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According to some doctors, the widespread use of antibiotics since the 1940s has produced an ‘epidemic’ of Candida overgrowth, or candidiasis. They also believe that too much sugar in the diet, and the use of the contraceptive Pill have contributed to the problem. Sugar is the natural food of yeasts (which is why they are used in brewing), and it is clear that sugary diets do encourage Candida to grow. The role of the Pill is slightly less obvious, but the statistics show that the Pill increases the risk of Candida overgrowth for women.

Exactly how the Pill produces this effect is unknown – the simplistic explanation usually offered is that the hormones in the Pill promote Candida because they are steroids, but this is really no explanation at all. It is true that corticosteroids will promote infection by Candida in susceptible individuals, because they have a general depressive effect on the immune system (see p318). Among its many other duties, the immune system has the responsibility of keeping gut microbes where they belong – only in the gut and not in the body’s tissues. But the steroids in the Pill are of a different sort – they are the female sex hormones (or closely related chemicals) and they do not act in the same way as corticosteroids.

There is great disagreement over the effect of the Pill on immune function. Some studies have shown that the Pill decreases antibody production slightly, and others have shown more allergies, infections and autoimmune diseases among Pill-takers. But the differences are very small indeed, and most doctors feel that the effects of the contraceptive Pill on the immune system are insignificant.

However, there does seem to be a relationship between the level of the female sex hormones, oestrogen and progesterone, and the ease with which Candida infects the body. But this is not a general suppression of the immune system, more a specific interaction between the sex hormones and Candida. This may explain why candidiasis is so much more common in women generally, as well as showing how the Pill might influence candidiasis.

Anything that depresses the activity of the immune system can lead to Candida overgrowth. Long-term use of corticosteroids for diseases such as asthma or rheumatoid arthritis can make people more susceptible, and Candida infections in the mouth and throat are a feature of AIDS. Vitamin and mineral deficiencies can affect the immune system, as can stress, and these factors may be important in some people with candidiasis.

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