Patient's question:
UntreatedDuration and persistence of this illness: 1 year
Current general condition: Pain worsens before and after menstruation
Previous diagnoses, treatments, and outcomes: Metronidazole was effective when administered vaginally. I have visited many large hospitals, and the diagnosis was bacterial vaginosis with thickening of one adnexa. The condition worsens after menstruation. The initial onset was caused by bacterial vaginosis leading to adnexitis with mycoplasma, but now the mycoplasma has been eliminated. I feel that the bacteria have invaded the adnexa. May I ask if long-term oral or topical metronidazole is possible? Are the side effects significant? Additionally, I am also taking traditional Chinese medicine, but can it cure the bacteria? I have self-examined.
Doctor's answer:
Vaginal candidiasis Use alkaline solutions such as 2~4% sodium bicarbonate or soapy water to rinse the external genitalia and vagina, changing the vaginal pH to make it unfavorable for the growth of fungi. After rinsing, insert nystatin tablets or suppositories into the vagina, 100,000~200,000 units each time, once a night, for a course of 10~14 days. Apply 3% miconazole cream to the external genitalia afterward for better results. For stubborn cases, oral itraconazole or fluconazole can be taken to eliminate intestinal candidiasis, or topical miconazole can be used. During treatment, sexual intercourse should be avoided, and underwear should be changed, washed, and boiled daily. After one course of treatment, a fungal test should be negative. Subsequent fungal tests should also be negative after each menstrual cycle. Continuous consolidation treatment for three courses is required to be considered cured. It is best for the male partner to be treated concurrently. Shoes and socks should be washed separately from underwear. Condoms are recommended during intercourse.