Most women will notice that from time to time, they have discharge from the vagina but they unknow what causes vulvovaginal candidiasis.

This is normal, as it keeps the mucous lining of the vagina moist. The discharge is usually clear but may dry on underclothes leaving a faint yellowish mark. This type of discharge does not require any medication even when quite profuse, as is often the case in prenancy.

Vulvovaginal candidiasis is the name often given to candida albicans, an infection of the vagina associated with a dermatities of the vulva (an itchy rash). “Vaginal thrush” and “monilia” are also names for the candida albicans infection.

Excessive vaginal discharge may rarely be due to a retained tampon, cervical disease, desquamative vaginitis or lichen planus.

Vaginal discharge may also be due to microorganisms such as:
*Vulvovaginal candidiasis
*Trichomoniasis (due to a small parasite, Trichomonas vaginalis)
*Bacteria vaginosis (due to an imbalance of the amounts of bacteria which live in the vaginal).

What is the cause of vulvovaginal candidiasis?
About 20% of non-pregnant women aged 15 to 55 harbour candida albicans the the vagina. Most have no symptoms and it is harmless to them. Overgrowth of Candida albicans causes a heavy and whitish curd-like vaginal discharge, a burning sensation in the vagina and vulva and / or an itchy rash on the vulva and surrounding skin.

Oestrogen causes the lining of the vagina to mature and contain glycogen, a substrate on which Candida albicans thrives. Lack of  oestrogen in younger and older women makes vulvovaginal candidiasis much less common.

Overgrowth of Candida albacans occurs most commonly with:

**Pregnancy

**Higher dosage of combined oral contraceptive pill and oestrogen-based hormone replacement therapy.

**A course of broad spectrum antibiotics such as tetracycline or amoxiclav

**Diabetes mellitus

**Iron deficiency anaemia

**Immunological deficiency

**On top of other skin conditions, often, psoariasis, lichen planus or lichen sclerosis

**Other illnesses

What are the symptoms?
Symptoms of vulvovaginal candidiasis, ie, an overgrowth of Candica abbicans, include:

**Itching, soreness and / or burning discomfort in the vagina and vulva

**Heavy white curd-like vaginal discharge

*Bright red rash affecting inner and outer parts of the vulva, sometimes spreading widely in the groin to include pubic areas, inguinal areas and thighs. These may last just a few hours or persist for days, weeks, or rarely, months. Symptoms may sometimes be aggravated by sexual intercourse.
Treatment
There are a variety of effective treatments for candidiasis. Topical antifungal pessaries or vaginal tablets are usually recommended – in mild cases a single treatment is all that is necesarry. A cream formulation may be used if Candida albicans infection is severe or recurrent.

The creams can be used safely in pregnancy, but the tablets are best avoided.

Not all genital rashes are due to candida, so if treatment is unsuccessfuk it may bacause you have another reason for itching or burning.

There is some evindence that the following measures can be helpful:

**Contton or moisture-wicking underwear and loose fitting clothing, avoid uylon pantyhose.

**Soaking in a salt bath. Avoid soap – use a non soap cleanser or aqueous cream for washing.

**Apply hydrocortisone cream to reduce itching and treat secondary dermatitis affecting the vulva.

**Treat with an antifungal cream before each mentrual period and before antibiotic therapy to prevent relapse.

**A prolonged course of a topical antifungal agent is occasionally warranted (but these may themselves cause dermatitis or result in proliferation of non-albicans candida).

Change the personal life style to prevent Vulvovaginal candidiasis and most of common diseases as well.