Q: Good morning doctor, I have been having scanty period since December last year. I went for treatment it was diagnosed it was candidiasis. I was place on drugs to clear it. In March I had my normal follow. In April it became scanty and this may it has come after 14days. Please what do I do please? Thanks
A: A reduction in flow (scanty period) is called hypomenrrhea (pronounced hai-po-men-oria) and a reduction in the number of days of flow to less than 3 days is called oligomenorrhea (oli-go-men-oria).
Now at the onset of puberty, the flow and cycle can vary from one cycle to the other; the same goes for the other extreme of life (old age).
Other issues that can cause a decrease in flow include pregnancy (the supposed period may be an implantation bleed), crash dieting (when you want to lose all the weight you added in 5 years in one week :D), intense physical activity, Polycystic Ovary Disease (PCOD), imbalance of hormones and use of contraceptives. Previous instrumentation like Dilatation and Curettage (D and C), where the procedure was too ‘vigorously’ done can result in a condition called Asherman’s syndrome which manifests as reduction in menstrual flow. In the same way that stress can delay a menstrual period, it can also cause a reduction in flow.
You must work with your gynaecologist in order to manage this. If the cause is PCOD, focus will be on the treatment; if due to intense exercise, reducing intensity will be helpful; if due to crash dieting, focus on eating a proper balanced diet will help etc. Your gynaecologist will carry out a detailed examination and investigation to arrive at the cause and advice on treatment.
This situation (scanty mensis) is very different from candidiasis. However, the two conditions can occur together.
Candidiasis is caused by an organism called Candida (Candida albicans), a fungus (yeast). This infection can result in cheesy white (like ground melon/egusi seeds) vaginal discharge and vaginal itching. This itching can lead to irritation in the vagina which can become further infected by bacteria.
Candidiasis is very common in diabetics (the sugar in their urine makes the vagina a rich culture medium for them) and pregnant women who have altered glucose tolerance. This infection is also common in people whose immune systems are compromised and people who wear tight panties that do not allow their delicate inner selves to ‘breath’. Preferred materials for undies would be cotton and should be loose (I see my fashionistas frowning :D). It also happens in people who take a lot of antibiotics. Normally, some bacteria and fungi (yeast) co-exist peacefully 😀 in the vagina. To encourage this peaceful co-existence, the bacteria produce some acid that hold the yeast in check and prevent their over-growth. When antibiotics are abused, this leads to a situation where the yeast takes over (almost like a coup, right?). Though this infection can be passed on through sexual intercourse…especially oral-genital contact, it’s not really called an STI because women who are not sexually active can be infected with this.
Treatment is with anti-fungal vaginal tablets and/or anti-fungal cream which can be used for between 1-3 days depending on drug of choice. A single course dose of Fluconazole can also be taken orally. Any of these regimen may be extended if the infection is complicated…let your doctor be the best judge of that
Prevention is targeted at causes:
Wear loose fitting cotton undies
Stay away from or limit time spent in hot tubs or saunas
Stick strictly with the prescription for antibiotics in terms of quantity and duration
Change out of wet clothes eg swim suits as soon as possible
Remember that your treatment will not work if you keep exposing yourself the risk factors like wearing tight, nylon undies, taking antibiotics indiscriminately etc. Candida infections would usually occur about a week before a menstrual period (though it can and does occur at other times too).
Have a good night y’all 😀