Vaginal Inflammation: Treatment, Concerns, and Solutions

Vaginitis and medication issues?

Hello, Doctor.
I have a few questions to ask you:
1.
I had vaginal inflammation about two weeks ago and have been using a suppository for nearly 11 days.
Currently, there are no visible discharge (though I'm unsure about the vaginal area), and the redness and swelling have subsided.
Occasionally, I experience a brief itching sensation throughout the day.
Does this indicate that the inflammation or infection has not completely resolved? Should I continue using the suppository until there is no discharge or itching, or is it possible that my symptoms will improve on their own after significant improvement?
2.
If the doctor only prescribed me a suppository and I use it for more than a week, will this lead to antibiotic resistance? Or is antibiotic resistance primarily a concern with oral antibiotics? Does frequent use of suppositories thin the vaginal tissue?
3.
During sexual intercourse (which I started last year), I consistently experience skin tearing and splitting at the lower vaginal opening, even when using condoms and lubricant.
If there is no issue with a narrow vaginal opening, what can I do to address the tearing problem? Is it due to insufficient foreplay, not being relaxed enough, or could it be a matter of positioning? Thank you, Doctor.

Miss Huang, 20~29 year old female. Ask Date: 2021/01/11

Dr. Zhang Kunmin reply Obstetrics and Gynecology

Hello, the treatment for vaginal candidiasis primarily involves the use of suppositories and topical creams.
If there is no improvement after continuous treatment, it is advisable to consult a physician for further examinations, such as microscopic examination of secretions and culture tests.
For patients with drug resistance and recurrent infections, oral medications may also be used; during the treatment period, it is recommended to temporarily abstain from sexual intercourse.
Additionally, for patients with drug resistance and recurrent infections, oral medications can be considered, but liver function should be monitored for any abnormalities.
If symptoms do not improve after one week, it is important to seek evaluation from a physician.
Difficulties with sexual intercourse may be influenced not only by structural and functional factors but also by psychological factors, so it is necessary to have relevant examinations and assessments arranged by appropriate specialists for diagnosis and treatment.
Thank you! Wishing you peace and health, Dr.
Zhang.

Reply Date: 2021/01/11

More Info

Understanding vaginal inflammation and its treatment is crucial for maintaining reproductive health. Based on your questions, let's delve into the various aspects of vaginal inflammation, its treatment, and the concerns you have raised.

1. Ongoing Inflammation and Treatment: It's encouraging to hear that your symptoms have improved after using the suppositories for 11 days. The absence of discharge and the reduction in redness and swelling are positive signs. However, the occasional itching you experience may indicate that the inflammation has not completely resolved. It's essential to follow your healthcare provider's advice regarding the duration of treatment. If the symptoms are significantly improved, it may be reasonable to discontinue the suppositories, but you should consult your doctor before making that decision. They may recommend continuing the treatment until you are symptom-free to ensure that the infection is fully eradicated.

2. Antibiotic Resistance and Suppository Use: Concerns about antibiotic resistance are valid, especially with the overuse of antibiotics. However, the risk of developing resistance is more commonly associated with oral antibiotics rather than vaginal suppositories. Suppositories typically contain antifungal or antibacterial agents that target specific pathogens without the systemic effects of oral medications. Using suppositories for an extended period does not usually lead to resistance, but it’s always best to use them as directed by your healthcare provider. Regarding the concern about vaginal tissue thinning, prolonged use of certain medications can potentially affect the vaginal mucosa, but this is more commonly associated with hormonal changes or specific medications rather than standard antifungal or antibacterial treatments.

3. Managing Pain During Intercourse: Experiencing tearing or skin breakage during intercourse can be distressing and may stem from several factors. Since you are already using condoms and lubricants, it’s essential to ensure that the lubricant is adequate for your needs. Water-based lubricants are common, but some individuals find silicone-based lubricants to be more effective for reducing friction. Insufficient foreplay can also contribute to discomfort, as adequate arousal is necessary for natural lubrication. If you feel anxious or tense during intercourse, this can lead to muscle tightening, which may exacerbate tearing. Communication with your partner about comfort levels and preferences can help create a more relaxed environment. Additionally, experimenting with different positions may alleviate pressure on sensitive areas.

In summary, while your symptoms are improving, it’s crucial to continue monitoring your condition and maintain open communication with your healthcare provider. They can provide tailored advice based on your specific situation, including whether to continue treatment and how to address discomfort during intercourse. Remember that vaginal health is a vital aspect of overall well-being, and seeking professional guidance is always a wise choice. If symptoms persist or worsen, do not hesitate to return to your healthcare provider for further evaluation and management.

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