Paul G. Donohue, M.D.

DEAR DR. DONOHUE: I haven’t seen an article about vaginal yeast infections. The doctor gave me an oral antiyeast medicine for it and a cream to apply. In addition, he gave me something to stop the itching. It seemed worse after the treatment, so the doctor gave me five more days of the oral medicine. What would you suggest if it comes back again? Could it be something I am eating or taking? — N.F.

ANSWER: Candida is the name of the yeast responsible for vaginal infections. Itching is a prominent sign. The vaginal lining also often is irritated and painful. Intercourse can be uncomfortable. White patches adhere to the vaginal lining, and there may be a white discharge. Close to 75 percent of all women will experience at least one Candida infection during their life. It has nothing to do with what you eat or take.

Somewhere between 20 percent and 50 percent of woman harbor this yeast in their vagina but don’t have any symptoms of it. If these women are put on an antibiotic for an unrelated infection, the vaginal bacteria that keep the population of Candida at small numbers die off. Without those good bacteria, the Candida yeasts reproduce at a rapid rate and lead to symptoms.

You were put on a standard treatment for Candida. Those treatments are antiyeast medicines that come as ointments, creams or vaginal suppositories. There are many of them. The oral antiyeast fluconazole (Diflucan) is another approved treatment.

Recurrence of this infection is common and hard to abolish. If it happens, longer treatment with vaginal antiyeast medicines coupled with a weekly dose of oral Diflucan for six months is a reasonable action. If that fails, referral to a center that has the capability to check Candida’s sensitivity to antiyeast medication can end the problem. Unproven but popular ways of attacking this infection include eating yogurt with live lactobacillus in it to repopulate the vagina’s normal bacterial population. Another unproven approach is to treat the male partner. It hasn’t been shown that such an approach works, but some experts resort to it.

Vaginal infections are discussed at length in the booklet on that topic. To obtain a copy, write: Dr. Donohue — No. 1203W, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.75 U.S./$6 Canada. with the recipient’s printed name and address. Please allow four weeks for delivery.

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DEAR DR. DONOHUE: What can you tell me about hypothyroidism? Does taking iodine help? I hear that taking thyroid hormone is a lifetime commitment. — C.N.

ANSWER: Hypothyroidism is a thyroid gland that’s putting out way too little thyroid hormone. All body processes slow. People become weak and are exhausted. They’re cold when others are pleasantly warm. They gain weight without overeating. Their skin dries. The face becomes puffy. The heart beats slowly.

Worldwide, iodine deficiency is the main cause of a sluggish thyroid gland. It is not in North America. Here, the main cause is an attack on the gland by the immune system.

The appropriate treatment is supplying the hormone in pill form. It usually is a lifelong treatment, but it’s not an onerous one. It’s taking only one pill a day.

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Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475.