How should candidiasis be treated?

Patient's question:

Is candidiasis vaginitis long-term and chronic? If treated, can it be cured? Is the treatment cycle very long? Will it affect female fertility? Will it be inherited?

Doctor's answer:

Hello: Candidal vulvovaginitis is very stubborn and prone to recurrence. Treatment should be standardized and cover the entire course without affecting fertility or heredity. If diagnosed as candidal vulvovaginitis, a 2%–4% soda solution can be used daily to rinse the external genitalia and vagina or for sitz baths, with a 10-day course to alter the pH and create conditions unfavorable for the survival of the fungus. Then, nystatin can be used, such as in powder, tablet, suppository, or ointment form, inserted into the vagina or applied locally, at a dose of 100,000–200,000 units per time, once nightly, with a 10–14-day course. The external genitalia can also be treated with 3% miconazole ointment for better results. Due to the stubborn and recurrent nature of the disease, local treatment is generally preferred. Oral nystatin tablets (500,000–1,000,000 units) can also be taken three times daily, with a 7–10-day course, followed by a follow-up to confirm three negative results before considering it cured.
In daily life, attention should be paid to:
1. Proper disinfection and maintaining clean and dry external genitalia.
2. Wearing loose, breathable underwear to avoid irritation and worsening symptoms. Change underwear frequently and boil underwear, bowls, towels, etc., for disinfection to prevent reinfection.
3. Adhering to standardized medication is key to treating the condition. During treatment, both married partners should take medication simultaneously, and use condoms during intercourse to prevent cross-infection.
4. Choose bedtime for medication to facilitate full decomposition and absorption of the drug.
5. Since candidal vulvovaginitis often recurs after menstruation, even when tests show negative results, follow-up is still necessary after menstruation. Three consecutive negative results are required to confirm cure.