Patient's question:
Doctor:I started experiencing external itching around the fourth or fifth day of my period. The menstrual flow had already stopped, but the discharge was slightly light yellow and somewhat like cottage cheese, yet it also resembled normal discharge (a bit like white, sticky mucus). What kind of inflammation could this be?
On the eighth day, since my discharge was yellow instead of the usual menstrual flow, I performed a rinse and inserted a medication. Is it okay to use medication like this on the first day after my period?
Previous diagnoses and treatments
Doctor's answer:
Hello: You may have candidal vulvovaginitis, which can be diagnosed through a vaginal discharge test. The most common symptoms of candidal vulvovaginitis are external genital itching and a significant increase in vaginal discharge. The itching symptoms of patients can vary in intensity, occurring intermittently. The itching caused by candidal vulvovaginitis is generally more pronounced than that caused by trichomoniasis. Severe itching can make it difficult for patients to sit or lie down, causing restlessness and disturbed sleep and appetite. 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, painful urination, and dyspareunia may 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 membrane is wiped away, the exposed mucosa may appear red, swollen, eroded, or have superficial ulcers.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 survival of fungi. Then, antifungal agents such as powder, tablets, suppositories, or creams can be inserted into the vagina or applied locally. The dosage is 100,000–200,000 units per time, once daily, with a 10–14-day course. A 3% miconazole cream can also be applied to the external genitalia for better results. Since this condition is stubborn and prone to recurrence, local treatment is generally preferred. Alternatively, oral antifungal tablets (500,000–1,000,000 units) can be taken three times daily, with a 7–10-day course, followed by a follow-up examination. A condition is considered cured only if three consecutive tests are negative.