Patient's question:
Detailed medical condition and consultation purpose: Vaginal itching, pain, what kind of disease might be possible. If it is a yeast infection, what kind of medicine is better to use?Duration of this illness: About five days
Medical history: None
Doctor's answer:
Hello: The possibility of candidal vulvovaginitis is the highest. A wet mount examination can be performed for confirmation. The most common symptoms of candidal vulvovaginitis are external genital itching and a significant increase in vaginal discharge. The itching symptoms of the patient may vary in intensity and occur intermittently. The itching caused by candidal vulvovaginitis is generally more pronounced than that caused by trichomoniasis. Severe itching may cause the patient to be restless and unable to sleep or eat properly. The patient may also experience a burning sensation in the vagina, which is particularly noticeable during urination. In more severe cases, symptoms such as frequent urination, dysuria, and pain during intercourse may also occur. An increased amount of vaginal discharge is another main symptom of this condition. The discharge is usually viscous and may be white or yellow, or sometimes thin. The typical discharge of candidal vulvovaginitis is curd-like or cottage cheese-like, or creamy clumps. During gynecological examination: 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 edematous. The vagina may contain a large amount of viscous discharge, or the vaginal mucosa may be covered with a white membrane. If the membrane is wiped away, the exposed mucosa may appear red, swollen, eroded, or have superficial ulcers.If diagnosed with candidal vulvovaginitis, 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 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. The dosage is 10–20 million units per time, once daily, with 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. Oral nystatin tablets can also be taken, with a dosage of 5–10 million units three times daily, for a 7–10-day course, followed by a follow-up examination.