Yeast Infections Defy Self-Diagnosis

Study finds only a third of women guessed right when buying over-the-counter treatments

FRIDAY, March 1, 2002 (HealthDayNews) -- Before you step up to that drugstore checkout counter, think twice about buying that vaginal yeast infection treatment and consider calling your doctor instead.

That's the advice of a new study that found even women who were certain their symptoms spelled yeast infection were often way off the mark.

The new research, appearing in the March issue of the Journal of the American College of Obstetricians and Gynecologists, found only a third of women who believed they had a yeast infection actually had one.

What makes this study interesting is that it defies conventional wisdom. Most doctors believe women who have had a previous yeast infection would be savvy about recognizing one if it returned. Even the U.S. Food and Drug Administration suggests these women, as well as those who read package labels, are the best candidates for self-care.

However, the new study showed when it came to getting the diagnosis right, neither factor made much difference.

"Surprisingly, the women who had a previous yeast infection were even less likely to identify a second infection correctly than women who never experienced it before," says Dr. Daron G. Ferris, study author at the Medical College of Georgia, where the research was conducted.

What's more, Ferris says, the women who were the most certain about the accuracy of their diagnosis were wrong as often as the women who were far less confident about what was wrong. In addition, women who read labels made mistakes as often as those who did not.

For Dr. Cynthia Krause, the findings are not surprising or alarming.

"I think there is no real downside to buying the wrong over-the-counter yeast treatment, or treating for a yeast infection when you don't really have one, so as long as you realize that if the problems you are experiencing don't clear within a week, you must stop self-treating immediately and see a doctor," says Krause, an assistant professor of obstetrics and gynecology at Mount Sinai School of Medicine in New York City.

Ferris agrees, but adds women should also be aware that a yeast infection is not likely to cause pelvic pain, fever or a foul-smelling yellow, gray or green discharge.

"If you have these symptoms, even along with the classic symptoms of a yeast infection, (a thick, cheesy-looking white discharge, usually accompanied by itching and burning ), then you may have a dual infection, or something else entirely, and you need to see a doctor right away," Ferris says.

Case in point: One woman in the study who thought she had a yeast infection actually had a potentially life-threatening form of pelvic inflammatory disease.

In addition, Ferris says, women should know that at least one type of vaginal infection often confused with yeast infections -- bacterial vaginosis -- may increase their risk of contracting HIV. Other studies have shown that disease can also be linked to pregnancy problems, including increased risk of miscarriage.

The new study looked at 95 women between the ages of 18 and 67 who bought over-the-counter yeast treatments in Georgia, Pennsylvania, Michigan, South Carolina or Nebraska between 1997 and 1999.

At the time of the purchase, store clerks asked the women to volunteer for the study. That meant not using the preparation at all, and instead visiting a nearby study site clinic for testing. If the women agreed, two tamper-proof seals were applied to the product, which the women then took to the clinic. All were seen within 24 hours of making their purchase.

Once at the clinic, the sealed medication was handed over. Then, the women answered questions about what kind of infection they believed they had, how confident they were about their diagnosis, and whether they had read the package label. They were also asked about their gynecological history, including any previously diagnosed yeast infections.

Each woman also received a battery of tests, including laboratory cultures, to help confirm their diagnosis.

Finally, they were classified into four groups: those with a previous infection; those with no previous infection; those who read the package label; and those who did not. The laboratory diagnoses were then analyzed for each group.

The result: Of the 95 women in the study who thought they had a yeast infection, only 33.7 percent actually did. While another 20 percent were diagnosed with yeast infections, they also had at least one other simultaneous infection of which they were not aware.

In addition, 18.9 percent of the woman had bacterial vaginosis, 21.1 percent had mixed vaginal infections with no yeast, 2.1 percent had an infection known as Trichomonas, 10.5 percent had another diagnosis entirely (such as inflammation), and nearly 14 percent had no vaginal infection of any kind.

Comparing those who had previous infections or those who read labels to those who did not yielded similar results.

"For some women, self-diagnosis is clearly an option, but it doesn't seem to work for the majority of women," Ferris says. "So, if your infection has not cleared within a week, or if you are immune-compromised, pregnant or taking any antibiotics, see your doctor as soon as you can."

What To Do

For the symptoms and treatments of yeast and other vaginal problems, check out The National Vaginitis Association.

For information on a variety of vaginal infections, visit The National Library of Medicine.

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