Patient's question:
Hello! I had a vaginal suppository for candidiasis last year, which cured it. This year, in May, I had an ectopic pregnancy surgery, and after the surgery, I had a recurrence of candidiasis. I have been treating it for 4 months, but it hasn't improved. I have used oral medication, drops, and vaginal washes, but nothing has helped. I suspect it might be due to vaginal dysbiosis. I am 39 and eager to have a child. Could you please recommend a good treatment plan?Doctor's answer:
Candidiasis vulvovaginitis, first rinse the external genitalia and vagina with an alkaline solution such as 2-4% sodium bicarbonate or soapy water to alter the vaginal pH, making it unfavorable for the growth of fungi. After rinsing, insert nystatin tablets or suppositories into the vagina, 100,000-200,000 units each time, once a night, for a course of 10-14 days. Then, apply 3% miconazole ointment to the external genitalia for better results. For stubborn cases, oral itraconazole or fluconazole can be taken to eliminate intestinal candidiasis, or topical miconazole can be used. During treatment, sexual intercourse should be avoided, and underwear should be changed, washed, and boiled daily. After one course of treatment, a fungal test should be negative. Subsequently, a fungal test should be negative after each menstrual cycle. Continuous consolidation treatment for three courses is required to be considered cured. It is best for the male partner to be treated concurrently. Shoes and socks should be washed separately from underwear. Condoms are recommended during intercourse, as recurrence is likely otherwise. The reasons for recurrence are generally incomplete treatment and reinfection from the sexual partner.