>A client claims that she is clear of vaginal yeast infections when she
>doesn't have sexual relations with her husband.  Once she resumes, she
>says the yeast returns.  Her gyn says that men cannot pass yeast
>infections to his partner.
>By the way, she claims that the irritation is mostly in/around the
>vulva.
Firstly, we have to remember that not all vulvar symptoms are thrush
infections: it may be vulvar vestibulitis, dermatitis or herpes. She may
need to see someone interested in vulvar problems to work it out.
Or it could be the low oestrogen effects of breastfeeding. Using lubricant
with intercourse may not be enough, regular vaginal moisturizer may help
(or local oestrogen cream).
Or, of course, it could be thrush. The reason some doctors say that it
isn't passed from their partner is because some studies have shown that
treating the male partner doesn't decrease recurrences of vaginal thrush.
However other studies show the same biotype of candida is usually present
in both partners and partners of women with recurrent thrush often have
oral candida (the refs are in Candidiasis and Breastfeeding, LC Series).
Using a condom (and a lubricant) cuts down transmission of candida.
Other things to do for vulvar symptoms are to avoid soap (use soap
substitute) and to have short showers, not too hot. If her skin is
generally dry she can use a vegetable oil on the vulva after showers to
avoid dryness, or a sorbolene cream or zinc and castor oil if she has itching.
Sorry about the lecture! But I see women who have been treated for chronic
thrush when they have something else (yesterday it was herpes; recently
lichen sclerosis in one of my patients with a history of nipple thrush).
Lisa Amir
GP / IBCLC in Melbourne, Australia