AYURVEDIC REMEDIES FOR

11 VAGINAL CANDIDIASIS
Dr.Vaishali Jadhav*, Dr. Mohan Kale, Ms. Riya Kamble,
Ms. Rutuja Jawalkar, Mr. Dipesh Gamare.
Konkan Gyanpeeth Rahul Dharkar College of Pharmacy and
Research Institute, Karjat, District Raigad, Maharashtra, India.
vaishaliyjadhav21@gmail.com, +919619560080

ABSTRACT: various decoctions, powder, pastes

Vaginal candidiasis is a vaginal yeast
infection which belongs to the lower
reproductive tract of females and
mostly observed in reproductive age
or child bearing age of female. This
infection is caused due to invasion or
overgrowth of candida albicans in
their favourable conditions. The main
symptoms are vulvar itching,
abnormal vaginal discharge which
may cause pain eventually. The cause
of this infection may vary such as use
of antibiotics, improper diet, lifestyle,
pregnancy, unmaintained physical
hygiene, improper clothing, etc.
Diagnosis is performed with different
methods like pelvic examination,
laboratory methods etc. Generally for
treatment of vaginal candidiasis
allopathic medicines are preferred
due to safe and easy administration
but ayurvedic medicines cannot be
ignored due to minimal side effects
and natural way to cure infection.
Azole class of antifungal drugs such
as fluconazole, clotrimazole,
ketoconazole are prescribed as
primary treatment for vaginal
candidiasis but the infection is
observed to reoccur with increase in
growth of Candida albicans
frequently. On the other hand, in
ayurvedic treatment natural herbs and
medications are used which consist of
and gels etc. Herbs with antifungal
properties like nimba, manjistha,
nagavalli etc. are used. Besides with
ayurvedic treatment candidiasis is
completely cured as it inhibits the
growth of the yeast completely and
minimizes the underlying symptoms.
The immune system is also
strengthened with herbal remedies
thus reducing the chances of
recurrence of vaginal candidiasis. In
this review we discussed the common
causes, symptoms, diagnosis along
with allopathic and ayurvedic
treatment for candidiasis.
INTRODUCTION:
Majority of the women’s irrespective
of their age undergoes some vaginal
infections causing discomfort in the
vagina and one of them is vaginal
candidiasis also called vulvovaginal
candidiasis which accounts for 90%
of the infection.[1] In ayurveda it is
called as “Slaishmiki yoni vyapat.[2]
During the reproductive age, about
75% of women have at least one
episode of vulvovaginal candidiasis
and approximately 50% have two or
more episodes. [3]. Vulvovaginal
candidiasis is characterized by
inflammation, erythema and swelling
of the vagina and is caused by
infection with candida albicans

AYURVEDIC REMEDIES FOR THE DISEASES OF MICROBIAL ORIGINE 140

which though a normal human
microbiome can cause infections like
normal skin infections to life-
threatening systemic infections. The
other candida species such as candida
tropicalis, candida glabrata,
and candida krusei are also found to
infect especiall women. [4]
Thevulvovaginal candidiasis is
categorized intouncomplicated and
complicated of which uncomplicated
cases are sporadic episodes of mild
infections caused by C. albicans. [5]
On the other hand complicated cases
are caused by other species of
Candida generally during pregnancy,
or medical conditions such as
immunosuppression or diabetes.
The vagina is normally resistant to
infection but changes to these layers
that affect the vaginal microbiology,
vaginal epithelium, or vaginal pH
lead to an increased sensitivity to
vaginal infections. [6]If this
candidiasis is left uncured the vaginal
y the HIV-infe pH will get altered to
lower acidic range or higher alkaline
range and which will lead to
alteration and replacement of the
columnar epithelium layer of
ectocervix with that of squamous
epithelium resulting in immature
unstable cells.[2] The predominant
symptom of vulvovaginal candidiasis
is vulvar itching, abnormal vaginal
discharge (which may be minimal - a
'cheese-like' material or a watery
secretion) eventually causing pain
whereas the thers symptoms include
burning sensation during urination or
sex, experiencing pain during sex,
irritation, redness and rash, fragile
skin of the vulva may cause small
cuts or tiny cracks in the area.[7]
AYURVEDIC REMEDIES FOR THE DISEASES OF MICROBIAL ORIGINE
Causes
The disturbance in the chemical
balance in the vagina can be caused
due to various reasons such as
environmental factors such as warm
weather and moist area may lead to
growth of candida albicans, tight and
improper clothing, unmaintained
hygienic health, use of antibiotics
may kill harmless bacteria and fungi
such as lactobacillus which normally
help to limit yeast colonization,
fragile immune system -sometimes in
case of disease like HIV or AIDS,
these medications can weaken
immune system, wet skin, pregnancy
–during pregnancy and at the time of
using the hormonal contraceptives, it
can alter the hormonal level and thus
change in hormones can lead to
change in proportion of candida in
vagina, unprotected sex, improper
diet, stationary lifestyle, diseased
condition – eg. Diabetes- When you
have an uncontrolled diabetes, the
presence of more amount of sugar in
urine impacts on the vagina due to
excess of sugar.[7-9]
Diagnosis
In vaginal candidiasis, exact
incidence of infection is difficult to
evaluate as a high rate of self-
treatment with over-the-counter
medications is reported. Moreover,
the diagnosis is frequently based
entirely on signs and symptoms
without any tests to confirm the
diagnosis. [12]
The treatment for uncomplicated and
complicated cases is different
depending upon the severity of the
disease. Short-term local therapy or
141
 Table 11.1. Methods of diagnosis for vaginal candidiasis
single-dose oral treatment is effective
for treating 90% of uncomplicated
cases whereas the complicated cases
of vulvovaginal candidiasis require
prolonged treatment. In recent years
mainly because of self-medication
the resistance to common antifungal
medication has increased thus
enhancing the scope for traditional
medicine for antifungal and herbal
treatment.
PATHOPHYSIOLOGY
Imbalance of natural vaginal flora
due to some reasons such as
antibiotic use, pregnancy, use of oral
contraceptives, uncontrolled diabetes,
weak immune system, etc. may lead
to yeast infections like vaginal
candidiasis due to overgrowth of
Candida albicans species. The
patients suffering from this infection
may or may not observe symptoms.
C.albicans multiply or grow in the
suitable environment inside vagina
and carbon acts as their source for
AYURVEDIC REMEDIES FOR THE DISEASES OF MICROBIAL ORIGINE
colonization , which is provided by
an increased amount of glycogen due
to high concentration of estrogen and
hence being more susceptible to the
women in their reproductive age
(Figure 11.1).
[13 When C.albicans superficially
penetrates the mucosal lining of
vagina it initiates the innate immune
response and for the corresponding
anti-fungal defence the medication
advised are specially targeted to act
on vaginal epithelial cells. As these
cells contain mucin and keratin -like
surface material which acts as
mechanical and trapping barriers,
they also sense the invasion of
pathogens and mediate cell activation
by showing inflammation as an
immune response by intracellular
multiprotein complexes, known as
‘inflammasomes’.]
Some of the cellular and humoral
factors present in the vagina
contribute to the anti-
Candida defence such as the
gathering of polymorphonuclear cells
142
to the vagina, cytokine (specifically
IL-1β and IL-18) production and
activation of the lymphocyte subsets
T-helper 1 and T-helper 17. [14]
Abbreviations : SAP : Secreted
aspartyl proteinase; PMN :
Polymorphonuclear ;
PRR: Pattern recognition receptor
ALLOPATHIC REMEDIES
may include a single dose of
fluconazole or other antifungal drugs
(Figure 11.2). Topical medications
applied on the skin or inside the
vagina may consist of boric acid,
nystatin, miconazole or clotrimazole.
[4]
AYURVEDIC REMEDIES
Ayurveda is coming up as the best
herbal therapy or medicine to cure
several infections and diseases. As
these medications are inexpensive
and have no or minimum side effects,
many people tend to choose
ayurvedic treatment over allopathic.
As per ayurveda unhealthy diet and
improper lifestyle leads to more
production of kapha or ‘Ama’, it
destroys healthy immunity and self-
defence built by the kapha which
reaches the reproductive system by
mixing with the blood. Ama reduces
cell immunity and changes
permeability of cells due to which
inflammation is seen as the cells
oozes fluid out. In ayurvedic terms,
vaginal candidiasis is considered
under diseases affecting the vagina
and it is called as yoni vyapat. The
AYURVEDIC REMEDIES FOR THE DISEASES OF MICROBIAL ORIGINE
main cause for this infection is said to
be improper digestion of the food
which leads to accumulation of ama
(toxins). And to treat this, the
ayurvedic herbs (Table 1.2) should
activate healthy digestive function
(Table 1.3) and should have
antifungal and antimicrobial
properties along with boosting the
immune system.[16]Along with the
Panchakarma methods like basti and
virachan , some other methods can
also be performed such as,
a. Snehana which is the lubrication of
the internal and external body for
removal of imbalanced doshas.
b. Abhyanga which is oleation of the
external body with the help of
medicated oil (massage),has a
rejuvenating effect. It also promotes
antibody production
c. Swedana means production of
sweat with the help of various
methods such as taking steam,
sweating using heated sand, sweating
by immersion in hot liquids etc.to
reduce stiffness, coldness and
heaviness in the body. As sweating
helps to dissolve accumulated toxins
in the body tissue it ease the removal
of ama (toxins)
d. Pichu is a process in which
medicated tampon-shaped cotton pad
is used to insert in the vagina. It
consists of several medicated oils.
[17]
Ayurvedic medicines used in
treatment of vaginal
candidiasis
1. Nimbadi yoni varti
In Ayurveda it is used as a vaginal
purifier and helps in the treatment of
143
 Fig.11.1 Pathogenesis of Vaginal candidiasis

Fig.11.2 Classification of allopathic drugs used in Vaginal Candidiasis [15]

AYURVEDIC REMEDIES FOR THE DISEASES OF MICROBIAL ORIGINE 144

Table 11.2 Ayurvedic herbs used for treating vaginal candidiasis (16, 17, 18)

AYURVEDIC REMEDIES FOR THE DISEASES OF MICROBIAL ORIGINE 145

AYURVEDIC REMEDIES FOR THE DISEASES OF MICROBIAL ORIGINE 146
 Fig.11.3 Ayurvedic herbs used for treating vaginal candidiasis
various vaginal conditions. It is
effective in decreasing discharge
odor, pain and itching in vagina. It is
a mixture of nimba with triphala
forming a decoction of it.
2. Panchavalkala Kwatha
It is a local treatment for vaginal
cleansing and enhancing immunity.
This formulation consists of various
beneficial properties such as
astringent, antiseptic, stops the flow,
anti-inflammatory and kapha-
pacifying.
3. Gandhak rasayana
This formulation has anti-fungal
properties and effectively used in the
treatment of sinuses in anal region,
skin diseases and gastrointestinal
conditions. This medication is
prepared from cow’s milk, purify
AYURVEDIC REMEDIES FOR THE DISEASES OF MICROBIAL ORIGINE
brimstone, a decoction including
cinnamon, cardamom, Indian rose
chestnut, dry ginger, guduchi juice,
bhringraj juice, ginger juice and other
herbal ingredients.
4. Hinguliyamanikyarasa
This formulation consists of purified
cinnabar, haritala (yellow orpiment),
gandhak and the juice of palash
flower. The herb haritala used here
has antimicrobial activity which
inhibits the growth of candida
albicans.
5. Abhayarishtam
It is prepared from amla, pippali,
jaggery, vidanga, black pepper and
eleven other herbs. This medication
is beneficial to reduce fever and
oedema and overall effective in the
147
 Table 11.3 Diet Management for vaginal candidiasis

people diagnosed with heart

conditions, piles, anaemia,
candidiasis, skin conditions, etc. [17]
Precautions to be taken to
avoid candidiasis
1. Avoid tight clothes.
2. Do not use synthetic material
undergarment.
3. Avoid sleeping during day and late
night awakening.
4. Live stress-free.
5. If sweating is more, then change
clothes accordingly.
6. Do not stop the urge of urination
and emptying of the bowel.
7. Maintain vaginal hygiene.
8. Properly clean the area after
defecation, so as to prevent vaginal
infection from minute faecal matter.
[19]
CONCLUSION:
Vaginal candidiasis being the largest
concern of majority of women is
always been self treated or neglected
leading to drugs resistance issues and
severe causes. Failure to treat
recurrent vaginal candidiasis
observed in 40-55% can lead to
various bio-psycho-social
consequences. Patients may present
with recurrent dysparenia, which may
lead to unhappy sexual life. Even
though numerous allopathic
formulations are available in the
market, the formulations are unable
to treat recurrent vaginal candidiasis
completely. Taking allopathic
treatment in case of chronic infection
can also invite the toxic effects of the
drugs. The ayurvedic approach to
treat the diseases in a natural way is
more preferable rather than allopathic
because it shows a feasible way of
therapies for curing the infection. The
panchakarma methods are popular for
internal cleansing of the body and by
removing the toxins and free radicals
out of the body it reduces the chances
of overgrowth of candida albicans. A
large plethora of ayurvedic

AYURVEDIC REMEDIES FOR THE DISEASES OF MICROBIAL ORIGINE 148

medications having antifungal
properties are available in nature. The
herbal remedies along with antifungal
properties also have vaginal purifying
and immunity boosting properties
leading to wide scope in treating and
avoiding the recurrence of vaginal
candidiasis. Also patients suffering
from candidiasis infection must avoid
salty, sour and sweet food and
maintain health conditions. Along
with medication, relaxation therapies
like yoga and massage should also be
followed for faster recovery. Besides
this detoxification, stress
management, cleanliness and proper
clothing is also necessary to get rid of
this yeast infection.
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