Some tend to be especially prevalent, like Lactobacilli.

有些往往特別普遍，如乳酸菌。

These bacteria produce an acid that lowers the vagina's pH, limiting what can survive there and preventing against certain infections.

這些細菌產生一種酸，降低了陰道的pH值，限制了什麼可以在那裡生存，並防止某些感染。

Candida yeasts are also usually present in small quantities.

念珠菌酵母通常也以少量存在。

Most of the time, these fungi are harmless.

大多數情況下，這些真菌無害。

The body's immune system keeps them in check while other microorganisms, like Lactobacilli, combat and outcompete them for nutrients and territory.

身體的免疫系統控制著它們，而其他微生物，如乳酸菌，會攻擊並戰勝它們以獲得營養和領土。

But under certain conditions, Candida yeasts can cause infections.

但某些條件下，念珠菌酵母會引起感染。

One species in particular, called Candida albicans, is the usual culprit of vaginal thrush or yeast infections, which affect three out of every four people with a vagina.

特別白色念珠菌，它是陰道鵝口瘡或酵母菌感染的常見罪魁禍首，每四個有陰道的人中就有三人受到影響。

So, how exactly does a yeast infection happen?

那麼，酵母菌感染究竟是如何發生的？

Candida albicans yeasts are shapeshifters.

白色念珠菌的酵母是變形體。

And when the balance within the vagina is disrupted, like the pH increases or there are fewer microbes to compete with, Candida albicans may assume their disease-causing forms.

而當陰道內的平衡被破壞時，筆如pH值增加，或有較少的微生物與之競爭，白色念珠菌就可能呈現其致病形式。

They multiply and metamorphose, substituting their rounded structures for elongated thread-like forms called hyphae.

它們的繁殖和蛻變，替換他們的圓形結構為細長的線狀形式，稱為菌絲。

Then, they secrete enzymes that degrade the epithelial cells lining the vagina and permeate the tissue.

然後，它們分泌的酶會降解陰道內的上皮細胞，並滲透到組織中。

Immune cells rush to the site, generating some of the most recognizable symptoms of yeast infections: itching, burning, swelling, and redness.

免疫細胞就會湧向該處，產生一些最常見的酵母菌感染的症狀： 瘙癢、灼熱、腫脹和發紅。

These may also be accompanied by a change in vaginal discharge, the fluid that's frequently flushed from the vagina to keep it healthy and clean.

這些也可能伴隨著陰道分泌物的變化，分泌物也就是經常從陰道中衝出的液體，以保持陰道的健康和清潔。

During a yeast infection, discharge may become thicker and whiter because the vagina is shedding more epithelial and Candida cells.

在酵母菌感染期間，分泌物可能會變得更厚和更白，因為陰道內脫落的上皮細胞和白色念珠菌細胞更多。

A few major factors, like antibiotic treatments and lower immunity, can make people more susceptible to vaginal yeast infections.

幾個主要因素，如抗生素治療和免疫力降低會使人們更容易受到陰道酵母菌感染。

When someone's immune system is compromised, from illness or otherwise, their body may be unable to control Candida effectively.

當某人的免疫系統因疾病或其他原因受到損害時，他們的身體可能無法有效控制念珠菌。

And in treating bacterial infections, antibiotics kill harmful bacteria, but they can also wipe out beneficial ones, like Lactobacilli, allowing Candida to multiply more easily.

而在治療細菌感染時，抗生素會殺死有害細菌，但它們也可能消滅有益的，如乳酸菌，讓念珠菌更容易繁殖。

Many other factors also help set the stage for yeast infections.

許多其他因素也有助於為酵母菌感染創造條件。

Hormonal changes and diet alter the vaginal microbiome.

荷爾蒙變化和飲食改變了陰道微生物組。

Semen is relatively basic, so it can disrupt the vagina's pH.

精液是相對鹼性的，所以它可以破壞陰道的pH值。

Tight, non-breathable, and wet garments incubate moisture and are thought to facilitate a more Candida-friendly environment.

緊身、不透氣的和潮溼的服裝會孵化出溼氣，並認為有助於建立一個更有利於念珠菌的環境。

Soaps can damage the protective mucus that coats the vagina, making it easier for Candida to permeate.

肥皂會損害覆蓋在陰道上的保護性粘液，使得白色念珠菌更容易滲入。

That's why many doctors recommend just gently washing the vulva with water.

這就是為什麼許多醫生建議只用清水輕輕地清洗外陰。

And it's important to wipe from front to back to avoid introducing more Candida as well as other potentially harmful microbes to the vagina.

而且由前到後的擦拭很重要，可以避免引入更多的念珠菌以及其他潛在的有害微生物到陰道。

Most yeast infections are mild and clear up within two weeks.

大多數酵母菌感染是溫和的，並在兩週內痊癒。

Antifungal medications usually offer dependable treatments by reducing the number of Candida cells, allowing the immune system and other microorganisms to regain control.

抗真菌藥物提供可靠的治療方法，通過減少念珠菌細胞的數量來讓免疫系統和其他微生物重新獲得控制。

And interestingly, the solution to treating some yeast infections could be more yeasts.

有趣的是，治療一些酵母菌感染的辦法是可能是更多的酵母菌。

Preliminary studies with probiotics containing the harmless yeasts we use in brewing and baking have shown promise in keeping Candida in check while reducing inflammation.

對益生菌的初步研究包含了我們在釀造和烘烤中使用的無害酵母菌，讓我們看到了控制念珠菌的希望以及減少發炎症狀。

But some yeast infections require more extensive therapies.

但有些酵母菌感染需要更廣泛的治療。

About 5 to 10% of people with vaginas experience at least four yeast infections a year.

約有5至10%的人有陰部一年至少經歷四次酵母菌感染。

For some of those, the cause seems to be genetic.

對於其中一些人來說，其原因似乎是遺傳的。

Some people have gene variants that make it harder for their immune systems to recognize and regulate Candida cells.

有些人的基因變異使他們的免疫系統更難發揮作用以識別和調節念珠菌細胞。

But why many others have recurrent infections is currently unclear, and requires a lot more research.

但為什麼其他許多人的感染會反覆出現，目前還不清楚並且需要更多的研究。

In fact, so does basically everything we've just talked about.

事實上，我們剛才談到的所有事情基本上都是如此。

We don't know nearly enough about the vaginal microbiome.

我們對陰道微生物組的瞭解還遠遠不夠。

This is probably because of stigma and underfunding when it comes to topics that traditionally fall under the umbrella of "women's health."

這可能是對於在「婦女健康」大傘下的這種話題的恥辱感和資金不足。

For instance, while erectile dysfunction affects a much smaller percentage of people than vaginal yeast infections, there's about six times more research on the subject.

例如，雖然勃起功能障礙比起陰道酵母菌感染影響人數的比例要小得多，但關於這個問題的研究大約有六倍之多。

Hopefully, we'll soon have a better understanding of the many microorganismal multitudes we contain, and how best to keep them in balance.

希望我們很快會能對於體內包含的眾多微生物，以及如何讓他們倒持平衡有更好的了解。