Patient's question:
A few weeks ago, I got candidiasis (yeast infection), and after one course of treatment, it got better. But yesterday, I went to the hospital for a check-up, and the doctor said I had both candidiasis and bacterial vaginosis. He only prescribed Daktarin suppositories and fluconazole capsules (oral medication), telling me to treat the candidiasis first. Why hasn’t it completely gone away in the past few months? I’m really worried.First follow-up question: Are fluconazole capsules (oral medication) very harmful? Can I take them?
Second follow-up question: The doctor said I have a mixed infection—both candidiasis and bacterial vaginosis—so how should I treat it?
Doctor's answer:
Hello:Vaginal candidiasis is a vaginal infection caused by the fungus Candida albicans. It has a high incidence rate and is prone to recurrence, making it a common gynecological condition. Fungi thrive in acidic environments. They are commonly found in the vagina, mouth, and intestines, leading to mutual infection. The risk factors for vaginal candidiasis include:
1. Transmission through sexual intercourse.
2. Recent use of broad-spectrum antibiotics, which disrupt the vaginal flora and favor fungal growth.
3. Use of corticosteroids, immunosuppressants, or patients with autoimmune diseases are more susceptible to fungal infections.
4. During pregnancy, the prevalence of vaginal candidiasis carriers or infection rates significantly increases.
5. Coexisting diabetes.
6. Oral contraceptive use.
7. Wearing tight nylon pants, etc.
The clinical manifestations of vaginal candidiasis primarily include external genital itching and changes in the amount and characteristics of vaginal discharge. Diagnosis relies on medical history, physical examination, and laboratory tests, and should be differentiated from trichomoniasis, non-specific vaginitis, and mycoplasma or chlamydia infections.
Treatment commonly involves cleaning the external genitalia and vagina with a solution of 2% sodium bicarbonate, followed by local application of antifungal medications such as Daxin or Daktarin. In recent years, incomplete treatment or deep vaginal tissue infections have led to recurrence. For recurrent vaginal candidiasis, oral medications like fluconazole or Spironolactone are effective for prevention. These drugs are taken every 2–4 weeks for 3–6 months, completely controlling symptoms. Monthly premenstrual follow-ups are recommended, and three consecutive negative results indicate cure. Sexual activity should be avoided during treatment, and both partners should be treated simultaneously.
After contracting vaginal candidiasis, the patient is both a source of infection and a victim. Therefore, on one hand, they must actively seek treatment, and on the other, prevent spreading the infection to others.
(1) Vaginal candidiasis is a common and prevalent condition among women. Patients should not feel psychologically burdened and should avoid self-medication. Instead, they should follow medical guidance, take medication correctly, undergo regular follow-ups, and complete the full course of treatment to ensure cure. Never give up halfway.
(2) Identify the underlying cause to reduce the likelihood of recurrence or reinfection. Use antibiotics judiciously.
(3) Maintain clean and dry external genitalia, and avoid scratching as much as possible. When washing daily, use lukewarm water to prevent damaging the skin. Change underwear daily, and wash personal underwear separately. Boil towels, underwear, and utensils for disinfection. Avoid wearing synthetic underwear. Wash hands before and after defecation.
(4) Avoid sexual activity during the illness, especially during acute phases. If intercourse occurs, use condoms to prevent transmission. Both partners should receive treatment simultaneously.
(5) Adjust dietary habits and consume more vitamin-rich foods. During the illness, minimize intake of red meat and spicy foods to avoid worsening itching symptoms.