Candida Infections: Persistent Symptoms and Treatment Options

Q: Candida Infections: Persistent Symptoms and Treatment Options

Hello Miss Ali： 1. <br>Vaginal candidiasis is a condition that is prone to recurrence and does not necessarily indicate that there is a problem in any specific area. <br>2. <br>Vaginal suppositories are a form of localized treatment and generally have fewer side effects compared

Candida fungus

Hello Doctor:
1.
My symptoms:
(1) Since the end of June, I have experienced abnormal vaginal discharge, which was diagnosed as a Candida infection (during that time, I had chronic tonsillitis for about two months and was on antibiotics for a period).

(2) After the doctor prescribed oral antifungal medication, I returned to normal, but I continued taking antibiotics.
Not long after, I started to notice yellow-green, chunky discharge (with some itching).

(3) From July until now, I have visited both a gynecology clinic and a large hospital multiple times.
The doctors prescribed vaginal suppositories (with antifungal and anti-yeast properties), and after using them, I returned to normal.
However, shortly after or a few days after my period, the vaginal discharge recurred.

(4) Additionally, I had a Pap smear at the gynecology clinic in August, and the report indicated signs of vaginal inflammation.
2.
Lifestyle improvements:
(1) I have made dietary changes, avoiding sweets and high-sugar fruits.

(2) I wash immediately after exercising and try to keep the area dry and ventilated.

(3) I also wash my intimate clothing separately (cold wash → soak in hot water → boil for sterilization).

(4) I have even started taking "Feminine Probiotics" (is this okay?).
3.
My questions:
(1) The yellow-green discharge reappears a few days after my period, and it is bothersome because it is wet and sticky.
I am unsure which aspect may be problematic.

(2) After using the vaginal suppositories for a while, do they have any side effects on the body (are they also considered antibiotics)?
(3) I am concerned that there may be issues elsewhere in my body.
Should I undergo a physical examination?

A Li, 20~29 year old female. Ask Date: 2019/11/26

Dr. Huang Yiwen reply Obstetrics and Gynecology

Hello Miss Ali: 1.
Vaginal candidiasis is a condition that is prone to recurrence and does not necessarily indicate that there is a problem in any specific area.
2.
Vaginal suppositories are a form of localized treatment and generally have fewer side effects compared to oral medications.
They are classified as antifungal agents, which are different from antibiotics that specifically target bacteria.
3.
A physical examination should not be necessary.

Reply Date: 2019/11/26

More Info

Candida infections, particularly vaginal candidiasis, can be persistent and frustrating for many individuals. Your symptoms and experiences highlight a common issue faced by those dealing with recurrent yeast infections. Let’s break down your concerns and provide some insights into the nature of these infections, potential causes, and treatment options.

Understanding Your Symptoms
1. Persistent Vaginal Discharge: The yellow-green discharge you describe, along with itching, is characteristic of a Candida infection. However, it’s important to note that other infections, such as bacterial vaginosis or sexually transmitted infections, can present with similar symptoms. The fact that you have had recurrent symptoms after treatment suggests that there may be underlying factors contributing to this persistence.

2. Antibiotic Use: You mentioned taking antibiotics for chronic tonsillitis. Antibiotics can disrupt the natural balance of flora in the vagina, leading to an overgrowth of yeast. This is a well-known side effect, as antibiotics can kill beneficial bacteria that normally keep yeast levels in check.

3. Menstrual Cycle Influence: The recurrence of symptoms after your menstrual cycle could be linked to hormonal changes. Estrogen levels fluctuate during your cycle, and higher estrogen levels can promote yeast growth. This is why some women experience increased yeast infections around their menstrual periods.

Treatment Options
1. Antifungal Medications: It seems you have been prescribed antifungal treatments, both orally and as vaginal suppositories. These are effective in treating Candida infections. However, if symptoms return shortly after treatment, it may indicate that the infection was not fully eradicated or that there are other contributing factors.

2. Probiotics: You mentioned taking probiotics, specifically "婦淨康益生菌." Probiotics can be beneficial in restoring the natural flora of the vagina, especially after antibiotic use. They can help maintain a healthy balance of bacteria and may reduce the recurrence of yeast infections.

3. Lifestyle Modifications: Your efforts to improve your lifestyle, such as reducing sugar intake, maintaining hygiene, and ensuring your intimate wear is clean and dry, are excellent steps. Yeast thrives in warm, moist environments, so keeping the area dry and well-ventilated is crucial.

Addressing Your Questions
1. Recurring Symptoms: The recurrence of yellow-green discharge after your period could be due to several factors, including hormonal changes, persistent yeast infection, or even a new infection. It would be wise to consult with your healthcare provider for further evaluation, including possible cultures to identify the specific organism causing your symptoms.

2. Vaginal Suppositories: While antifungal suppositories are generally safe, overuse can lead to irritation or disrupt the natural flora. They are not antibiotics but are specifically designed to target fungal infections. If you are using them frequently, it may be worth discussing with your doctor to ensure you are not causing further irritation.

3. Concerns About Other Health Issues: Your concern about other underlying health issues is valid. Persistent infections can sometimes indicate an underlying condition, such as diabetes or immune system issues. If your symptoms continue despite treatment, it may be beneficial to undergo a comprehensive evaluation, including blood tests to check for any underlying conditions that could be contributing to your recurrent infections.

Conclusion
In summary, recurrent Candida infections can be challenging, especially when compounded by antibiotic use and hormonal fluctuations. It’s essential to work closely with your healthcare provider to identify the root cause of your symptoms and develop a tailored treatment plan. This may include a combination of antifungal treatments, probiotics, and lifestyle modifications. If symptoms persist, further investigation may be warranted to rule out other health issues. Remember, you are not alone in this, and with the right approach, you can find relief from these frustrating symptoms.

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