Patient's question:
Doctor, hello. I often have symptoms of vaginal itching. The symptoms disappear after rinsing with clean water, but they return within a day or two. Occasionally, I have cheesy (cheesy discharge). I've also used Daktarin (a brand name for an antifungal medication) in large doses, but it seems like it hasn't completely cured the issue. I can only rinse the vagina with clean water every time I take a bath. Could you please tell me how to treat this condition? Thank you.Doctor's answer:
Hello: You may have a fungal vaginal infection, which can be diagnosed through a routine vaginal discharge test. The most common symptoms of a fungal vaginal infection are external genital itching and a significant increase in vaginal discharge. The itching symptoms of patients can vary in intensity and frequency. The itching caused by a fungal vaginal infection is generally more pronounced than that caused by trichomoniasis. Severe itching can make it difficult for patients to sit or lie down, and they may have trouble sleeping and eating. Patients may also experience a burning sensation in the vagina, which is particularly noticeable during urination. In more severe cases, symptoms such as frequent urination, painful urination, and pain during intercourse may also occur. An increased amount of vaginal discharge is another main symptom of this condition. The discharge is usually thick and can be white or yellow, or it may be thin. A typical fungal vaginal infection discharge is cottage cheese-like or creamy in consistency. During a gynecological examination, the following may be observed: Depending on the severity of the condition, the labia minora and vaginal mucosa may show varying degrees of congestion, and the labia minora may be swollen. The vagina may contain a large amount of thick white discharge, or the vaginal mucosa may be covered with a white membrane. If the membrane is removed, the exposed mucosa may appear red, swollen, and eroded, or may have superficial ulcers.If diagnosed with a fungal vaginal infection, a 2%–4% soda solution can be used to rinse the external genitalia and vagina daily or for sitz baths, with a 10-day course to alter the pH and create conditions unfavorable for fungal survival. Then, an antifungal medication such as nystatin can be used, in the form of powder, tablets, suppositories, or ointment, inserted into the vagina or applied locally, with a dosage of 100,000–200,000 units per application, once daily, for a 10–14-day course. A 3% miconazole ointment can also be applied to the external genitalia for better results. Since this condition is stubborn and prone to recurrence, local treatment is generally preferred. However, oral nystatin tablets (500,000–1,000,000 units) can also be taken three times daily for a 7–10-day course, followed by a follow-up examination.