Symptoms and main methods of treatment of vaginal candidiasis

Vaginal candidiasis or, in other words, thrush is a well-known disease provoked by microscopic yeast-like fungi of the genus Candida.

The infection attacks only a weakened body, so it is impossible to cause the disease in a woman with good immune defense. At the same time, the pathology tends to be persistently chronic, despite treatment.

General practitioner: Azalia Solntseva ✓ Article checked by doctor

Vaginal candidiasis in women

Candidiasis (thrush) is an infectious disease caused by yeast-like fungi and characterized by irritation, discharge and severe itching at the level of the vagina and external genitalia. It is one of the types of vaginitis (inflammatory diseases of the vagina).

Although candidiasis is not considered a sexually transmitted disease, transmission of the fungus is still possible through oral contact with the genitals. The infection responds well to drug treatment. In case of recurrent form of the disease (> 4 times per year), a longer course of treatment may be required.

Women of fertile age are more often affected by yeast-like infections. Less commonly, they can occur during menopause, those not taking estrogen replacement therapy, and very rarely in girls who have not had menstruation.

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Signs and symptoms

Signs of vaginal candidiasis:

• itching and irritation in the external genital area and around the vaginal opening;
• pain during urination;
• dryness and irritation at the genital level;
• painful sexual intercourse;
• redness and swelling of the genitals;
• In some women, discharge may be absent or become watery/cheesy in nature.

Symptoms of vaginal candidiasis often resemble those of bacterial vaginosis, trichomoniasis and dermatitis. It is impossible to accurately determine whether the itching is caused by candidiasis or another disease; a specialist can confirm the signs of the disease after examination.

Contact your healthcare provider if you experience these symptoms. They may clinically resemble other vaginal infections and may require different medications. The doctor will tell you if you really have thrush and prescribe the necessary treatment.

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Treatment medications - ointment, gel cream and other medications

What medications for vaginal candidiasis should I pay attention to? A short course of treatment with topical agents (single doses and 1-3 days) is effective. Local use of drugs from the imidazole group is preferable to nystatin. In 80-90% of cases, treatment with imidazole groups relieves symptoms and bacterial growth.

Ointment for vaginal candidiasis: tioconazole 6.5% 5g intravaginally.

Gel: metronidazole (metrogel-vaginal) 0.75% in women with recurrent bacterial vaginosis.

Cream applied intravaginally:

• clotrimazole 1% 5 g, 7-14 days;
• clotrimazole 2% 5 g, 3 days;
• miconazole 2% 5 g, 7 days;
• miconazole 4% 5 g, 7 days;
• miconazole 2% 5 g, 7 days;
• butoconazole 2% 5 g, once;
• terconazole 0.4% 5 g, 7 days;
• terconazole 0.8% 5 g, 3 days.

Pills:

• fluconazole 150 mg orally, once;
• clotrimazole 100 mg vaginal tablets (gynelotrimin, mycelex-7) one tablet is inserted into the vagina for 7 days, or 2 tablets for 3 days;
• clotrimazole 500 mg vaginal tablets – one tablet, once.

Candles:

• miconazole 100 mg, suppositories administered once a day, 7 days;
• miconazole 200 mg, administered every 3 days;
• miconazole 1200 mg, administered once;
• terconazole 80 mg, one suppository – 3 days.

The above creams and suppositories are oil-based and may reduce the effectiveness of condoms and vaginal diaphragms. Read the condom instructions carefully for more information. Intravaginal preparations containing clotrimazole, miconazole and tioconazole are available without a prescription.

All women who experience a return of symptoms within 2 months after treatment should be clinically assessed. Misuse of these drugs is widespread and can lead to treatment delays and side effects.

www.cdc.gov

Causes of vaginal pathology

The disease is caused by a yeast-like fungus of the genus Candida. Normally, the vagina contains a balanced mix of microorganisms, including fungi and bacteria. Lactobacilli produce acid, which inhibits the growth of yeast.

This balance can become disrupted and lead to the growth of yeast infections. Too much yeast in the vagina causes itching, burning and other classic symptoms of such an infection.

Causes of vaginal candidiasis:

• the use of antibiotics that reduce the number of lactobacilli in the vagina and reduce acidity;
• pregnancy;
• uncontrolled diabetes;
• immune system disorders;
• the use of oral contraceptives or hormonal therapy, which increases estrogen levels.

Candida albicans is the most common fungus responsible for yeast infections. Sometimes other members of the Candida genus may be involved and may require more aggressive treatment.

Yeast infections are more commonly associated with certain sexual activities, especially during oral-genital intercourse. However, the fungus is not a sexually transmitted disease. This infection can develop even in women who are not sexually active.

www.mayoclinic.org

Illness during pregnancy - how to treat the infection

Vulvovaginal candidiasis, often called a yeast infection, affects 3 out of 4 women in their lifetime. More than 40% of those who get sick will have it again. Pregnant women are more susceptible.

The increase in estrogen and glycogen in vaginal secretions during pregnancy is thought to increase the risk of developing vulvovaginitis. Since women of childbearing age are the most affected, it is important to understand the mechanism of this disease, as well as the risks associated with taking medications during pregnancy.

There are many safe treatments for candidiasis in pregnant women. Local antifungal agents from the imidazole group (butoconazole, clotrimazole, miconazole, fluconazole, terconazole) have been well studied, are commercially available and do not require a doctor's prescription.

To relieve symptoms of itching and redness during pregnancy, short-term use of weak topical glucocorticoids is considered safe.

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Prevention of female problems

Women with weakened immune systems are more likely to develop yeast infections. This can occur in cancer with chemotherapy, treatment with steroid drugs and diabetes.

Pregnant women and those taking oral contraceptives are also at risk. They need prevention to maintain their own health and normal fetal development.

Taking antibiotics can disrupt the normal bacterial flora in the vagina, creating a favorable environment for yeast to grow. Any fungal infection of the vaginal mucosa should be treated comprehensively.

Taking steps to reduce moisture in the genital area can help reduce the risk of developing a yeast infection. To do this, you need to wear cotton underwear, loose pants and avoid prolonged contact with wet clothing, such as after playing sports or swimming.

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Recurrent type of disease

Recurrent vulvovaginal candidiasis (RVVC) usually means 4 or more episodes of the disease per year. It is rare, occurring in no more than 5% of women.

C. glabrata and other fungi occur in 10-20% of women with recurrent vulvovaginal candidiasis. Conventional antifungals are not as effective against these species as they are against C. albicans. The disease is especially dangerous during pregnancy.

Treatment: basic medications. If the pathology is caused by the C. albicans virus, it can be easily treated quickly with oral or local drugs from the imidazole group.

However, for clinical and mycological control purposes, some experts recommend longer treatment (7-14 days with topical agents or oral fluconazole 100 mg, 150 mg, or 200 mg, once daily, on days 1, 4, and 7) to initiate mycological remission before starting maintenance therapy.

If this regimen is not possible, intermittent use of topical medications may be considered. Maintenance therapy has proven effective in reducing the incidence of infection.

However, if treatment is interrupted, 30-50% of women experience a return of infection. If after a course of maintenance therapy there are still symptoms of the disease and a positive culture, you should consult a specialist.

www.cdc.gov

Bacterial vaginosis as an inflammation

Bacterial vaginosis is a form of vaginal inflammation caused by an overgrowth of bacteria normally found in the vagina.

Women of reproductive years are most susceptible to this disease, but you can get sick at absolutely any age. The causes of the pathology are not fully understood, but the risk increases with unprotected sex and frequent douching.

How to treat bacterial vaginosis:

1. Metronidazole (Flagyl, Metrogel-Vaginal). Dispensed in the form of tablets for oral administration. Also available as a gel for insertion into the vagina. To reduce the risk of developing gastrointestinal symptoms, you should avoid drinking alcohol while taking the medicine and for at least one day after.
2. Clindamycin (Kleotsin, Klindes). Cream for insertion into the vagina. May reduce the effectiveness of condom use during treatment and for at least 3 days after.
3. Tinidazole (Tindamax). Oral route of administration. Just like when using metronidazole, it can cause side effects from the gastrointestinal tract when drinking alcohol.

These remedies should be used as prescribed by your doctor, even if the symptoms disappear prematurely. The doctor may also prescribe an ointment that relieves symptoms. Interruption of treatment increases the risk of recurrence of infection.

www.mayoclinic.org

Candidiasis of the vulva and vagina

Risk factors for the development of vulvovaginal candidiasis are: recent use of antibiotics, uncontrolled diabetes mellitus, HIV infection. Although Candida albicans is the cause, other species such as C. glabrata and C. tropicalis are also diagnosed.

Patients with candidiasis of the vulva and vagina usually complain of itching (50%), swelling (24%), and urinary problems (33%). Vaginal discharge is usually cheesy and white. However, similar manifestations can occur in other diseases, which must also be kept in mind.

All standard treatment methods are quite effective. Topical products are available without a prescription. However, most women prefer a single 150 mg dose of fluconazole (Diflucan) taken by mouth because of its ease of use.

This treatment has been shown to be similar to seven days of intravaginal clotrimazole. However, it is worth keeping in mind that at the moment there is insufficient research on the safety of fluconazole during pregnancy.

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Acute type of illness

The diagnosis is made in women based on symptoms of vaginitis and microscopy of vaginal discharge, confirming the growth of yeast-like fungi, or other tests that show a positive result. Candidal vaginitis usually appears when the acidity in the vagina is normal. (pH < 4.5)

Microscopic examination with potassium hydroxide is indicated in all women with symptoms of vulvavaginal candidiasis. Vaginal thrush is an extremely unpleasant disease. The advanced form can cause a number of complications.

www.cdc.gov

Source: https://zemed.ru/mikoz/vaginalnyj-kandidoz.html

Vaginal candidiasis (thrush)

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For a woman, the period when thrush progresses becomes, to put it mildly, unpleasant. Itching in the vagina begins to bother you, which intensifies in the evening, and is accompanied by a curd-like discharge that is white in color and has a sour smell. The microflora in its composition changes dramatically, and beneficial lactobacilli begin to die. Ignoring the problem leads to the appearance of vaginitis and adhesions in the fallopian tubes, after which the woman faces infertility. To prevent this from happening, you need to know the main symptoms of thrush, the reasons for its intense manifestation and the rules of prevention.

Symptoms of vaginal candidiasis 

The symptoms of vaginal candidiasis are very difficult to confuse with the consequences of other infectious diseases. Even before visible signs appear, the woman already begins to feel itching in the vaginal area, which intensifies after water procedures with warm water and in the evening.

The disease has several variants: chronic and acute, which arise depending on the course of the disease itself, each of which progresses with different symptoms.

Acute vaginal candidiasis

• discharge of a cheesy consistency, which can be both moderate and abundant;
• burning and itching in the genital area (especially acute after urination, sexual intercourse, during the menstrual cycle and when wearing synthetic underwear);
• the frequency of urination increases, during which there is pain;
• swelling and redness of the vaginal walls are visually visible.

After 2 months, if treatment has not been carried out, thrush turns into recurrent vaginal candidiasis (chronic form).

Chronic vaginal candidiasis

With a recurrent disease, the symptoms are mild or disappear altogether, appearing periodically:

• discharge of a liquid consistency, white, odorless;
• atrophy of the vaginal mucosa can be visually observed;
• the itching is almost not felt, but increases after hypothermia and sexual intercourse.

During periods when the disease worsens, all the signs of the acute form begin to appear.

Vaginal candidiasis during pregnancy

Often women are concerned about another question: is it possible to get pregnant with vaginal candidiasis? Pregnancy with thrush is quite real, and many women do not feel any symptoms of the disease at all. The menstrual cycle does not change, and the reproductive organs function normally. Conception can only be affected by the altered microflora of the vagina itself, where it is problematic for sperm to survive, but more often this applies to those women who already have a chronic form of thrush.

Causes

By ignoring the problem at the first symptoms and not starting timely treatment, candida multiplies, and soon a discharge begins to appear that resembles a curd mass. Fungal growth can be triggered by:

• taking antibiotics that kill organisms that are part of the beneficial microflora, while the fungi themselves are almost not affected;
• passion for douching, as a result of which beneficial microflora is washed out;
• existing serious diseases, such as HIV infection, diabetes, various inflammatory processes, problems with the genitourinary or digestive systems;
• failure to comply with simple hygiene rules;
• pads and various hygiene products that are irritating to the skin;
• tight underwear made of synthetics;
• hypothermia and changes in climatic conditions;
• frequent stress;
• sexual intercourse with an infected (yeast) partner.

Thrush is common in women during pregnancy due to physiological changes in the body and a suppressed immune system.

Complications

Although thrush is considered a minor disease that is easily cured, ignoring it and refusing treatment can lead to serious consequences. Most often, complications appear in the form of:

• lesions of the mucous membrane of the genital organs, which may be subject to secondary infection;
• spread of infection to the kidneys;
• painful sensations during sexual intercourse;
• Having passed into the chronic stage, the disease leads to the growth of connective tissues, the appearance of various adhesions and the appearance of scars, after which infertility is diagnosed;
• complications such as adnexitis, endometritis and salpingitis, the disease no longer responds to treatment.

Treatment of vaginal candidiasis 

There is a lot of information on how to cure vaginal candidiasis on your own.

But when self-medicating, you need to understand that an untreated disease with an incorrectly selected drug therapy regimen can become chronic and lead to serious complications.

It is also necessary to take into account the reasons due to which the intensive growth of the fungus could be provoked.

By turning to the specialists of the K+31 Clinic medical center, a woman has the opportunity not only to receive effective treatment for vaginal candidiasis, but also to identify other diseases that provoke the growth of the fungus. The “Clinic K+31” center is equipped with the most modern equipment, which meets European standards and will help you undergo any tests, and highly qualified doctors will provide effective assistance.

Prevention of vaginal candidiasis 

• genitals must always be dry and clean;
• for water procedures, use only products made for intimate hygiene;
• try to avoid bath foams, various sprays and carefully select powder for underwear;
• Various laundry bleaches can have a detrimental effect on beneficial bacteria in the vagina;
• avoid douching;
• while taking antibiotics, you must also take lactobacillus preparations;
• use condoms during sexual intercourse;
• Avoid tight clothing if possible;
• purchase underwear only from natural fabrics;
• if a woman has diabetes, try to keep her sugar under control;

Proper nutrition is also of great importance for a woman, especially when suffering from thrush. The growth of bacteria increases significantly if you consume a lot of sugar, caffeine, as well as alcohol and nicotine. The consumption of garlic and yoghurts that contain acidophilus suppresses the growth of yeast.

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For more detailed advice on services and their costs, please contact the call center at the numbers listed above.

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Source: https://klinika.k31.ru/napravleniya/ginekologija/vaginalnyj-kandidoz-molochnitsa-simptomy-lechenie-prichiny/

Vaginal candidiasis: 7 pressing questions

Vaginal candidiasis is a “thrush” known to almost any woman of reproductive age. The disease is caused by microscopic yeast-like fungi of the genus Candida, which belong to the opportunistic microflora of humans.

They are not aggressive enough to cause disease in a woman with good immune defense, but with any decrease in immunity, Candida actively invades the mucous membranes of the urogenital tract.

Vaginal candidiasis in women tends to be persistently chronic, despite treatment with antifungal drugs. What is the reason for this feature and how to treat vaginal candidiasis?

What causes candidiasis?

The causative agent of the disease is an opportunistic fungus of the genus Candida, which includes various species. In our country, the overwhelming majority of cases of candidiasis are caused by Candida albicans, however, there are other types of fungus: glabrata, tropicalis, crusei. Atypical fungi are often resistant to common antifungal drugs, which is why therapy fails.

Yeast-like fungi normally live on the skin, oral cavity, and digestive tract of humans. At the same time, the vagina of a healthy woman is reliably protected from the penetration of various microorganisms from the outside. A number of features are noted in its structure that create a barrier to any infection:

• tight closure of the vaginal walls;
• durable stratified epithelium lining the walls of the vagina;
• lactic acid microflora of the vagina, which prevents the proliferation of any other microorganisms in its cavity;
• secretory protective protein immunoglobulin in vaginal secretions;
• acidic environment, destructive for most microbes and fungi.

The vaginal epithelium is sensitive to female sex hormones. Under the influence of estrogens, a large amount of glycogen, a carbohydrate, accumulates in epithelial cells, which serves as a nutrient substrate for lactic acid bacteria.

They break down glycogen and release lactic acid, so the pH value in the vagina does not rise above 5.

Problems begin when hormonal status changes or the body's immune defense decreases. The causes of vaginal candidiasis are varied and include:

• pregnancy;
• abortion, miscarriage;
• trauma to the perineum and vagina after childbirth;
• diabetes;
• long-term use of hormonal contraceptives;
• HIV infection and other immunodeficiency conditions;
• antibiotic treatment;
• taking glucocorticoids or cytostatics;
• chemotherapy and radiation therapy.

The number of sexual partners and unprotected sex do not affect the incidence of fungal vaginitis, that is, it cannot be classified as a sexually transmitted infection. The intensity of friction plays a certain role, since mechanical damage to the vaginal walls can lead to an exacerbation of chronic candidiasis.

How does candidiasis develop?

As mentioned above, Candida fungi live on the skin, and the vagina is well protected from the penetration of microorganisms from the outer covers.

When the protective forces of the reproductive tract are reduced, pathogens freely enter the vaginal cavity during sex, personal hygiene procedures, scratching the perineum, or through the ascending route.

Fungi attach to the cells of the upper layer of the epithelium and begin to multiply intensively.

The number of lactobacilli with the listed provoking factors of the disease is significantly reduced. They free up large areas and do not interfere with the proliferation of fungi.

The number of fungal bodies gradually increases, they release their waste products and destroy the cells of the mucous membrane. Fragments of destroyed cells trigger a cycle of reactions leading to the development of inflammation.

The vaginal mucosa swells, becomes hyperemic and painful.

At this stage, immune cells are activated: they actively enter the vaginal tissue from the blood vessels. However, they are not as aggressive towards yeast-like fungi as they are towards pathogenic bacteria and cannot completely destroy them.

This is due to the characteristics of the pathogen: fungi live in many cavities and on a woman’s skin, so immune cells recognize some of the candida proteins as safe.

Large accumulations of fungi, together with dead epithelial cells, stick together and are excreted with mucus. This is how typical manifestations of thrush are formed - a cheesy white coating, discharge and pain in the vagina. Among the products of fungal metabolism there are substances that irritate sensitive nerve endings and cause unbearable itching.

How does thrush manifest?

Approximately 20% of women are found to be asymptomatic carriers of Candida fungi. They coexist in a certain balance with lactobacilli and the immune system, without causing any inflammatory reaction. But under unfavorable conditions for the body, they can go on the offensive and cause typical symptoms of vaginal candidiasis.

A woman feels inflammation of the vaginal walls in the form of heat, discomfort, and distension in the perineum. She may experience pain when walking or during sex.

In some cases, the signs of the disease are limited to only these manifestations, which significantly complicates the diagnosis. Sexual life during acute inflammation is disrupted or causes discomfort to the woman.

She feels burning, dryness and pain during sexual intercourse.

The most characteristic sign of candidiasis is a white discharge. They are usually described as cheesy, scanty or mild, with a faint sour odor. However, they can also be in the form of thick cream: cloudy white in color, viscous, with a thick consistency. Sometimes white inclusions appear as flakes rather than lumps.

Itching occurs in varying degrees. In some patients it is weak and hardly bothers them. Severe itching occurs in women prone to atopic reactions or patients with diabetes mellitus. It intensifies closer to sleep, at night, after taking a hot bath or shower. The itching can be so painful that it causes serious suffering.

The general condition of the patient practically does not suffer. There are no symptoms of intoxication, body temperature does not rise, and performance is maintained. Deterioration in well-being is observed only in cases where a woman does not sleep well at night due to unbearable itching in the perineum or suffers from painful scratching.

How does the disease progress?

Acute vaginal candidiasis is the first episode of the disease. It usually occurs with a typical clinical picture with itching, discomfort in the perineum and discharge. The acute process resolves completely in less than 2 months. With improper treatment or its complete absence, the disease becomes chronic.

Chronic vaginal candidiasis is a condition in which inflammation in the vagina either occurs continuously or is interrupted for several months and occurs again. It can be complicated or uncomplicated.

In the latter case, candidiasis is combined with diabetes mellitus and other somatic diseases.

Recurrent vaginal candidiasis is diagnosed when there are 4 or more episodes of the disease within one year. It proceeds according to the type of remissions and exacerbations, and inflammation in the acute stage is less pronounced than during the first manifestation of thrush. The discharge is moderate, itching is mild or absent, pain in the perineum is insignificant.

Why is candidiasis dangerous for pregnant women?

The vast majority of women encounter thrush for the first time while pregnant. This is due to both a restructuring of hormonal balance and a decrease in immune defense. Suppression of the immune system is a necessary condition for bearing a child, since otherwise the immune response will lead to miscarriage. Thus, for Candida, pregnancy is the most fertile time.

Vaginal candidiasis during pregnancy is acute, with characteristic discharge and itching. Extensive contamination of the vagina with fungi can lead to infection breaking through into the uterus and fetal membranes, in which case the fungi enter the amniotic fluid.

But, despite close contact with the baby, they extremely rarely become the cause of intrauterine infection. Much more often, a child becomes infected during passage through the birth canal.

In this case, the fungus becomes the cause of candidal stomatitis, otitis media or intestinal dysbiosis in a newborn.

How is the diagnosis made?

A gynecologist diagnoses vaginal candidiasis. The doctor collects anamnesis, evaluates the patient’s complaints and how long ago the symptoms appeared, and examines her on the chair. As a rule, typical forms of the disease do not cause difficulties in diagnosis.

When examining the vagina in the speculum, the gynecologist sees hyperemic, swollen mucosa. At the beginning of acute inflammation, islands of white plaque are located on it, tightly fused to the underlying tissues.

When they are removed, a shallow erosion remains, which may bleed slightly. The longer the disease is, the easier and without consequences the plaque is removed.

The main method for diagnosing candidiasis is a microscopic examination of a smear. The gynecologist takes a small amount of mucus from the vaginal wall with a cotton swab, then transfers it to a glass slide and sends it to the laboratory. A laboratory doctor examines the smear under a microscope and sees a large number of fungi, if they are the cause of the pathological process.

Another important method is bacteriological. Vaginal secretions are inoculated on a sterile nutrient medium in order to grow colonies of the pathogen.

They grow for at least 3-5 days, after which their quantity, type and sensitivity to drugs are determined. The detection of at least 105 grade CFU (fungal cells) is considered significant.

Determining the type and sensitivity allows you to prescribe the most effective antifungal therapy.

If a concomitant infection with sexual transmission is suspected, the doctor will prescribe PCR. Blood tests, ELISA and other methods are not used to diagnose candidiasis.

How to treat candidiasis?

Treatment of vaginal candidiasis, in particular its chronic forms, is a big problem in modern gynecology. Despite the abundance of antifungal drugs, the infection remains viable for years, exhausting the patient and her doctor.

Treatment is carried out on an outpatient basis; hospitalization and sick leave are not required.

The treatment of the disease is based on the local use of antifungal drugs. These include vaginal suppositories that contain:

• polyene antimycotics (antifungals) – Nystatin, Natamycin;
• triazole antimycotics – Fluconazole;
• imidazole antimycotics – Clotrimazole, Miconazole;
• a combination of antimycotics with antibiotics (Metronidazole/Miconazole) and glucocorticoids (Terzhinan, Pimafucin).

Pimafucin suppositories can be used to treat candidal vaginitis in pregnant women - they are safe for the mother and fetus.

Combined drugs with glucocorticoids effectively eliminate the inflammatory reaction and itching by suppressing the immune system, so they can only be used as prescribed by a gynecologist.

In case of acute candidiasis, in addition to local antifungal agents, douching with a weak soda solution is prescribed 2 times a day.

Chronic candidiasis, especially with a persistent recurrent course, is treated with a combination of local and systemic drugs. Tablets for vaginal candidiasis also contain antifungal substances.

Unlike local remedies, they create a high concentration of it not only on the surface of the vaginal mucosa, but also in the thickness of its walls. The most famous and safest drug for the treatment of thrush is Flucostat capsules.

For acute candidiasis, it is necessary to take 150 mg of the substance once, the chronic form of the disease is treated with higher doses and long-term use.

All antifungal drugs are very toxic to the liver, so their systemic use is possible after a doctor’s prescription and under his supervision. If necessary, additionally prescribed:

• antihistamines - to eliminate itching (Diazolin, Zodak);
• antibiotics – when a fungal infection is combined with a bacterial one (Metronidazole, Cipralex);
• immunomodulators – restore the body’s immune defense (Likopid, Timalin);
• lactobacilli preparations - to normalize the vaginal microflora (Acilact).

In order for the treatment of candidiasis to be effective, the dosage, frequency of administration and the duration of the course must be strictly observed.

Otherwise, some fungi remain viable and become resistant to the drug that was used to eliminate them.

Is it possible to get pregnant due to a fungal infection? Fortunately, candidiasis does not affect a woman's reproductive function and, although it remains a widespread problem, does not lead to a decrease in fertility.

Source: https://ginekolog-i-ya.ru/vaginalnyj-kandidoz.html

Treatment regimen for vaginal candidiasis - thrush

75% of adult women experience signs of vaginal candidiasis (thrush). The disease can become chronic and recur more than 4 times a year.

Having encountered this problem and having studied various methods in practice, I propose to adopt the most effective methods of treating vaginal thrush.

Conclusion

• Vaginal candidiasis is a recurrent fungal disease that is treated with antifungal drugs;
• the course of treatment is 7-14 days;
• the prognosis is favorable if preventive measures are observed and relapses of the disease are prevented.

Causes and risk factors of pathology

Vaginal candidiasis or thrush is caused by a microscopic yeast-like fungus from the genus Candida. You can become infected through shared baths, bedding, sexual intercourse, and even due to stress.

Fungal infection of the genital organs most often occurs in women of reproductive age. The disease forms when the fungus begins to multiply rapidly.

The development of vaginal candidiasis is promoted by:

• decreased immunity due to hypothermia, pregnancy, poor nutrition;
• uncontrolled treatment with antibiotics, corticosteroids;
• urogenital infections;
• hormonal contraception;
• violation of intimate hygiene;
• using tampons instead of pads;
• hyperhidrosis;
• diabetes;
• non-traditional sexual contacts.

Symptoms of thrush

Vaginal thrush manifests itself:

• unbearable itching, worse at night;
• painful sexual intercourse;
• white, curd-like vaginal discharge;
• burning when urinating;
• redness, swelling of the external genitalia.

Advanced and chronic forms of the disease are characterized by the appearance of yellowish-green discharge with an unpleasant sour odor.

Diagnostics

Fungal infection is diagnosed using:

1. Taking smears from the vagina, cervix, and urethra to determine the composition of the microflora.
2. Determination of vaginal acidity.
3. Bacterial inoculation of scrapings from the vaginal walls on a nutrient medium.
4. Test for studying glucose in blood and urine.

At home, you can use the Frautest Candida test system to self-diagnose vaginal candidiasis.

When to see a doctor

An immediate visit to a gynecologist is necessary if:

• lack of results after a week of self-medication;
• bleeding from the vagina;
• pain in the lower abdomen;
• more than 2 relapses of the disease in 6 months;
• the occurrence of side effects during therapy with antifungal agents.

Pregnant women, in order to prevent intrauterine infection of the fetus, should treat this disease under medical supervision.

Treatment methods

Standard methods of treating vaginal candidiasis include the use of creams, ointments, suppositories intravaginally and taking tablets orally.

Drugs are prescribed in dosages that take into account body weight and the form of the disease.

Local treatment of candidiasis

Externally to combat Candida fungus use:

• ointment, cream or gel;
• antifungal vaginal suppositories;
• vaginal tablets;
• douching.

The following ointments are used intravaginally in courses of 7 days:

• Clotrimazole (1%);
• Miconazole (2%);
• Econazole (1%);
• Terconazole (0.4%).

To cure the fungus, a single use of Butoconazole ointment (2%) is sufficient, and only 3 days are required if you use the drug Clotrimazole (2%).

Systemic therapy

Complex therapy for vaginal candidiasis includes:

1. Take oral Fluconazole tablets once at 150 mg/day or Intraconazole tablets twice a day at 200 mg.
2. Intravaginal administration of an ointment with an antifungal effect.
3. Use of Miconazole suppositories.

To strengthen the immune system use:

• immunomodulators;
• adaptogens.

To restore the intestinal microflora, drugs with lactobacilli are used, prebiotics Duphalac and Normaze are prescribed.

Other useful tips for eliminating thrush

To reduce the manifestations of vaginal thrush you need to:

• use underwear selected according to your size, made from natural fabrics;
• exclude the use of intimate hygiene products with irritating effects;
• apply an emollient cream daily to the skin around the vagina;
• Avoid washing clothes in fermented powders.

If you have diabetes, it is impossible to cure vaginal thrush without controlling your blood sugar levels.

Treatment of recurrent candidiasis

For recurrent vaginal candidiasis, Metronidazole gel (1%) is prescribed. The medicine in an amount of 5 g is inserted into the vagina in the morning and evening for 7 days in a row.

1. If using the cream intravaginally for 7 days does not help, extend the course of treatment to 2 weeks.
2. Take 150 mg of Fluconazole every 7 days.
3. Introduce a vaginal suppository with miconazole once a week.

  What should a woman take for thrush - the best remedy

Maintenance therapy is continued for no more than six months. If the symptoms of the pathology persist, you should seek medical help.

What to do if treatment is ineffective

If antifungal drugs are ineffective, make an appointment with a doctor.

The lack of results from the use of antifungals may be explained by:

1. Bacterial form of infection (gardnerellosis).
2. Infection with the fungus Candidaglabrata, requiring other therapy.
3. Violation of drug dosage.
4. Concomitant use of an antibiotic or increased blood sugar levels.

Prevention

Vaginal thrush can be avoided if you follow the rules of prevention:

• perform hygiene of the intimate area with special soap, without perfumes;
• eat rationally;
• avoid stress;
• during antibiotic therapy, visit a gynecologist and take antifungal drugs;
• moisturize the vagina with lubricants during sex.

Forecast

In 4-5% of cases, vaginal candidiasis recurs. Treatment under medical supervision improves the prognosis of the disease and prevents the transition of acute vaginal thrush to the chronic form of the disease.

Treatment regimen for vaginal candidiasis - thrush Link to main publication

Source: https://endometriy.com/molochnitsa/lechenie-vaginalnogo-kandidoza

Gynecologist: how to properly treat thrush?

Most representatives of the fair sex know about the symptoms of thrush firsthand. It must be said that this disease does not bypass men either. Meanwhile, the causative agent of thrush is a resident of our normal microflora. Gynecologist Albina Romanova will tell you why he begins to behave aggressively and what to do about it.

How to properly treat thrush?

Thrush (vulvovaginal candidiasis) is a fungal infection that is caused by microscopic yeast-like fungi of the genus Candida (most often Candida albicans), and is characterized by inflammation of the mucous membrane of the vulvar ring, vagina, urethra, and perineum as a whole.

These fungi are classified as opportunistic microorganisms (that is, they are part of the normal microflora of the mouth, vagina and colon of almost all healthy people), therefore, for the development of this disease, it is important not just the presence of fungi of this genus, but their reproduction in very large quantities, and this, most often, occurs when immunity decreases.

Doctors call thrush and candidal colpitis, and vulvovaginal mycosis, and urogenital candidiasis, and genital fungus, but the essence does not change, it is the same pathological process.

Unfortunately, thrush is a very common disease among the female population. More than 75% of women all over the planet have suffered from this disease at least once in their lives, and a third of them, who have received sufficient therapy, get sick again (a relapse of the disease occurs).

Factors contributing to the spread of thrush

• wearing synthetic, tight-fitting underwear (for example, the well-known “thong”) - damage to the mucous membranes in areas of friction, transfer of microflora from the anus to the vagina.
• Use of daily sanitary pads.
• Unnatural sexual intercourse (anal, oral) - there is a disruption of the normal microflora of the vagina, which contributes to the development of thrush.
• Diabetes mellitus - strong changes in the immune system, frequent urination, obesity (usually accompanying diabetes mellitus), difficulties with personal hygiene, ulceration of the mucous membranes of the genitourinary tract - contribute to the development of thrush.
• Treatment with broad-spectrum antibacterial drugs - they kill not only pathogenic microorganisms that caused the disease (for example, pneumonia), but also opportunistic microorganisms inhabiting our gastrointestinal tract and genital tract: in the “empty” place, fungal flora develops and grows very well - thrush occurs.
• Pregnancy - during pregnancy, immune protection decreases so that the fertilized egg is not perceived by the body as a foreign body, so expectant mothers are more susceptible to any infections, including candidiasis.
• The use of high-dose oral contraceptives (containing 30 mcg or more of ethinyl estradiol), intrauterine contraceptives (spiral), spermicides, diaphragm (for contraception) - weakening of the local protective barrier in the vagina.
• The use of glucocorticosteroids is a factor in changing metabolism in organs and tissues, contributing to the development of thrush.

Vulvovaginal candidiasis (thrush) is not a sexually transmitted infection, despite the fact that the same strains of fungi are detected in sexual partners. Most likely, this pathology can be associated with a defect in the immune system at different levels (decreased general or local immunity). Candidiasis carriage is not a disease, since a healthy person has these opportunistic microorganisms.

Thrush is classified into:

1. Acute candidiasis.
2. Recurrent (chronic) candidiasis.

Manifestations of thrush:

1. Itching and burning in the vagina and in the area of ​​the external genitalia, intensifies during sleep, after water procedures, after sexual intercourse, during menstruation.
2. Leucorrhoea is a profuse or moderate curdled discharge from the genital tract, white to gray-yellow in color, odorless.
3. Painful intercourse.

4. Painful (with pain) and frequent urination.
5. Swelling and redness of the mucous membranes of the external genitalia, traces of scratching (maceration of the skin and mucous membranes).

There may be all of the above signs of thrush, or some of them (the disease is erased, without pronounced complaints from the patient).

What is required to diagnose thrush (candidiasis)?

The patient has complaints of itching, curdled discharge from the genital tract, impaired urination, symptoms of local inflammation in the external genital area (swelling, redness, maceration), laboratory data: microscopy of vaginal smears - detection of yeast-like fungi and pseudohyphae, vaginal pH 4 -4.5, the amino test is negative (when alkali is added to the vaginal discharge - there will be no smell of stale fish), when sowing the vaginal discharge on appropriate nutrient media, the growth of fungi is observed (here you can evaluate their species, quantity, sensitivity to this or other antibacterial drug). There are additional (and expensive) methods for confirming the diagnosis of vulvovaginal candidiasis - immunofluorescence diagnostics (“CandidaSure”), compliment binding reactions, immunological studies and express methods. They are most often based on an antigen-antibody reaction, that is, to a pathogenic microorganism (antigen), our immune system produces protection (antibody): the antibody binds to the antigen, neutralizing the latter. This complex (antigen-antibody) can be identified by these diagnostic methods, or only the antibody is recognized.

Treatment of thrush

Carried out only under the supervision of a specialist, self-medication of thrush is fraught with the transition of the acute form of candidal colpitis to chronic, with frequent exacerbations and difficult cure.

Stages of treatment for thrush:

1. Combating predisposing factors (rational antibiotic therapy, maintaining and protecting the immune system, personal hygiene)
2. Diet (restriction of carbohydrates)
3. Rejection of bad habits.
4. Drug local treatment of thrush (choose one drug):

•  Butoconazole, 2% cream 5 g once, topically.
•  Ketoconazole, suppositories 400 mg, 1 suppository x 1 time per day for 3 or 5 days.
•  Fluconazole, orally 150 mg once (Flucostat).
•  Itraconazole, orally 200 mg x 2 times a day for 3 days or 200 mg (Irunin) x 10 days tablets that are inserted deep into the vagina.
•  Sertaconazole, 300 mg (1 suppository) once.
•  Clotrimazole, 100 mg (1 tablet in the vagina) for 7 days.
• Miconazole: vaginal suppositories 100 mg (1 suppository) at night for 7 days.
• Nystatin: vaginal tablets 100,000 units (1 suppository) daily x 1 time, before bed, for 14 days.

1. Drug treatment of chronic thrush:

• - systemic antimycotic (itraconazole 200 mg orally 2 times a day for 3 days or fluconazole 150 mg once a day for 3 days) and
• - local therapy with azole drugs (most often within 14 days):
• Imidazole preparations:

• ketoconazole (nizoral) - Use 400 mg/day for 5 days;
• clotrimazole (canesten) - Used in the form of vaginal tablets, 200-500 mg for 6 days;
• miconazole - 250 mg, 4 times a day, 10-14 days.
• bifonazole - 1% cream, 1 time per day at night, 2-4 weeks;

Triazole preparations:

• fluconazole - 50-150 mg 1 time per day, from 7 to 14 days;
•  itraconazole (orungal) - 200 mg 1 time / day, 7 days.

Despite the high effectiveness of local treatment of thrush, many patients experience a relapse (exacerbation) after 1-3 months.

This is due to taking antibiotics that change the normal microflora of the vagina, concomitant diabetes mellitus, taking oral contraceptives, pregnancy (increased glycogen levels in the vaginal epithelium - a good environment for the proliferation of fungi), an increase in the number of infected patients who are more pathogenic (and more resistant to traditional methods of treatment ) species of fungi - C.pseudotropicalis, C.glabrata, C. parapsilosis.

Is it necessary to treat the patient’s spouse for thrush?

Thrush is not a sexually transmitted disease, and most often there is no need to treat your spouse.

But there are situations when a man has clinical manifestations (symptoms of itching, irritation and scratching on the penis, white discharge that worsens after sexual intercourse) with a confirmed diagnosis of candidiasis in a woman.

In this case, the treatment regimen for thrush is the same as for a woman. Only treatment is carried out not with local drugs, but for oral administration (Pimafucin, 100 mg x 1 tablets 4 times a day for 10 days).

Typically, a man does not have symptoms of this disease, even if the woman is sick and undergoing treatment. If symptoms of thrush occur in a man, then his body as a whole should be examined to exclude infections that significantly reduce immune surveillance (such as HIV (AIDS), hepatitis B and C, acute leukemia).

What to do to prevent thrush recurrence

1. In order to prevent relapse (exacerbation) of the disease, it is necessary to use:
2. - systemic antimycotic (itraconazole 200 mg orally or fluconazole 150 mg on the first day of menstruation for 6 months, that is, 6 courses);
3. - therapy with local drugs once a week for 6 months (drugs that are used in suppositories for vaginal use).

Monitoring the treatment of thrush

• — In the acute form of thrush, treatment control is carried out 7 days after the end of treatment (smears and cultures are taken to test the sensitivity of the microflora to antibiotics).
• - In case of chronic candidal colpitis, the effectiveness of treatment is assessed during 3 menstrual cycles on the 5-7th day of the cycle (as soon as bleeding from the genital tract stops after menstruation - smears and cultures are taken for sensitivity).
• In special cases, for example, treatment of thrush in pregnant women, local antifungal drugs are used, such as: Natamycin 100 mg (pimafucin) 1 suppository at night for 3-6 days (the drug is approved for use in pregnant women even in the first trimester of pregnancy, that is, up to 12 weeks), or clotrimazole, 1 vaginal tablet (100 mg) x 1 time per day at night, for 7 days (the drug is approved for use in pregnant women only from 13 weeks of pregnancy).
• If the sick patient is a child, then thrush is treated according to the following regimen: fluconazole 2 mg per 1 kilogram of the child’s body weight; the entire dose is taken orally once with a small amount of water.

However, when describing in detail the drugs for the treatment of vaginal candidiasis (thrush), their dosage regimens and courses of treatment, it is necessary to understand that all treatment must be supervised by a doctor. After all, the clinical picture (symptoms of the disease) typical for thrush are also characteristic of many pathological processes in the vagina, for example: bacterial vaginosis, atrophic (cyanotic) colpitis, bacterial vaginitis, chronic cervicitis, leukoplakia or krause of the vulva (vagina), chlamydial cervicitis, adnexitis , gonorrhea, therefore the question of treatment should only be in the doctor’s office, under careful laboratory and clinical monitoring of the patient’s cure.

Source: https://azbyka.ru/zdorovie/ginekolog-kak-pravilno-lechit-molochnicu