When I touch my wife's vagina with my hand during foreplay, a few days later she suffers from painful yeast infection. This seems to happen no matter how well I celan my hands. Even worse, oral sex causes a more severe reaction. The problem has gotten worse over time, and it's gotten to a point where we have had to cease these activities. We woudl like to know if there is something we can do to prevent these infections. We are both in out early 40s.

--D.

The first step is to get your wife to see her gynecologist during one of these reactions. Not all vaginal irritations are yeast infections. Only a visit while she is having symptoms will allow for a correct diagnosis.

If the symptoms are indeed caused by yeast, then there are some things that you can both do to help keep your lovemaking from turning into a nightmare a few days later. First, in addition to handwashing, a shower before intercourse may help -- yeast organisms are all over our bodies, and although bathing will not remove yeast completely, it may help. Recent reports in the medical literature have described women married to bakers who were having frequent yeast infections due to the strains of yeast used to make bread rise! Also, you should see your physician and be checked for thrush, or oral yeast infection. A prescription of nystatin "swish and swallow" will lower the amount of yeast in your mouth as well as the common reservoir of yeast in the gastrointestinal tract; other medications are also available for this purpose.

Another option, again if yeast is the confirmed culprit, is for your wife to either use a topical cream like Monistat or Gyne-Lotrimin after intercourse, or even the oral prescription Diflucan. She should speak to her physician before using any medications. If she douches on a regular basis, then stopping that may help preserve the vagina's ability to ward off infections. Eating yogurt with active cultures or taking a high-quality acidophilus supplement may also help maintain normal vaginal balances and decrease yeast infections.

Your wife's problem is not uncommon, and it can be helped. She should see her gynecologist while she has symptoms. With a little investigation and appropriate treatment, you should both be able to enjoy sex and foreplay again.