DEAR DR. ROACH: If a young, newly married woman has a long history of frequent yeast infections, would it seem rational that some dietary treatment would be sought? What kind of testing should be done? — E.B.

ANSWER: Yeast and bacteria are found normally in the vagina, even if a woman has no symptoms. When the yeast grow out of control and cause symptoms, we refer to this as a yeast infection.

Diet does not seem to play a major role in most women, and studies including a careful diet have not been able to prove that diet reduces symptoms or longevity of yeast infections.

Anecdotally, I certainly have had women patients who have found that diet does seem to play a role in development of yeast infections.

Since diabetes is a common risk factor, testing for diabetes is a good idea, although it’s unlikely to be found unless there are other risk factors.

The data suggest that healthy bacteria, especially lactobacillus, may help prevent recurrence. In that vein, perhaps the woman would consider taking probiotics as a “dietary treatment.”

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DEAR DR. ROACH: I am a 30-year-old female with a weight issue. I am about 100 pounds overweight, according to doctors. I get plenty of exercise and have tried diets. Being overweight runs in my family on both sides.

Doctors do not want to give me anything to help with my metabolism or anything else. I also have acid reflux, but it is not severe enough for medical insurance to cover any type of weight-loss surgery. I am really lost. Doctors claim that the reason I cannot get pregnant is because of my weight. I really, really want to have children. I hope you can offer some ideas and hope. — K.L.

ANSWER: Losing weight • and keeping it off — is one of the hardest things we doctors ask people to do. But it sounds like you are not getting the help you need from your doctors. It’s time to find someone who can work with you. In addition to diet and exercise, medications sometimes can be of benefit. For a 30-year-old who is 100 pounds overweight, I think weight-loss surgery would be appropriate if other treatments alone don’t do the job. Weight-loss experts can work with your insurance company.

It is absolutely true that being very overweight reduces a woman’s chance of getting pregnant, and losing weight can improve her chances. I recommend waiting at least a year after surgery (if that’s what you do) before trying to get pregnant.

DR. ROACH WRITES: I want to congratulate Dr. Paul Donohue on more than three decades of writing this column — an amazing feat. I am also very grateful for the opportunity to take over this column and will try to continue giving the good, practical, usable advice that readers have appreciated through the years. I join the many letter writers who have written to wish Dr. Donohue the best in his retirement. I have seen many heartfelt letters noting advice he has given them that has really made a difference in their lives.

Dr. Donohue, here’s to YOUR good health!

Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to ToYourGoodHealth@med.cornell.edu or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Health newsletters may be ordered from www.rbmamall.com.


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