Vaginal Health: Infections, Treatments, and CA125 Testing

Vaginal issues

Hello Doctor, I would like to ask you the following questions:
1.
On October 22, I had a pelvic examination.
The doctor did not mention a trichomonas infection but said that the inflammation was not severe.
I was given suppositories and ointment, and when I asked if I needed a follow-up appointment, the doctor said to come back only if I still felt uncomfortable after using the suppositories.
However, the medication bag had "Clotrimazole suppository - for acute and chronic vaginitis, vaginitis caused by trichomonas, cervicitis, and other causes of abnormal vaginal discharge" written on it.
I would like to know if this medication indicates a trichomonas infection, or if it is also used for candidiasis.
I found online that trichomoniasis is considered a sexually transmitted infection.
Before using the suppository, my discharge was milky white, itchy, and had a strong odor.
2.
On the same day, I also had a CA-125 blood test, and the results will be available in two weeks.
I would like to know if the inflammation mentioned earlier could affect the accuracy of the test results.
Last year, I had a CA-125 level of 58, but the result was uncertain because my menstrual period had not fully cleared.
Thank you for your assistance, Doctor.

Lying, 20~29 year old female. Ask Date: 2018/10/26

Dr. Huang Jianzhong reply Obstetrics and Gynecology

1.
On October 22, during the pelvic examination, the doctor did not mention a trichomoniasis infection but stated that the inflammation was not severe.
I was given suppositories and ointment, and I asked the doctor if a follow-up visit was necessary.
The doctor said to return only if I still felt uncomfortable after using the suppositories.
However, the medication bag indicated "Clotrimazole suppositories - for acute and chronic vaginitis, vaginitis caused by Trichomonas, cervicitis, and other causes of abnormal vaginal discharge." I would like to know if this medication indicates a trichomoniasis infection or if it is also a common treatment for candidiasis.
I found online that trichomoniasis is considered a sexually transmitted infection.
Before using the suppository, my discharge was milky white, itchy, and had a strong odor.
Answer: Currently, the suppositories and ointment are broad-spectrum, indicating they are common treatments for both trichomoniasis and candidiasis.
2.
On the same day, I also had a CA-125 blood test, and the results will be available in two weeks.
I would like to know if the inflammation status will affect the accuracy of the test results.
Answer: It will not affect the accuracy, as I had a value of 58 at the end of last year, but the result was uncertain due to an incomplete menstrual period.

Reply Date: 2018/10/26

More Info

Understanding vaginal health, particularly in relation to infections, treatments, and specific tests like CA125, is crucial for maintaining overall well-being. Let's address your questions systematically.

1. Medication and Infection Diagnosis: The medication you received, Clotrimazole (克路淨), is an antifungal agent commonly used to treat yeast infections (candidiasis) and is also effective against some forms of vaginitis, including those caused by Trichomonas vaginalis, which is a protozoan parasite. The fact that your doctor prescribed this medication suggests that they are considering a potential yeast infection or a trichomoniasis infection, especially given your symptoms of itching and abnormal discharge. However, the absence of a definitive diagnosis of trichomoniasis means that it is not confirmed that you have this infection. Trichomoniasis is indeed classified as a sexually transmitted infection (STI), and it can cause significant discomfort, including itching and unusual discharge. If your symptoms persist after completing the treatment, it would be advisable to follow up with your healthcare provider for further evaluation, which may include specific tests for trichomoniasis or other infections.

2. CA125 Testing and Inflammation: CA125 is a protein that can be found in higher concentrations in women with certain conditions, including ovarian cancer, endometriosis, and pelvic inflammatory disease. It is often used as a tumor marker, but it is not specific to cancer. Inflammation, such as that caused by infections or other benign conditions, can elevate CA125 levels. Therefore, if you are experiencing inflammation or infection, it could potentially affect the accuracy of the CA125 test results. Since you had a previous elevated CA125 level of 58, it is important to interpret this result in the context of your overall health and any current symptoms. If your inflammation is resolved, it may provide a clearer picture of your CA125 levels. It is essential to discuss these results with your healthcare provider, who can help determine the next steps based on your complete clinical picture.

In summary, your symptoms and the medications prescribed indicate that your healthcare provider is taking a comprehensive approach to diagnosing and treating your condition. If you have concerns about the medications or the implications of your CA125 results, do not hesitate to reach out to your doctor for clarification. They can provide personalized advice based on your medical history and current health status. Regular follow-ups and open communication with your healthcare provider are key to managing your vaginal health effectively.

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