Yeast Infections
Certain antibiotics and corticosteroids (prednisone) have been known to change the normal levels of acidity and bacteria in the vagina. For this reason, women with CF are especially likely to get vaginal yeast infections (also called fungal vaginitis or thrush) caused by a microorganism called Candida albicans.
Symptoms of yeast infections include itching, irritation, discomfort, and pain during sex or urination. Men with CF can also experience yeast infections, although it is far less common. Men may have symptoms such as sores on the penis, irritation, and itching.
Yeast infections can often be treated easily with antifungal creams. In more severe cases, oral medications may be used. If you are being treated for a yeast infection with an anti-fungal medication and take a CFTR modulator, it is important to ask your CF care team whether you need to adjust when and how you take your modulator therapy.
Natural remedies, such as eating yogurt that contains live bacterial cultures, have been thought to potentially help the body re-establish its population of beneficial bacteria. Not all of these remedies have been scientifically proven.
Because yeast infections are so common among women with CF, it is important to schedule annual exams with a primary care doctor or gynecologist. Getting regularly checked and treated for yeast infections and other infections is critical to your sexual and reproductive health and can help improve your everyday comfort.
Urinary Incontinence
Urinary incontinence is the unexpected release of small amounts of urine during activities like sneezing or coughing. One in four women with CF experience urinary incontinence on a regular basis.
Frequent coughing can weaken the pelvic floor muscles. So can physical stresses such as childbirth. Clearing your lungs of mucus is an important form of CF treatment, so making sure that your urinary incontinence does not go untreated and prevent you from coughing fully is important to your larger CF care.
Kegel exercises can help women with CF strengthen the group of muscles that support the bladder. These exercises involve regularly contracting and then relaxing your pelvic floor muscles for up to three seconds. They are recommended to be done in sets of 10 at least three times a day. By working the correct pelvic muscles, women with CF can help prevent and control urinary incontinence.
In addition to Kegel exercises, it is important to strengthen core muscle groups in your back and abdomen to support your pelvic floor. Consultation with a physical therapist who specializes in pelvic floor therapies may be helpful.
Other nonsurgical options to improve symptoms of urinary incontinence include disposable pads or tampon-like devices. Consultation with a urogynecologist or urologist may also be helpful to explore surgical options for urinary incontinence.
Puberty and Periods
One in four adult women with CF report that their CF symptoms worsen with their menstrual cycle. If you notice a change in your CF symptoms during your menstrual cycle, it is important to bring this up with your CF care team.
Poor nutrition, low body weight, and reduced lung function all affect the body's ability to ovulate and menstruate regularly. For this reason, some women with CF who are underweight or malnourished may have absent or irregular periods.
Most females with CF get their first period at a similar age compared to their peers without CF. Still, studies have shown that up to one-third of young women with CF perceive that they continue to have delayed puberty compared to their peers.
If you are missing periods or ovulating less frequently, it is important to talk to your CF care team. Together, you can work on addressing any lung or nutrition problems, improving your general health, and finding ways to put on weight if needed. You can also consider referral to a reproductive health specialist to rule out other causes for absent or irregular periods or delayed puberty.
