Persistent Candida Infection: Exploring Treatment Options for Men and Women

Candida infection, with the male partner's symptoms not improving over time?

Hello Doctor, my discharge is a milky white, clumpy substance that does not flow out and requires manual examination.
It is odorless and does not cause itching.
I have visited several gynecologists (different clinics, not consecutively), and they all diagnosed it as a yeast infection (one mentioned it was complex).
Aside from prescribing medication, they advised me to improve my diet and lifestyle.
However, I maintain a regular routine, adhere to hygiene principles, and reduce sugary foods, yet there has been no improvement in the discharge, only variations between less and more clumpy.
I previously used a suppository for an entire week, which improved my condition for a few days, but then it reverted to the clumpy state.
I would like to ask the doctor what other methods I can use to improve this situation.
Since I do not have any discomfort, I may have transmitted it to my boyfriend.
He experiences redness and itching around his glans and anus.
He has seen a doctor once and has been using antifungal cream for three months, with no sexual activity, yet his condition fluctuates.
The itching around the anus is more severe than that of the glans, and sometimes it worsens at night and after bowel movements.
Could there be other underlying causes? What possible methods are there for improvement? Thank you very much for your patience in reading this, and I look forward to your response!

Xiao Ke, 30~39 year old female. Ask Date: 2020/04/14

Dr. Wu Xianghui reply Obstetrics and Gynecology

Vaginal infections are the most common conditions among women, influenced by various factors.
Treatment methods require comprehensive health education, and it is recommended to seek evaluation from a specialist in obstetrics and gynecology at an outpatient clinic.

Reply Date: 2020/04/14

More Info

Persistent Candida infections can be quite challenging to manage, especially when they do not respond to standard treatments. It appears that both you and your partner are experiencing symptoms that may be related to a Candida infection, but the persistence of these symptoms despite treatment raises some important considerations.

Understanding Candida Infections
Candida is a type of yeast that is normally present in small amounts in the body, particularly in the mouth, gut, and vaginal area. Under certain conditions, such as a weakened immune system, antibiotic use, or hormonal changes, Candida can overgrow and lead to infections. In women, this often manifests as vaginal yeast infections, characterized by symptoms such as itching, burning, and abnormal discharge. In men, it can cause symptoms like redness, itching, and irritation of the genital area.

Treatment Options
1. Antifungal Medications: The first line of treatment for Candida infections typically includes antifungal medications. These can be topical (like creams or ointments) or systemic (oral medications). If you have been using topical treatments without success, it may be worth discussing the possibility of a longer course of oral antifungal medication with your healthcare provider.

2. Probiotics: Some studies suggest that probiotics may help restore the natural balance of flora in the body, potentially reducing the recurrence of Candida infections. Probiotics can be taken in supplement form or through fermented foods like yogurt, kefir, and sauerkraut.

3. Dietary Changes: While you mentioned that you have already made dietary adjustments, it may be beneficial to further reduce sugar and refined carbohydrates, as these can feed yeast. Some individuals find success with a low-sugar, anti-inflammatory diet that includes plenty of vegetables, lean proteins, and healthy fats.

4. Hygiene Practices: Maintaining good hygiene is crucial. Ensure that you are wearing breathable cotton underwear and avoiding tight-fitting clothing. After bathing, make sure to dry the genital area thoroughly, as moisture can promote yeast growth.

5. Addressing Underlying Conditions: If you have any underlying health conditions, such as diabetes or hormonal imbalances, addressing these may help reduce the frequency of Candida infections.

Partner Considerations
Regarding your partner's symptoms, it is essential for him to seek further evaluation. Persistent redness and itching around the genital area could indicate a few possibilities:
- Candida Infection: It is possible that he is experiencing a Candida infection, especially if he has been in contact with you. However, if the antifungal treatment has not resolved his symptoms, it may be worth considering other diagnoses.

- Bacterial Infections: Conditions such as bacterial balanitis could also cause similar symptoms.
- Contact Dermatitis: Irritation from soaps, lotions, or even the antifungal creams themselves could lead to persistent symptoms.

- Sexually Transmitted Infections (STIs): Although you mentioned no sexual activity during his treatment, it is still advisable for him to be screened for STIs, as some can present with similar symptoms.

Next Steps
1. Follow-Up with Healthcare Providers: Both you and your partner should follow up with your healthcare providers. It may be beneficial for your partner to see a urologist or dermatologist for a more specialized evaluation.

2. Testing for Other Conditions: If symptoms persist, consider testing for other infections or conditions that could be contributing to the symptoms.

3. Communication: Open communication with your partner about symptoms and treatment is essential. If either of you experiences new or worsening symptoms, it is crucial to seek medical advice promptly.

In summary, while persistent Candida infections can be frustrating, exploring a combination of treatment options, lifestyle changes, and thorough medical evaluations can help address the issue effectively. Always consult with healthcare professionals for personalized advice and treatment plans.

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