Patient's question:
Dear Dr. Zhang, my friend is 20 years old. She had her first sexual experience with her boyfriend in June of this year, right after her period ended. She didn't bleed, but soon after, she got a yeast infection (which she later found out through a check-up). Her boyfriend should have some issues, as he gave her azithromycin tablets, but it didn't help much. She just used the medicine to rinse. Being her first time with this kind of infection, she didn't dare to see a doctor. Later, when she wasn't feeling better, her boyfriend had sex with her twice in one day, and as a result, the infection became very severe. Everything was swollen and red, and it hurt terribly when touched. The secondDoctor's answer:
Hello; Actively treat, pay attention to hygiene, and it is best for both parties to be treated together. Disinfect and sun-dry clothes.Treatment:
a. Eliminate triggers. If diabetes is present, provide active treatment; promptly discontinue broad-spectrum antibiotics and estrogens. Change underwear frequently. Boil used underwear, basins, and towels.
b. Change the vaginal pH. Use a 2%–4% sodium bicarbonate solution to rinse the vagina, creating conditions unfavorable for Candida survival.
c. Antifungal agents. After alkaline solution rinsing, choose the following medications:
c1: Clotrimazole (clotrimazole) suppositories or tablets, once daily, 1 suppository or tablet each time, inserted deep into the vagina, for 7 days;
c2: Miconazole nitrate (Daktarin) suppositories, 1 suppository inserted into the vagina each night, for 7 days;
c3: Nystatin (nystatin) suppositories or tablets, once daily, 1 suppository or tablet each time (100,000 U), for 7–10 days;
c4: Miconazole vaginal effervescent tablets, 1 tablet inserted into the vagina each night, for 5 days;
c5: 1% gentian violet solution for vaginal application, 3–4 times per week, for 2 weeks. The drug is inexpensive and highly effective, but the concentration must be carefully controlled. If the drug is too concentrated or used too frequently, it may cause chemical vulvitis and epidermal erosion. Due to its tendency to stain clothes, it is now rarely used in clinical practice.
d. Treatment for stubborn cases
① This condition often co-occurs with diabetes. If it does not improve after prolonged treatment, check for urinary and blood sugar levels.
② It may also co-occur with trichomoniasis, so check for trichomonas infection.
③ To prevent mutual intestinal Candida infection, oral nystatin (500,000–1