Patient's question:
Detailed medical condition and consultation purpose: Doctor, you just said that my mold recurrence needs to be treated for one or two months. I would like to ask, is it necessary to take medication every month except during menstruation? Can we have sexual relations during this period if my husband uses a condom? I am currently using Compound Copper Clotrimazole Ointment externally and Miconazole Suppositories internally. Is this okay? Should the vagina be flushed with medication? When I went to the hospital, the doctor said not to flush the vagina casually to avoid disrupting its pH balance. The oral medication makes me very uncomfortable, but the doctor said it's not necessary to take it; medication alone is sufficient. Before each menstrual period, I feel uncomfortable and only need to use two pills of medication for the vagina. However, I feel uncomfortable every month.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 the 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 a solution of 2% sodium bicarbonate, followed by local application of antifungal medications such as Daxin and Dakin. In recent years, incomplete treatment or deep tissue infections in the vagina have led to higher recurrence rates. For recurrent vulvovaginitis, oral medications are highly effective for prevention. Commonly used antifungal drugs include fluconazole and sporanox, taken orally every 2–4 weeks for 3–6 months, which can completely 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.