What causes yeast infections, and how do you get rid of them? - Liesbeth Demuyser

譯者: Wei C. 審譯者: Bruce Sung

The vagina harbors hundreds of different kinds of microorganisms.

陰道內住著數百種不同的微生物

Some tend to be especially prevalent, like Lactobacilli.

其中有些特別普遍， 像是乳酸桿菌

These bacteria produce an acid that lowers the vagina’s pH,

這些細菌會產生一種酸 來降低陰道中的酸鹼值

limiting what can survive there and preventing against certain infections.

限制可以存活的生物 與預防特定感染

Candida yeasts are also usually present in small quantities.

念珠酵母菌也會少量存在

Most of the time, these fungi are harmless.

大多時候這些真菌是無害的

The body’s immune system keeps them in check while other microorganisms,

身體的免疫系統會時刻控制

like Lactobacilli,

而其他微生物如乳酸桿菌

combat and outcompete them for nutrients and territory.

為了養分與地盤 會打擊並最終贏過它們

But under certain conditions, Candida yeasts can cause infections.

但在某個特定的條件下 念珠酵母菌會造成感染

One species in particular, called Candida albicans,

特別是一個菌種叫白色念珠菌

is the usual culprit of vaginal thrush or yeast infections,

是陰道鵝口瘡或稱 酵母菌感染的常見元凶

which affect 3 out of every 4 people with a vagina.

有陰道的每四個人中 便有三個會深受其擾

So, how exactly does a yeast infection happen?

那麼，酵母菌感染 究竟是如何發生的？

Candida albicans yeasts are shapeshifters.

白色念珠菌會變形

And when the balance within the vagina is disrupted—

當陰道中的平衡被打破

like the pH increases or there are fewer microbes to compete with—

像是酸鹼值上升或是 能對抗的微生物變少時

Candida albicans may assume their disease-causing forms.

白色念珠菌就可能成為病原體

They multiply and metamorphose—

它們會繁殖與變形

substituting their rounded structures

將原本圓形的結構

for elongated thread-like forms called hyphae.

變成細長線狀的菌絲

Then, they secrete enzymes that degrade the epithelial cells lining the vagina

之後，它們會分泌出酵素 分解陰道的上皮細胞

and permeate the tissue.

隨後滲透進組織中

Immune cells rush to the site,

免疫細胞會盡速趕到現場

generating some of the most recognizable symptoms of yeast infections:

產生酵母菌感染的 一些最常見的症狀：

itching, burning, swelling, and redness.

搔癢、發熱與紅腫

These may also be accompanied by a change in vaginal discharge,

也會造成陰道分泌物的改變

the fluid that’s frequently flushed from the vagina to keep it healthy and clean.

原本經常流出陰道 保持它健康與乾淨的液體

During a yeast infection, discharge may become thicker and whiter

在酵母菌感染時 會成白色黏稠狀

because the vagina is shedding more epithelial and Candida cells.

因為陰道剝落出 更多上皮與念珠菌細胞

A few major factors, like antibiotic treatments and lower immunity,

幾個主要原因如 抗生素治療與免疫低下

can make people more susceptible to vaginal yeast infections.

會讓人更容易受到 陰道酵母菌感染

When someone’s immune system is compromised, from illness or otherwise,

若免疫系統同時 遭受其他疾病所苦

their body may be unable to control Candida effectively.

身體可能更無法 有效控制念珠菌

And in treating bacterial infections, antibiotics kill harmful bacteria,

假如正在治療細菌感染 使用抗生素能清除有害細菌

but they can also wipe out beneficial ones, like Lactobacilli,

但同時卻會殺掉 如乳酸桿菌等益菌

allowing Candida to multiply more easily.

讓念珠菌能更輕易繁殖

Many other factors also help set the stage for yeast infections.

其他原因也可能 助長酵母菌感染

Hormonal changes and diet alter the vaginal microbiome.

荷爾蒙與飲食改變會 影響陰道的微生物群落

Semen is relatively basic, so it can disrupt the vagina’s pH.

精液相對鹼性 所以能改變陰道酸鹼值

Tight, non-breathable, and wet garments incubate moisture

緊身、不透氣和潮濕的衣物 會留存濕氣

and are thought to facilitate a more Candida-friendly environment.

被認為提供了 有助於念珠菌滋生的環境

Soaps can damage the protective mucus that coats the vagina,

肥皂會破壞附著陰道的保護黏液

making it easier for Candida to permeate.

讓念珠菌更容易滲透

That’s why many doctors recommend just gently washing the vulva with water.

這也是為什麼許多醫生都推薦

只要稍微用清水清洗外陰即可

And it’s important to wipe from front to back

而從前到後地擦拭也十分重要

to avoid introducing more Candida as well as other potentially harmful microbes

可以避免感染更多念珠菌

與其他潛在對陰道有害的微生物

to the vagina.

Most yeast infections are mild and clear up within two weeks.

大多酵母菌感染都很溫和 並且會在兩周內痊癒

Antifungal medications usually offer dependable treatments

通常會透過抗真菌藥物 來降低念珠菌細胞的數量

by reducing the number of Candida cells,

以此提供可靠的治療

allowing the immune system and other microorganisms to regain control.

允許免疫系統跟其他 微生物能重獲控制權

And interestingly, the solution to treating some yeast infections

而有趣地是，有些治療 酵母菌感染的方法

could be more yeasts.

可能是使用更多的酵母菌

Preliminary studies with probiotics containing the harmless yeasts

目前初步的研究顯示

含有無害的酵母菌、 用於釀造與烘焙的益生菌

we use in brewing and baking have shown promise in keeping Candida in check

可以有效控制念珠菌數量

while reducing inflammation.

同時可以抑制發炎

But some yeast infections require more extensive therapies.

但有些酵母菌感染 需要更進一步的治療

About 5 to 10% of people with vaginas

有陰道的人中約 5-10%

experience at least 4 yeast infections a year.

一年會至少經歷 四次酵母菌感染

For some of those, the cause seems to be genetic.

其中一些人的成因似乎是遺傳

Some people have gene variants that make it harder for their immune systems

有些人具有變異基因

使得免疫系統更難 辨認與控管念珠菌細胞

to recognize and regulate Candida cells.

But why many others have recurrent infections is currently unclear—

但為什麼有些人會復發感染 原因至今仍然不明

and requires a lot more research.

需要更進一步的研究

In fact, so does basically everything we've just talked about.

事實上，我們談到的 幾乎所有的事皆是如此

We don’t know nearly enough about the vaginal microbiome.

我們對陰道微生物所知無幾

This is probably because of stigma and underfunding

這大概是因為偏見與缺乏資金

when it comes to topics that traditionally fall under the umbrella

當討論到傳統上歸類為

of “women’s health.”

＂女性健康＂的議題

For instance, while erectile dysfunction affects a much smaller percentage

舉例來說，勃起功能障礙佔比

of people than vaginal yeast infections,

較陰道酵母菌感染的人要少許多

there’s about 6 times more research on the subject.

但卻有六倍多的研究

Hopefully, we’ll soon have a better understanding

希望我們能盡快有更好的了解

of the many microorganismal multitudes we contain—

對於我們所擁有的 多種大量微生物

and how best to keep them in balance.

以及如何最好地維持它們的平衡