Patient's question:
I am a 34-year-old married woman. I have never had any abnormal reactions before, just feeling unwell these days.Doctor's answer:
Hello: It may be candidiasis. The main manifestations are vulvovaginitis. Common symptoms include increased vaginal discharge and itching of the vulva and vagina. It may be accompanied by burning pain of the vulva and vagina, especially during urination. It may also include frequent urination, dysuria, and dyspareunia. Typical candidiasis, the vaginal discharge is viscous, white, like bean curd or cottage cheese. Sometimes the discharge is thin, containing white flakes or appears normal. Examination reveals white, flaky membranes attached to the inner side of the labia minora and vaginal mucosa. After wiping them off, the entire vaginal mucosa appears red and swollen. During the acute phase, damaged erosion or superficial ulcers may be visible.2. Vulvovaginitis caused by candidiasis
The vulva has a burning sensation and itching. It is often reported that sexual intercourse is painful and urination is painful. The vulva is red and swollen. There may be vesicular papules appearing in clusters or eczema-like erosion. The inflammation is limited to the vulva or extends to the perineum, around the anus, and the groin folds. In severe cases, it may form ulcers.
(1) General treatment: Actively treat other diseases that can cause candidiasis and eliminate susceptible factors. Keep the vulva clean and dry, avoid scratching. Abstain from sexual intercourse during treatment. Avoid spicy and irritating foods.
(2) Changing the vaginal pH: The optimal pH for the growth of Candida is 5.5. Therefore, using alkaline solutions to rinse the vulva and vagina and altering the vaginal pH can inhibit the growth and reproduction of Candida. A 2%–4% baking soda solution can be used to rinse the vagina once or twice daily, with 2 weeks as one course. After rinsing, dry the vulva to keep it dry and inhibit the growth of Candida.
(3) Vaginal medication: Using imidazole ointments for vaginal medication is very effective for candidiasis. Clotrimazole ointment: 1 capsule nightly, inserted into the vagina after rinsing, with 10–14 days as one course; or Daktarin ointment: 1 capsule nightly, inserted into the vagina after rinsing, with 7 days as one course.
(4) Topical ointments: Using clotrimazole ointment or Daktarin ointment for topical application can treat vulvovaginitis caused by Candida infection and relieve itching and pain of the vulva. Apply externally several times daily for 2 weeks. Eucerin ointment, which contains econazole as the main ingredient and a small amount of topical steroid, has a good anti-itch effect and is more suitable for those with severe itching due to vulvovaginitis or vulvovaginal candidiasis. Apply to the vulva once in the morning and once in the evening.
(5) Oral medication: Since Candida infection can be transmitted between partners through sexual contact, oral medication can be used to treat both partners. Oral medication can also inhibit intestinal Candida. Fluconazole oral: 150 mg once daily. Or Sporanox oral: If it is a first-time infection of vaginal candidiasis, take 200 mg once in the morning and evening, for only 1 day; if it is recurrent candidiasis, the dose of Sporanox needs to be increased. Take 200 mg once daily for 3 days, or take 100 mg twice daily for 3 days. All medications should be taken after meals.