bacterial Vaginosis and Cytolytic Vaginosis
- Bacterial vaginosis. When there’s no yeast but you’ve chronic discharge or chronic irritation in the vaginal area. Sometimes the discharge smells really bad or there’s really a lot of it.
- Treatments. Oral probiotics and suppository probiotics to bring the good bacteria back into balance. For some people, that works really well. For others, a candida approach works better, a bit of a diet just to restore the normal bacterial flora throughout the body, plus anti-bacterial herbs to kill off the wrong bacteria, replenish the good bacteria.
- Sometimes if you have really stubborn cases of bacterial vaginosis then you really need to look at detoxification functions of the body, elimination functions, digestion.
- Cytolytic vaginosis. Looks kind of like a yeast infection, but is treated very differently. Dr Whimster treated a women who had three years of what she was told were chronic yeast infections, but it turned out it was cytolytic vaginosis and we treated that and in two weeks the symptoms cleared out.
Cervical Dysplasia, HPV, Herpes
- Conventional treatment. They usually just watch-and-wait and if it gets severe enough, they’ll do a procedure called LEEP, which is sort of like an electrified wire to take out just part of the cells that are abnormal. It’s a pretty safe procedure, but sometimes, the cells come back abnormal again, so some women don’t want to do that because it can affect fertility in the future.
- Naturopathic treatment. Lots of supplementation, lots of herbs, adjust the diet, look at any other risk factors like smoking, birth control pill, weight, STIs, vaginal suppositories.
- Success story. A patient had six years of abnormal paps, and I think she’d had LEEP. Her doctors told her she might get cervical cancer. In 3 months she went from high-grade to low-grade, and over the next year or so I treated her period, digestion, stress and she ended up below low-grade, which is called ASCUS, and she’s all good now.
Vaginal Infections Video Transcriptions
Yeast Infection – Kate
Kate: Chronic yeast infections is sort of the most common thing that people complain of because you know most women will have a yeast infection at some point in their life because yeast is normally present in vaginal area like it’s not abnormal. It’s just when it goes out of control, you get symptoms like itching, burning, discharge, sometimes pain. So a lot of women will have that at some point. The issue becomes when it come… happens over and over and over again. And a lot of times you’ll see that after using antibiotics, a lot of women will get yeast infections or urinary tract infections, like women will also get yeast infections or they’ll use antibiotics with urinary tract infections and get yeast infections and through these infections they’ll get a urinary tract infection. So… so what I find like a lot of women getting rid of the yeast is not a problem like you can take medica…over-the-counter medication, creams, all these stuff exist to get rid of the yeast and it’s effective but it always comes back.
Phil: ‘Cause you’re not fixing the reason.
Kate: You’re not fixing the problem, which is like the body is conducive to this yeast overgrowth and that’s not really being corrected on its own. So typically like one of the first things I do is just try to confirm that it is yeast. Sometimes it’s not yeast, and it’s not being treated appropriately. And that can be a reason that doesn’t resolve. So it could also be like bacterial vaginosis is another sort of bacterial infection, which is very different than yeast. And there’s another sort of like lesser known called cytolytic vaginosis, which looks a lot like yeast, same symptoms as yeast, same type of discharge, and it’s usually mistaken for yeast and treated as yeast, but it doesn’t respond to treatment for yeast. So if we can confirm that it is indeed a yeast infection through a vaginal swab and usually when they have this or they haven’t, I could do that in the office. Then short-term, we’ll do some stuff just to starve the yeast so low-sugar diet. These are things that like most people can find online or read about at home like no sugar in the diet or even like… like very few starches in the diet. There’s a lot of anti-fungal herbs you can take, you know, getting more sleep and like doing some hygienic stuff like wearing cotton underwear, not wearing underwear at night when you sleep that kind of thing for some people can make a big difference. I’ll often do sort of a candida diet, which is like no sugar, low sugar diet combined with anti-fungal herbs and I’ll often do suppositories as well that are anti-fungal just to get rid of the yeast. And the last thing I’ll always do is oral probiotics just to replenish the normal bacteria. And that usually like symptom-wise, no problem. Long-term, you have to sort of change the environment a little bit so that the yeast doesn’t come back. And for that, you know, often hormonal balance can play a role in that. So looking at do they have a history of period problems or other clues that like hormonal balance is an issue. Sometimes the immune system is an issue so like sometimes people with lots of different infections, I always get colds and flus, I always get yeast infections like they’re getting all kinds of infections so the issue there is their immune function and it’s not like a hormonal thing. And sometimes it’s neither of those things. It’s just that the vaginal environment has been sort of compromised so much that it can’t really get back on track. So depending on how what’s going on with the person, I’ll treat the underlying cause and usually like within a few months, you can have like a huge resolution of yeast. Even doing like a little bit of detox helps get rid of the yeast and sort of change the environment in the body such that you can eat a little bit more normally. No one’s gonna stay in the candida diet forever; it’s pretty strict. But you can get someone back to eating normally with no problems with yeast or pretty minimal symptoms.
Phil: Nice, and so within a few months they’re often doing better and you just…
Kate: Yeah like usually the yeast is gone, like within a month you can get rid of yeast symptoms and then like within a few months you wanna look like it’s not recurring.
Kate: And then typically what I’ll do with those patients is sort of transition more into working on like what are those underlying things ‘cause there are always something else going on. And those are the things that are sometimes more like the stubborn, chronic issues again like period problems or immune system problems, and work on that. And like the yeast will be resolved and we just sort of keep an eye on. And other thing is making sure people are equipped if they do have a flare up of symptoms of the yeast infection, that they know what to do, or they know I should change my diet this way or I can do these simple things at home to like relieve and sometimes that’s all they need to do and my resolve itself on its own once their body is sort of functioning better.
Yeast Infections – Tehseen
Phil: Let’s talk about yeast infections. First of all I’m actually interested – can women diagnose this themselves because there could be a few different things that might like a yeast infection, right?
Tehseen: Exactly. Ya, so generally it’s not advisable to diagnose it yourself, although there are some tell-a-tale signs of a yeast infection, it can be easily confused with other conditions such as bacterial vaginosis or an STI, which is a sexually transmitted infection, as well as other bacterial origins and things like that, so it’s really important, specifically for recurrent candida infections or yeast infections to make sure that you’re diagnosing it correctly to prevent things from reoccurring as well.
Phil: Okay so that’s when they can come in to see you and you can fairly easily figure out which one it is, or is it a challenge?
Tehseen: Ya, so it’s definitely a detailed history. A lot of time it’s important for me if I’m unsure to send them and refer them to their medical doctor as well to get a pap test done and a swab. So the vaginal swab will give us a clear-cut answer for what organisms are in the vaginal canal. So candida is normal in all women and most women will have that in their vaginal flora, and it’s when it becomes out of balance that we get infections. So a lot of times if the vaginal swab comes back with that, I’ll have a good idea that okay, that’s a possibility. But you do need the signs and symptoms to know, too, because sometimes the swab will be positive, but there may not be signs and symptoms, because it’s part of the normal flora as well.
Phil: Okay, so what do you do when you have diagnosed a yeast infection. What can they do about it?
Tehseen: So there’s lots that you can do. At home, basically they can follow a low sugar diet, low carbohydrate diet, because sugar feeds yeast, so that’s one of the main things to be aware of when you have yeast infections, especially recurring yeast infections. So following an anti-candida diet for a short time…
Phil: How long?
Tehseen: So anti-candida diet is very restrictive, so this is something that I usually recommend to my patients for acute symptoms, when they’re actually experiencing the symptoms, that can be really helpful, but on a day to day basis, avoiding sugar is usually the best benefit. And the reason why sugar is usually the best benefit is because sugar depresses the immune system. So a lot of times there’s a candida overgrowth because your immune system is not strong enough, and you don’t have enough of the good bacteria to offset the candida, and that’s why it overgrows. So making sure that you’re immune system is strong, and not feeding the candida with sugar, is going to help with that. So dietary changes are really important for something that they can do at home, as well as avoiding things that are synthetic origin, so making sure that you’re wearing cotton underwear and favoring unfragrant soaps and pads over tampons and things like that – natural cotton pads are better. So avoiding anything that going to irritate the area and cause it to increase the risk of an infection.
Phil: Okay, and on top of that what would you do to really help them overcome this?
Tehseen: For sure, when people come in with yeast infections, usually some of the things that I will recommend are having garlic in the diet because that’s antifungal – that’s something dietary, but there’s much more that you can do botanically, with different botanical herbs. There’s a bunch of suppositories if indicated that can be helpful in treating acute conditions. So these are the things that you use for an acute condition, but as a naturopathic doctor I wanna see what’s causing it to being with? Why does somebody continue to have yeast infections? Most women – about 75% of women – will have a yeast infection once in their life. Is that something to be overly concerned about? Probably not. But if it’s reoccurring over and over and over again, this is something that can signal immune dysfunction, hormonal imbalances, digestive issues – a lot of times digestion is very correlated with vaginal yeast infections because there may be excess candida in the digestive tract. So depending on where we’re looking, we’re gonna treat that root cause. So making sure that they have the tools and the knowledge to work with that on a daily basis so that it’s not continuing to recur. Probiotics are something I definitely will always recommend, but it’s important they’re getting the right type of probiotics, so there’s so many different strains of probiotics, and that’s our good bacteria, but there’s different ones that have been researched to be more effective in yeast infections versus some other type of infection, so educating my patients on which probiotics they would need, and using them both orally and vaginally sometimes is important. So it depends on where we’re at and going through the history and determining what is best.
Phil: And they can expect – is it something you feel pretty confident that you can help get rid of recurring yeast infections?
Tehseen: For sure. So the good thing about natural therapies or naturopathic approaches compared to something say over the counter, antifungal medications which are a prescription, or something like Monostat which you can buy over the counter – the natural therapies actually work against the resistant strains, so a lot of times – and they don’t have many side effects – and a lot of times the conventional treatment, the prescription drugs will have side effects, although they are effective, they’ll have side effects that most people are not wanting, and it can be hard on the liver as well.
Phil: And wouldn’t most of the prescriptions be more focused on just killing the yeast instead of changing the environment?
Tehseen: Exactly. Ya, so that’s exactly it, so it’s working on a symptom basis more so, and they’re not always effective against the resistant strains. So with naturopathic support, you’re doing the symptom approach to because you want to get rid of it – it’s not comfortable – so you want to get rid of it, but then at the end we’re looking at making sure it’s not recurring again. So not only treating on a surface level – finding out where that disfunction is in the body that’s continually making the person susceptible to having them over and over and over again, and that’s where I think naturopathic medicine really excels for yeast infections.
Kate: So bacterial vaginosis is something that probably like yeast is stubborn and annoying but there’s more options for treatment. Bacterial vaginosis is when there’s no yeast, it’s not a yeast infection, but you’ve like chronic discharge or chronic irritation in the vaginal area. And sometimes the discharge smells really bad or it’s like really a lot of discharge and women are kind of like of embarrassed or they’re like I really don’t understand what’s going on but it’s not really severe enough to really be obviously wrong. So a lot of women will sort of let that go of that for awhile or just think it’s gonna resolve. And typically what you’ll see is there’s no yeast but if you do vaginal swab, the result will say either bacterial vaginosis or it will say something like altered vaginal flora but not consistent with bacterial vaginosis. In either case what you have is sort of like that the normal bacteria, which… tons of different kinds of bacteria that live there, it’s just not quite in the right balance so in that case, it’s a little more subtle. Typically, what I’ll do is oral probiotics and also there’s some suppositories you can buy like vagina suppositories that are probiotics, and that sort of like brings locally like the good bacteria back into balance. And for some people, that works really well. But for some people, even if they do that, it sort of reverts back overtime. And so sometimes I’ll do like a little bit like a candida approach, like a little bit of a diet just to sort of like restore the normal bacterial flora throughout the body. I’ll typically do more like anti-bacterial herbs to sort of kill off the wrong bacteria, replenish the good bacteria and again look at any underlying problems or any history because bacterial vaginosis can also rise from after antibiotic use again because you killed off some bacteria and they don’t come back quite the same. So looking at that and sometimes if people are chronically using antibiotics because they’re getting lots of infections. So again, you’re going back to why are you getting so many infections, what’s your immune response, what’s happening with that, and sometimes if you have really stubborn cases of bacterial vaginosis then you really need to look at detoxification functions of the body, elimination functions, digestion. Sometimes those are the underlying issues and if you address that, you sort of solve the problem. But again like, bacterial vaginosis is one where it’s like it’s not really about just treating locally, it’s about understanding why is the body permitting this to continue and how you can correct that balance and keep it that way.
Phil: When… so when you do the swab, do you have to wait for results? Do you send it away?
Kate: Yeah, so like a vaginal swab, usually it takes like about a week to get results of vaginal swab. We’ll test for yeast, bacteria and another like a sexually transmitted infection called trichinosis. So when people come in and they have like an abnormal discharge. Usually if their doctor has done a swab like that, I’ll get a copy, like I’ll fax and get a copy of that results to confirm what it is. But if they haven’t had that, it’s really important to diagnose because the treatment would differ a little bit.
Phil: Do you see chronic yeast infections… yeast infections more often?
Kate: Yeah, probably. Yeah. Yeah because that… bacterial vaginosis is more subtle.
Kate: But it…
Phil: It’s hard to always pinpoint that’s exactly what it is, but you can often tell it’s a bacterial issue rather than a yeast issue?
Kate: Yeah, they’re different like with yeast you’ll get more like itching, burning, like a lot more irritation. With bacterial vaginosis sometimes the only symptom is lots of discharge that smells bad. And I don’t think this is normal but like no other symptoms. Yeah.
Phil: Okay, anything else on that topic?
Kate: I think like the only other thing I’d say about that topic which would be yeast, bacterial vaginosis… there’s this third thing which I mentioned cytolytic vaginosis, which is a little bit lesser known. And those are the three things I’m looking at. So if you can rule out bacterial vaginosis, if you can rule out yeast, then you’re kind of like… your diagnosis of exclusion is this third thing which is cytolytic vaginosis which is related. It’s again, an imbalance of bacteria, just a different type of imbalance. But a lot of women… like some of the chronic yeast infection symptom patients actually don’t have yeast. And everybody’s been trying treating yeast for years, and it hasn’t been effective. And as soon as you treat cytolytic vaginosis, you’ll have like amazing results. And I had like a really good case of a woman who… it was three years of chronic yeast infections and her case had started with a new sexual partner. So I was kinda like, “Hmm I wonder if she has like a sexually transmitted infection?” No one had tested her for chlamydia. So I tested her for chlamydia – it was negative. I test… everything else was all negative, including yeast; it was negative. And in her case, it was cytolytic vaginosis and we treated that and it was like in two weeks symptoms cleared out. So…
Phil: What a cool job you have. It’s so cool ‘cause she’s been sitting around for three years with this…
Yeah and she’s been treated by all kinds of different people.
Kate: And… but it took us even like a little bit of time to figure it out because when she came in it sound really like yeast but it wasn’t.
Kate: Cervical dysplasia, like typically women will have a screening test, a Pap test, which is just checking their cervix, which is like the entrance to the uterus for abnormal cells. If there’s abnormal cells, there’s called cervical dysplasia just like abnormal cells of some type.
Phil: What’s prompting them to get this as a sort of regular check?
Kate: So often… it’s oh… typically like it used to be every year where you get a Pap, now it sort of depends, like if you’re in a monogamous relationship, the guideline is usually like every three years, if your all other Paps have been normal. So it’s the screening test for what would be the precursor to cervical cancer.
Kate: So usually if you have abnormal cells, typically that’s caused by HPV – human papillomavirus, which is a sexually transmitted virus. There’s really no way to know that you have it except some strains that it can cause genital warts, but some strains don’t cause genital warts so you would never know except the abnormal cervical cells. But not everyone, like lots of people are exposed to this virus, but not everyone has any reaction to it like most people’s immune systems will clear it, and there’s no problem.
Phil: So they’re only finding it from Pap smear…
Kate: They’re finding it from a screening test.
Phil: And what would conventional medicine do about it?
Kate: So typically like conventional medicine will take a watch-and-wait approach because most people within two years can clear the virus and everything will return to normal without doing anything. So that’s like the majority of people but sometimes it will just like linger and linger and it will become more and more severe so the abnormal cells will become more like high-grade as what they call it and eventually it can progress into cervical cancer on some people. So just like any immune system thing, like this is a chronic virus, and the question is why is the body allowing this chronic virus to persist and it’s not like fighting it or getting rid of it. And that’s really, really common like a lot of patients that contact me that’s why because there’s a lot of good naturopathic treatments. Conventional treatment – watch-and-wait and if it gets sort of severe enough, they’ll do a procedure called LEEP which is loop electrosurgical excision procedure, which is sort of like an electrified wire to take out just part of the cells that are abnormal with the hope that they grow back to normal.
Kate: So a lot of women do that, and it’s a pretty safe procedure and usually and sometimes, that’s effective. Sometimes, the cells come back abnormal again. Some women don’t want to do that, or they don’t wanna start there because if you do that procedure once or few times, like there’s a chance that you can cause scarring on the cervix, it can affect fertility in the future, that kind of thing. So if a woman is of child-bearing age, a lot of women are like, “I’d rather be more cautious and not mess around here because I don’t wanna affect my ability to have children.”
Phil: And also it seems to me, it’s still not looking at the root cause of the issue.
Kate: Yeah, it’s not addressing the root cause, which is like a chronic virus usually.
Kate: So naturopathically, I’m looking more like at stimulating the immune system to fight the virus. So I’ve a very sort of typical protocol like three months we’ll do lots of supplementation, lots of herbs, adjust the diet if necessary, look at any other risk factors like smoking, birth control pill, weight, whether they have any other sexually transmitted infections, all those kinds of things can make your risk higher. And I’ll do vaginal suppositories, and typically do that for about three months and then go down to sort of like a maintenance on that, and that’s when I’ll look at addressing any underlying issues. And I tend to group people into sort of two major groups, which is one group where there’s chronic immune system dysfunction. So often, you’ll see HPV, you’ll see herpes, you’ll see frequent colds and flus or sinusitis or urinary tract infections or whatever like lots of infections and this is just another one. So their immune system is not quite responding well. And then the other group of people is chronic hormonal imbalance where their immune system is fine – you don’t really see that but you see lots of period problems or taking lots of different forms of birth control that don’t react well to hormonal birth control. You know like some people develop cervical dysplasia following pregnancy which is a big hormonal shift, sort of the hormonal-issue people. And typically I’ll take quite a different approach with each of those type of people because that’s the underlying cause. And so typically like within six months to a year, you can get back to like a normal path. And then the key is to keep it that way ‘cause in some people it recurs and recurs. So yeah, typically three months. We’ll really focus on the HPV virus and then after that look at the underlying issues with the person and sort of keep tabs on what’s going on with them.
Phil: It does sound like it’s worth getting on top of it because down the road it can cause some big issues.
Kate: Yeah, and so some people come in because they’re like, “Oh, I’m worried and I wanna do something, be proactive.” And some people are more content to wait a little bit until their doctor’s like, “Okay, this isn’t going away on its own. You should do something.”
Phil: Okay. Is that all there?
Kate: Yeah, if you want an example I have like a case study that’s actually on my website.
Kate: But the example… this is really a good example ‘cause it was really chronic, like really stubborn case. So this was a patient who I think for… by the time that she came to see me, it was six years of abnormal paps. I think she’d had LEEP. And after the LEEP everything was just the same, like nothing changed. And she didn’t want to do it again. She had been referred to a specialist to do another procedure, which is called like a laser procedure, which is again removing the tissue but a little bit differently. She came to me like literally like in tears, terrified ‘cause her doctors were like, “You’re gonna get cervical cancer.” So in her case, we did the protocol – three months. I saw her in August, she had an appointment with a specialist in November, so it was like September, October, so it was like three months later. And I said, “You know what? I would put off that appointment because you may not really see any difference at that appointment. It may be too early.” But she’s like, “No, I’m terrified. I’m going to the appointment anyway.” So she went to the appointment and they did an examination and even within three months they said, “You know what? It doesn’t look abnormal to us. We’re not gonna do the procedure to remove the abnormal tissue. We’re just gonna do a pap test and see what comes back.” And so I had gone down from like high-grade to a low-grade at that point. So we treated a little bit more. I did a lot of like a host of treatment on her. So treatments anything the period, digestion, stress, anything and everything and she was like a model patient. In the spring, the next year, she was still low-grade. So we actually repeated our three-month like more intensive protocol. And then she very quickly… I think from there, it was low-grade, and it became like a grade that’s less than low-grade, which is called ASCUS. And I think within, it was like, I started treating her in August of 2012, and I think May 2014 or it was 2013? It was 2014, everything was normal. And she’s fine. Everything’s done.
Kate: So that was like a very long standing case. Most people aren’t going like after six years before they do something or before they see me so typically you can see results like faster than that; it depends on the person.