Patient's question:
Main symptoms: Leukorrhea like bean curd; cannot flow out, no odor, especially itchy. Onset time: Over 4 and a half months. Test results: Candidal vaginitisDoctor's answer:
Analysis of the Condition: The symptoms of candidal vulvovaginitis include vulvar itching, which can severely affect sleep and work. There is an increase in vaginal discharge, which appears as white, thick, curd-like material.Guidelines for Treatment: Candidal vulvovaginitis can be treated with either pure Western medicine or a combination of Western and traditional Chinese medicine.
(1) General Treatment: Actively treat other conditions that may cause candidal vulvovaginitis and eliminate predisposing factors. Maintain vulvar cleanliness and dryness, and avoid scratching. Abstain from sexual activity during treatment. Avoid spicy and irritating foods.
(2) Changing the Vaginal pH: The optimal pH for Candida growth is 5.5. Therefore, using alkaline solutions to rinse the vulva and vagina can alter the vaginal pH, inhibiting the growth and reproduction of Candida. A 2%–4% baking soda solution can be used to rinse the vagina once or twice daily, with 2 weeks constituting one course. After rinsing, dry the vulva to maintain dryness, which helps inhibit Candida growth.
(3) Vaginal Medication: Using imidazole ointments for vaginal application is highly effective for candidal vulvovaginitis. Clotrimazole suppositories: Insert one nightly after rinsing, for 10–14 days per course. Alternatively, Daktarin suppositories: Insert one nightly after rinsing, for 7 days per course.
(4) Topical Ointments: Clotrimazole cream or Daktarin cream can be applied externally to treat vulvar inflammation caused by Candida infection, alleviating itching and pain. Apply externally several times daily for 2 weeks. Eucerin cream, which contains econazole as the active ingredient and a small amount of topical steroid, provides excellent anti-itch effects and is particularly suitable for those with severe vulvar itching due to candidal vulvovaginitis. Apply to the vulva once in the morning and once in the evening.
(5) Oral Medication: Since Candida infection can be transmitted between partners through sexual activity, oral medication can be used to treat both individuals. Oral medications can also inhibit intestinal Candida. Fluconazole oral: Take 150 mg once. Alternatively, Sporanox oral: For first-time Candida vulvovaginitis infection, take 200 mg once in the morning and evening for 1 day. For recurrent candidal vulvovaginitis, increase the dose to 200 mg once daily for 3 days, or 100 mg twice daily for 3 days. All medications should be taken after meals.
(6) Herbal Treatment: Boil herbs with (clearing heat and detoxifying) and (insecticidal and anti-itch properties) effects, and use the decoction to rinse the vulva. This can alleviate symptoms and inhibit or eliminate Candida. Due to the significant reduction in vulvar itching and burning after rinsing, this method is particularly suitable for women with acute candidal vulvovaginitis, helping to reduce their discomfort. Additionally, herbs can be prepared as powders or suppositories for vaginal application.
Lifestyle Advice: Avoid prolonged use of alkaline rinses, as they may initially relieve itching but disrupt the vaginal acidic environment, leading to more severe dysbiosis. Also, avoid scratching. Wearing loose cotton underwear is recommended. Wishing you a speedy recovery.