Vaginal candidiasis, caused by fungi, what to do about foul-smelling discharge

Patient's question:

Detailed medical condition and consultation purpose: Want to stop the odor
Duration and frequency of onset: Frequent and irregular
Current general condition: Odor
Medical history: Trichomonas and mold
Previous diagnosis and treatment history and effectiveness: Used vaginal suppositories and solutions
Auxiliary examinations: Gynecological examination
Other infections are very severe

Doctor's answer:

A wet mount test can be performed to confirm the diagnosis. The most common symptoms of candidal vulvovaginitis are external genital itching and a significant increase in vaginal discharge. The itching in patients can 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 restlessness and sleep disturbances. 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, 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. A typical candidal vulvovaginitis discharge appears like cottage cheese or curd-like. 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 significant amount of viscous discharge, or the vaginal mucosa may be covered with a white membrane. If the discharge membrane is removed, 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 growth of Candida. Subsequently, nystatin can be used, such as in powder, tablet, suppository, or ointment form, inserted into the vagina or applied locally. The dosage is 100,000–200,000 units per application, once daily, for a 10–14-day course. Additionally, a 3% miconazole ointment can be applied to the external genitalia for better results. Due to the stubborn nature of this condition and its tendency to recur, local treatment is generally preferred. Alternatively, oral nystatin tablets (500,000–1,000,000 units) can be taken three times daily for a 7–10-day course, followed by a follow-up examination. The condition is considered cured only if three consecutive negative tests are obtained.