Patient's question:
Detailed medical condition and consultation purpose: One month ago, I had a vaginal discharge issue. An endocrine examination revealed candidiasis (yeast infection) with excessive discharge. I used medication for a week, including clotrimazole cream, suppositories, and a vaginal wash. I felt that the clotrimazole became more irritating with each use, so the doctor advised me to stop using it. After using the suppositories and wash for seven days, the irritation stopped. However, it returned immediately after my period. I went back to the hospital for more medication, including suppositories and wash. But I didn’t use the wash. Instead, I followed my Chinese medicine teacher’s advice and used herbal sitz baths. This time, I used the suppositories for seven days and had sitz baths for 12 days. There were no more symptoms, so I stopped the medication. Now, I use the wash to rinse every other day, and I occasionally have some irritation down there.Doctor's answer:
Hello: Your condition has not been completely treated, and it is recommended to continue medication.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 disease. Candida thrives in acidic environments and often colonizes the human 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, leading to vaginal flora imbalance and favoring Candida growth.
3. Use of corticosteroids, immunosuppressants, or patients with autoimmune diseases are prone to concurrent Candida infection.
4. During pregnancy, the vaginal carriage rate and infection rate of Candida significantly increase.
5. Coexisting diabetes.
6. Oral contraceptive use.
7. Wearing tight nylon pants, etc.
The clinical manifestations of vaginal candidiasis are primarily 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, nonspecific vaginitis, and mycoplasma or chlamydia infections.
Treatment commonly involves cleaning the external genitalia and vagina with Betadine solution and 2% sodium bicarbonate solution, followed by local application of antifungal medications such as Daxin or Daking. In recent years, incomplete treatment or deep tissue vaginal infection has been shown to easily lead to recurrence. For recurrent vaginal candidiasis, oral medication is highly effective for prevention. Common antifungal drugs include fluconazole and Sporanox, 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.