Patient's question:
Detailed medical condition and consultation purpose: Doctor, I went to the hospital because of excessive vaginal discharge. I was diagnosed with a fungal infection (vaginitis), and the doctor prescribed some medication. However, after taking the medication, there is still a lot of discharge, and there is no improvement at all. What could be the reason for this?Doctor's answer:
Hello: Common medications for candidal vulvovaginitis include nystatin suppositories, one suppository (10,000 units) inserted deep into the vagina each night, with a 10-day course of treatment. Additionally, you can take nistatine tablets orally for one week. After completing a course of treatment, it is necessary to return to the hospital for a follow-up to determine if further medication is required. While maintaining good hygiene for the external genitalia, your partner should clean the penis before sexual activity.Treatment for candidal vulvovaginitis can be approached with either purely Western medicine or a combination of Western and Chinese medicine.
(1) General treatment: Actively treat other conditions that may cause candidal vulvovaginitis and eliminate predisposing factors. Maintain cleanliness and dryness of the external genitalia, avoiding scratching. Abstain from sexual activity during treatment. Avoid spicy and irritating foods.
(2) Adjusting vaginal pH: The optimal pH value for Candida growth is 5.5. Therefore, using alkaline solutions to rinse the external genitalia 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 a 2-week course of treatment. After rinsing, dry the external genitalia to maintain dryness and inhibit the growth of Candida.
(3) Vaginal medication: Using imidazole-class suppositories for vaginal medication is highly effective for candidal vulvovaginitis. Clotrimazole suppositories, one suppository each night, are inserted into the vagina after rinsing, with a 10–14-day course of treatment; or Daktar suppositories, one suppository each night, are applied to the vagina after rinsing, with a 7-day course of treatment.
(4) External ointments: Applying clotrimazole ointment or Daktar ointment externally can treat vulvitis caused by Candida infection.