Recurrent Yeast Infections Associated with Chronic Stress

Women with recurrent yeast infections appear to have lower-than-normal morning levels of salivary cortisol, a sign of stress that could indicate an increased vulnerability to candida, according to a pilot study.

On the other hand, the Karolinska Institute investigators conceded, it could be that recurrent yeast infections produce chronic stress.

The investigators found that among 35 women with recurrent vulvovaginal candida, morning cortisol levels from saliva samples were significantly lower (P<.002) during the first 45 minutes after waking up, compared with 35 women who did not have frequent yeast infections.

These women may be more vulnerable to recurrent candida vulvovaginosis and other infections because chronic stress impairs immunity, explained a research team led by Sophia M. Ehrstro"m, M.D., and colleagues reported in the October issue of American Journal of Obstetrics and Gynecology.

Although cortisol typically rises in the morning, paradoxically, a lethargic cortisol level at that time of day could indicate chronic stress, the authors said.

The recurrent yeast infection group reported more genital infections overall. For example, the study also found 53% percent of the recurrent yeast infection group reported a history of bacterial vaginosis infection versus 9% among the controls, (95% confidence interval, 2.7-72.5, P<.001) and 43% reported a history of condyloma versus 6% in the control group (95% CI 2,3-122, P<.001).

However, they wrote, infection "is a condition per se that may produce chronic stress." The annoying symptoms of yeast infection, such as the repetitive itching, for example, may interfere with daily function and even sex, which could then impact relationships, they said.

The study compared two groups of women with a mean age of 27 and who had no significant differences in body mass index (BMI) or median age at first sexual intercourse. The women were asked to answer a questionnaire to provide details about their lifestyle, sexual behavior, and past medical history, including whether they used oral contraceptives. All 35 patients with recurrent yeast infections had experienced a minimum of four yeast infections in the past year.

Vaginal yeast infection
This is a vaginal infection caused most commonly by the fungal organism Candida albicans.

Causes, incidence, and risk factors

Candida albicans is a widespread organism with worldwide distribution. It is normally found in small amounts in the vagina, the mouth, the digestive tract, and on the skin without causing disease or symptoms (approximately 25% of women without disease symptoms have this organism present).