Patient's question:
Two months ago, I got vulvovaginal candidiasis. I took two courses of treatment, but after that, there's still a little itching. I use medication to rinse daily, but the itching comes back as soon as I stop taking the medication. What should I do?Doctor's answer:
Hello: Candidal vulvovaginitis 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. Candida thrives in acidic environments and commonly colonizes the human vagina, mouth, and intestines, leading to mutual infection. The risk factors for candidal vulvovaginitis include:1. Transmission through sexual intercourse.
2. Recent use of broad-spectrum antibiotics, which disrupt vaginal flora and favor Candida growth.
3. Use of corticosteroids, immunosuppressants, or patients with autoimmune diseases are more susceptible to Candida infection.
4. During pregnancy, the prevalence of Candida carriers or infection rates in the vagina significantly increase.
5. Coexisting diabetes.
6. Oral contraceptive use.
7. Wearing tight nylon pants, etc.
The clinical manifestations of candidal vulvovaginitis primarily include vulvar 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, nonspecific vaginitis, and infections caused by Mycoplasma and Chlamydia.
Treatment commonly involves cleaning the vulva and vagina with solutions such as Jieshu Liquid and 2% sodium bicarbonate, followed by local application of antifungal medications like Daxin and Daking. In recent years, incomplete treatment or deep vaginal tissue infection has led to higher recurrence rates. For recurrent vulvovaginitis, oral medications are highly effective for prevention. Commonly used antifungal drugs include fluconazole and spiramycin, taken orally every 2–4 weeks for 3–6 months to fully control symptoms. Monthly premenstrual follow-ups are recommended, with three consecutive negative results indicating cure. During treatment, sexual intercourse should be avoided, and both partners should be treated simultaneously.