What is going on with vaginal candidiasis?

Patient's question:

For several times after menstruation, my vagina itches and hurts. Every time I use antifungal medicine or solution, it usually gets better within about a week. However, the same symptoms appear again after my period. What could be the reason for this? Why does it keep recurring? Is there any harm in this? Thank you

Doctor's answer:

The reasons for the repeated occurrence of candidal vulvovaginitis can be summarized as follows:
First, the lack of diligent medication after developing candidal vulvovaginitis and the failure to achieve complete treatment are important factors leading to the recurrence of the disease. After treatment, candidal vulvovaginitis patients must undergo gynecological examinations and vaginal discharge tests at the hospital every time their menstrual cycle ends, for a total of three consecutive times. If signs of Candida infection are detected during this period, even once, it cannot be considered cured but rather a recurrence or reinfection, requiring continued treatment.
Second, both partners do not receive simultaneous treatment: If a woman contracts candidal vulvovaginitis, the pathogen can be transmitted to her husband through sexual activity, making him a carrier. Approximately 10% of men may develop balanoposthitis. If only the woman is treated while the man is not, even if the woman is cured, she will be reinfected by her husband, leading to the repeated "transmission" of Candida between the couple and the recurrence of candidal vulvovaginitis in women.
Third, failing to change and disinfect underwear and towels according to medical guidelines during treatment can also lead to reinfection with Candida.
Fourth, the human body itself can be a carrier of Candida. When Candida present in the intestines infects the vagina, it can cause candidal vulvovaginitis. For example, poor hygiene habits, such as wiping the external genitalia after defecation from the anus toward the urethra, may introduce intestinal Candida into the vagina, repeatedly triggering candidal vulvovaginitis. Therefore, when treating candidal vulvovaginitis, oral medication should be taken concurrently to eliminate intestinal Candida. Additionally, patients must improve their hygiene habits.
Fifth, frequent or prolonged use of antibiotics.