Can a woman get a vaginal yeast infection from using the mikveh? If so, what steps must be taken to prevent this from happening?
We are posting about this issues since we have received this question many times, though the answer is not definitive.
The vaginal area contains a natural system of checks and balances between yeast and good bacteria. When the good bacteria decreases, a fungus called candida can increase and this causes a yeast infection (called Candidiasis). This imbalance and the rise of candida is often due to the use of antibiotics or other medical issues. Generally, yeast infections are not transferred from one person to another, but rather are caused by internal changes in the flora.
However, we have received reports from women that infections are more common when they go to certain mikvaot than others.
So can the mikveh cause an imbalance and therefore lead to a yeast infection?
The mikveh waters are sterilized with a chemical mixture meant to kill bacteria (usually bromine or chlorine sterilizers). If too much chlorine is used the skin can become irritated, which can feel like a vaginal infection. Similarly, if too much of the chemincal is added, it can kill off the good bacteria and the candida may increase and cause a vaginal infection.
We have spoken to two doctors.
One has assured us that it is impossible in the short period of time in which a woman is in the mikveh that either enough bacteria could be killed off to cause a problem or that an infection would live long enough to pass from one woman to another.
However another doctor (a well known gynecologist) stated that there is an increase in patients with yeast infections in certain areas of Yerushalayim, which she feels is caused by improper sterilization techniques. Too much of the chemicals and the good bacteria is killed off as explained above. Too little, and the warm waters of the mikveh may act as a venue in which infections can flourish.
That is why attendants must be extra careful to add the correct levels of chemical, and be aware of the frequency at which the chemical sterilizers need to be checked and added to the water.
Another possibility is that a long, hot, soapy bath taken prior to mikveh immersion can disrupt the normal balance of flora in the vaginal area and bring on a yeast infection. This is especially true for women who have a tendency to get yeast infections often. If you find you get infections after mikveh night, switching to a hot shower instead of a hot bath, may reduce or eliminate the problem. In addition we also suggest coming early to the mikveh. Being one of the first ones in the mikveh can reduce one’s exposure to germs and irritants that enter the mikveh over the course of the evening.
In conclusion, while we don’t know for certain if women get yeast infections at the mikveh, it is clear is that women should be attentive to their own bodies, take the appropriate measures to prevent further infections if they tend to get them (shower, go early or find a different mikveh in which to immerse) and attendants must take care that there is the right amount of chemical sterilization — not too little nor too much.
That’s the best way to ensure that everyone stays healthy!