Patient's question:
Detailed medical condition and consultation purpose: I have had vaginitis since August this year. After treatment, there has been some improvement, but recently I feel it is getting worse again. My discharge is yellow-green, with a slight itching sensation. It becomes more severe after a few instances of sexual activity.Yesterday, I had another examination, and the results showed the presence of Candida. I also had tests for mycoplasma and chlamydia. The test results for mycoplasma were: 1.7x10^6. Could you please explain what this means and how I should address and treat this?
Doctor's answer:
Hello: As long as your condition is positive, treating your fungal infection will be fine! Candidal vulvovaginitis is a vaginal infection caused by the fungus Candida albicans. It has a high incidence rate and is prone to recurrence, making it a common gynecological condition. Fungi thrive in acidic environments and are commonly found in the human vagina, mouth, and intestines, leading to mutual infections. The risk factors for candidal vulvovaginitis include:1. Transmission through sexual intercourse.
2. Recent use of broad-spectrum antibiotics, leading to vaginal flora imbalance and favoring fungal growth.
3. Use of corticosteroids, immunosuppressants, or patients with autoimmune diseases are prone to concurrent fungal infections.
4. During pregnancy, the presence of fungal carriers or infection rates in the vagina significantly increase.
5. Coexisting diabetes.
6. Oral contraceptive use.
7. Wearing tight nylon pants, etc.
The clinical manifestations of candidal vulvovaginitis primarily include vulvar itching and changes in the amount and characteristics of vaginal discharge. Diagnosis relies on medical history, physical examination, and laboratory tests, and should be differentiated from trichomoniasis, nonspecific vaginitis, and infections caused by Mycoplasma and Chlamydia.
Treatment commonly involves cleaning the vulva and vagina with solutions like Jieshu Liquid and 2% sodium bicarbonate, followed by local application of antifungal medications such as Daxin and Daking. In recent years, incomplete treatment or deep tissue infections in the vagina have led to recurrence. For recurrent vulvovaginitis, oral medications are highly effective for prevention. Commonly used antifungal drugs include fluconazole and spiramycin, taken orally every 2–4 weeks for 3–6 months, which can completely control symptoms. Monthly premenstrual follow-ups are recommended, and three consecutive negative results indicate cure. During treatment, sexual intercourse should be avoided, and both partners should be treated simultaneously.