Fungal vaginitis is caused by Candida albicans. Its transmission and recurrence are indeed closely related to sexual activity, so it is one of the sexually transmitted diseases. The recurrence of fungal vaginitis in the wife is most likely due to Candida albicans lurking in the husband’s genital tract, mouth, and intestines. Since the environment is not suitable for the reproduction of the fungus, the damage and symptoms may not appear, but the fungus can be sent to the vagina, where it is most suitable for reproduction, through sexual activities such as intercourse, causing the recurrence of the old disease. It is important to prevent the recurrence of fungal vaginitis and the spread of the disease between men and women. It is most common in pregnant women, diabetic patients or those who have been on antibiotics for a long time.
I. Symptoms of the disease
Symptoms: Itching of the vulva and vagina, thick leucorrhea, bean curd, curd or white film, redness and swelling of the vaginal mucosa, and in severe cases, shallow ulcers. Patients have itching and burning pain in the vulva. In severe cases, the patient may be restless and in pain. There may also be frequent urination, painful urination and painful intercourse. In the acute stage, the leucorrhea is increased, and the typical leucorrhea is white and thick like bean residue. On examination, white membranous material can be seen attached to the inner labia minora and the vaginal mucosa, which can be removed to reveal the red and swollen mucosal surface. In the acute stage, erosion and superficial ulcers can be seen under the white membranous material. Candida albicans can be found in the secretions.
Second, the disease etiology
Mold is a category of fungi, mold (fungus) has many species, the most important in the human body is Candida albicans. Vaginal infections are caused by Candida albicans in 80% to 90% of cases, the rest are other species of Candida and spherical yeast (Tomlopsis), what is vulvovaginal candidiasis (VVC)? Fungal vaginitis refers to mycosis vaginalis which is actually Candida vaginitis or vaginal candidiasis (vagmal candidiansis).
Candida albicans is ovoid in shape and consists of budding spores and cells that germinate and elongate to form pseudomycorrhizae, which are connected to the spores in a branched or chained pattern. Candida is usually a kind of corrosive parasitic bacteria, there are Candida in the oral cavity, vagina and digestive tract of healthy people, which usually do not cause diseases, but when the immune function of the body is low, such as pregnant women, diabetic patients, as well as the long-term application of broad-spectrum antibacterial drugs, a large number of applications of estrogen, etc., can make the normal pH of the vagina change or dysbiosis, the body environment is suitable for the growth and reproduction of Candida, and then invade the host’s tissue disease. The organism environment is suitable for the growth and reproduction of Candida and then invade the host’s tissue. There are also cases where the disease is transmitted directly through sexual intercourse.
Are there bacteria in the vagina of a healthy woman? There are more than 400 species of normal vaginal flora that coexist in a relatively stable state. More than 20 kinds of microorganisms can be isolated from the vagina of healthy women, including Lactobacillus, E. coli, Staphylococcus, Streptococcus, Candida albicans, Mycoplasma, etc. Among them, Lactobacillus predominates and plays a key role in maintaining normal vaginal flora and vaginal self-cleaning.
Who is the culprit? The main pathogenic bacteria are yeast, of which Candida albicans accounts for about 80-90%, and often invades both the vulva and vagina, hence the name vulvovaginal candidiasis. About 10% of non-pregnant women with increased leucorrhea and about 30% of pregnant women have this bacteria parasitic in the vagina. When the vaginal glycogen increases and the acidity is greater than 4, or when the body’s resistance is reduced, it can become the cause of the disease. Long-term application of broad-spectrum antibiotics and adrenal corticosteroids can greatly increase mycobacterial infections.
Because these two drugs can lead to dysbiosis in the organism, changing the interrelationship between microorganisms in the vagina and reducing the ability to fight infection. In addition, vitamin deficiency (vitamin B complex), severe infectious diseases, and other wasting diseases can become favorable conditions for Candida albicans to multiply. During pregnancy, the glycogen content of vaginal epithelial cells increases and the vaginal acidity is greater than 4. In addition, the renal sugar threshold of pregnant women decreases, often with nutritional diabetes, and the sugar content in urine increases to promote the growth and reproduction of Candida albicans.
Therefore, once you have vaginitis, after you are cured. To prevent recurrence, it is important to know that the weak acidic environment of the vagina maintains the self-cleaning function of the vagina and to develop good hygiene habits. Ph4 weak acid formula of feminine care lotion is suitable for daily cleansing and maintenance and to avoid unclean sex.
Can foot fungus (Tinea pedis) be transmitted to the vagina? Generally speaking, no, it is different from the pathogenic bacteria in the vagina. Causes: Pregnant women; diabetic patients; high use of hormones; high use of broad-spectrum antimicrobials; high use of estrogen; oral contraceptives; nutritional transition; vitamin B deficiency; urinary tract obstruction; gastrointestinal transmission; alcoholism; wearing tight underwear;
Can it be transmitted sexually? It is more controversial, and it is generally believed that it is self-transmission rather than sexual transmission.
Third, the route of infection
1, indirect contact transmission is also a route of transmission of mycosis fungoides. Contact with the toilet seat, bath tub, bath chair, towels, the use of unclean toilet paper, can cause the transmission of mold infected patients.
2, sexual transmission is also one of the reasons for the occurrence. The female partner has symptoms of at least 10% of the male partner suffering from mycotic urethritis, should be given reasonable treatment at the same time to prevent cross-infection.
3. Taking a lot of antibacterial agents. Taking antibiotics changes the microenvironment of the vagina, and the pathogenic bacterial pathogens may multiply, eventually leading to a localized mycosis fungoides attack.
4. No common sense in health care. Some women often use medicinal lotions to clean their vaginas or vice versa in order to maintain hygiene, which can easily damage the acid-base environment of the vagina and make it easier to get infected with Candida vaginitis. For daily cleansing, you can use Guerin ph4 weak acidic feminine care lotion.
5. Diabetes and pregnancy may cause Candida to multiply in the vagina and increase the rate of infection.
Four, susceptible people
1. Heavy use of broad-spectrum antibiotics: Pregnant women are a susceptible group for mycosis vaginalis. Usually there are many bacteria parasitic in women’s vagina, and these different flora are not pathogenic as they constrain each other to form a symbiotic state. The large number and long-term application of broad-spectrum antibiotics disrupts the vaginal flora and changes the mutual inhibition, allowing Candida albicans to multiply. With the increasing use of antibiotics, the incidence of mycosis vaginalis has increased.
2. Pregnancy: The level of sex hormones in the body is significantly higher during pregnancy, which increases the glycogen content in the vaginal epithelium and increases vaginal acidity, creating an environment conducive to the growth of Candida; at the same time, pregnancy reduces the immunity of cells, which makes Candida susceptible to disease. According to statistics, 1/3 of pregnant women have Candida in their vagina, and the incidence is about 15%.
3, diabetes: after diabetes, the body’s sugar metabolism disorder, blood sugar increases, the vaginal epithelial cell glycogen content increased, also make the vagina acidity increased, Candida suitable for growth and reproduction.
4, application of corticosteroids: long-term application of corticosteroids can reduce the phagocytosis of white blood cells and reduce the immunity of the body; at the same time, corticosteroids can also increase the blood sugar level of the body, which increases the possibility of mycosis fungoides.
5, application of immunosuppressants: will make the body’s immunity is reduced, is susceptible to mycosis fungoides.
6. Application of estrogen: Estrogen has the effect of causing glycogen to be deposited in the vaginal epithelial cells. These glycogen are broken down into lactic acid by the action of vaginal lactobacilli, which increases vaginal acidity and favors the growth of Candida.
7. People who suffer from serious diseases that make their resistance decrease or vitamin B complex deficiency are also susceptible to mycosis vaginalis.
V. Diagnostic examination
According to the typical clinical manifestations and visual examination of vaginal excretion, it is usually not difficult to diagnose mycosis fungoides. However, for atypical cases, in order to confirm the diagnosis, where there is a suspicion of mycobacteria, or to understand the effectiveness of treatment, vaginal secretions must be examined. Vaginal discharge can be taken directly on a slide, add a small drop of isotonic sodium chloride solution or 10% to 20% potassium hydroxide solution, add a coverslip, microscopic examination with microheating, red and white blood cells and epithelial cells immediately dissolved, and mycobacteria that is in the form of thread-like fibers or mycelia (mycelia), and microspores or molecular spores (conidia) adhere. However, the reliability of this method is low (60%).
If a smear of vaginal secretion is taken by Gram staining, microscopic clusters of Gram-positive intensely stained ovoid spores can be found, or pseudomycorrhizal filaments can be seen connected to the emergent cells in chains or branches, which are easily identified and the reliability can be increased to 80%. The most reliable method is to perform mycobacterial culture. In addition, we should also pay attention to the relevant causative factors, such as the application of high-dose steroids or broad-spectrum antibiotics, and diabetic patients need to do urine glucose and blood glucose tests.
VI. Treatment plan
Pay attention to the cleanliness of the skin and vulva. Do not use public bath tubs and bidets, and disinfect vulva washing utensils and underwear by boiling at all times. Avoid sexual intercourse during treatment.
Avoid long-term use of broad-spectrum antibiotics and glucocorticoids. If you have diabetes, you should treat it actively.
Topical treatment: fungal infection mild manifestations of leucorrhoea more yellow, vulvar itching, pubic odor, heavy leucorrhoea in the form of bean residue, vulvar itching, putrid smell of the lower body, with imperial Yin Bao the next day after the slag-like discharge, three days after the itching disappeared, leucorrhoea gradually returned to normal, the lighter a cycle clean, heavy two cycles to solve. Clotrimazole pessary 0.1, 2/d for 3 d in total or 1/night for 7 d. Ketoconazole pessary 0.2 placed deep in the vagina, 1/night for 7 d as a course of treatment or ketoconazole cream applied to the vaginal wall, 1/night for 7 d in total. Oral medication: Mycobacterium toxin tablets 500,000 U, 4/d for 10 d as a course of treatment or trichostatin 100,000-200,000 U, 2/d for 5-7 d. Ketoconazole tablets 400 mg, 1 /d for 5d.
Couples should be treated simultaneously.
1.Conventional treatment
Eliminate the causative factors causing this disease, i.e., actively treat diabetes, stop using antibiotics and estrogen in time, change underwear regularly, and use boiling water for basin and towel, etc. 2. After rinsing the external vagina with weak acidic feminine care solution of JOYAN ph4, the following over-the-counter and prescription medications are available.
2.Conservation treatment
After swabbing the vagina with 0.1% Neosporin, 3% hydrogen peroxide or 2% sodium bicarbonate solution, the vaginal wall is coated with 1% gentian violet or pseudomycin cream (50,000 units of pseudomycin per gram of petroleum jelly); once a day, 7 times as a course of treatment. In addition, we can use JOYAN disinfectant gel to insert into the vagina once a night, 10-14 times for a course of treatment. For patients with recurrence and long term treatment, ashwagandha can be taken as an antifungal treatment.
3.Vaginal medication
Good effect, cheap drug, safe to use, available during pregnancy; Dacronin suppositories: 200mg/pcs, once a night for 7 days; 400mg/pcs, once a night for 3 days; Jiao Yan disinfectant gel: once a night for 14 days; Clotrimazole tablets: 100mg/tablet, once a night for 7 days; Kenitin (Clotrimazole 500mg + lactic acid), once on the drug; systemic medication: menstruation, virgins, people who are not convenient to use suppositories, more serious patients, can treat other parts of the infection at the same time.
Fluconazole tablets: 150mg, taken once; Itraconazole: 100mg, twice daily for one day; Ketoconazole: 200mg, twice daily for five days; How to treat during pregnancy? The prevalence increases 2-3 times after pregnancy, the purpose of treatment: it can prevent premature birth, premature rupture of fetal membranes, fungal infection in newborn; only topical medication can be used, oral administration is prohibited. You can use JOYAN disinfectant gel, Clotrimazole, Dakine, Kenitin, the usage is the same as during non-pregnancy.
What are the criteria for curing? Symptoms disappear; no abnormalities in gynecological examination; after treatment ends, after menstruation is clean, the smear of secretion is negative for 3 consecutive cycles; Why is it easy to relapse? Causes are not removed; incomplete treatment, stopping medication as soon as symptoms disappear, insufficient course of treatment; related to sexual life; combined with other infections; fungal infection of the digestive tract; unknown cause; how to treat recurrent relapse?
Remove the cause; suggest to do fungal culture and drug sensitivity, according to the results of the choice of drugs; intensive treatment, using low dose of long course of treatment; ketoconazole: 400mg/day, after taking 2 weeks, change to 100mg/day, take 6 months; fluconazole: 150mg/day, day 4, day 8 and then take the same dose, change to 150mg/week, take 6 months; itraconazole: 200 mg/day for 3 days, change to 100mg every other day for 6 months. At the same time, vaginal medication can be used: Dacrynic pessary: 200mg/pc/day for 7 days per month for 6 months; 400mg/pc/day for 3 days per month for 6 months; Clotrimazole: 500mg/pc/month for 6 months; JiaoYan disinfectant gel: 14 days per month for 6 months;
VII. Precautions
While the female partner is undergoing treatment, regardless of whether the male or female has symptoms, she should also take oral antifungal medication, such as itraconazole, under the doctor’s supervision to kill any Candida albicans that may be latent in her body. The female partner should take oral mycoplasma at the same time as the vaginal plug treatment to kill the Candida albicans in her own intestinal tract. Intercourse should be suspended during the treatment period. After the symptoms have completely disappeared and the course of treatment is over, intercourse can be resumed, but the male partner should still wear a condom. Until the white belt test does not find the fungus, you can not use condoms.
Change bad sexual habits. Oral or anal sex can introduce fungus from the mouth and intestines into the vagina and cause fungal vaginitis. Therefore, those who have such sexual habits should quit. Sexual disorders are the main means of transmission of sexually transmitted diseases, and it is a double insurance policy for both men to protect themselves and their partners from sexually transmitted diseases.
Diabetes or long-term use of broad-spectrum antibiotics can make you susceptible to fungal infections due to changes in the vaginal environment that are conducive to fungal colonization. Patients who have recurrent fungal vaginitis should actively eliminate these risks with the help of their doctor. In addition, you should pay attention to personal hygiene, change and wash your underwear regularly, and wash your underwear, used towels and bath tubs with boiling water during illness and treatment.
Eight, health care tips
Mycotic vaginitis is easy to enter when the body’s resistance decreases, or when you have a serious disease or a lack of vitamin B complex or long-term use of immunosuppressive drugs. Especially in spring, the scenery is good for women to come, said also “an eventful spring”. Why do you say so? Because the spring climate is humid and women are easily infested by these recovering bacteria due to their special physiological structure, and recently some women have been troubled by mold.
To prevent this disease is mainly to develop good hygiene habits, diligent change of underwear and put in a ventilated place to dry; dry basin, towels for their own use; underwear and socks wash in different pots. For married women, it is also important to take good care of the vagina. In addition to daily cleaning, it is also important to keep the vagina at a certain pH level and to restore the elasticity of the muscle tissue through functional exercises to avoid bacterial infestation.
1. Scientific cleaning of the vagina
Under normal circumstances, our vagina (disease) will keep the pH balance by itself. Don’t clean the vagina with detergent or water, or even over-brush it, as this may not only destroy the balance of the vaginal environment, but may also cause vaginal damage.
2. Wear cotton ventilated pants
Try to wear cotton ventilated inner and outer pants to keep dry. If you don’t have much secretion, don’t use sanitary pads, and if you do, make sure to change them regularly to avoid bacteria.
3, eat less stimulating food
Under normal circumstances, our natural immune system will automatically cope with these invasive strains, so we usually have to have a healthy and balanced diet, eat less stimulating food, so that the immune system normal movement.
4, do not abuse antibiotics
The use of antibiotics must be approved by the physician and prescription, because although antibiotics can kill bacteria, but will encourage the breeding of mold, so do not abuse antibiotics.
5. Have a normal and simple sex life
Many vaginal diseases are transmitted through sexual intercourse. If you have too many sexual partners, it is difficult to control the infection.
6. Stay in a happy mood
Keeping a happy mood is also a good way to boost your immune system, and it is important to have a normal routine so that your immune system can function properly.
Nine, the danger
When a woman is infected with vaginitis, the pH level in the vagina changes and the environment in the vagina becomes unsuitable for sperm to live and reproduce, and the pathogenic bacteria engulf the sperm, thus affecting female fertility. Especially if a woman is infected with vaginitis during pregnancy, the danger increases because it can also endanger the fetus – causing fetal movement in mild cases, or premature birth or miscarriage in severe cases. These can directly threaten the development and health of the fetus.
After a certain period of time, vaginitis infection directly brings adverse effects on normal sexual life, even causing sexual disharmony and pain in the vagina due to vaginitis infection, or worse, causing undeserved troubles to the couple due to bacterial infections that should not be triggered. Affects the quality of the couple’s sexual life.
If vaginitis is not treated in time, it may lead to a decrease in local resistance and other gynecological infections, such as pelvic inflammatory disease, cervicitis, and adnexitis. These are the common hazards of vaginitis in women, which should be treated promptly. Because vaginitis can be harmful, patients should not take it lightly.
1. Causes infertility
As we know, the vagina has a relatively safe environment under normal circumstances, with a balanced flora and pH level. It is very important that this environment is suitable for sperm to stay and pass through temporarily, and once this environment is disrupted, infertility is likely to occur. In case of mycosis vaginalis, the change in the pH of the vagina can inhibit sperm motility, and inflammatory cells can engulf sperm and reduce sperm motility, Candida albicans has the effect of agglutinating sperm, as well as painful intercourse and reduced libido when inflammation occurs, all of which can affect pregnancy. This kind of infertility can return to normal soon after active treatment. However, the infertility caused by mycosis vaginalis is temporary and can still be conceived after the disease is cured.
2. Affect the development of the fetus
When a pregnant woman has the disease, very few people have Candida in the vagina that can travel up through the cervix and infect the fetus through the fetal membranes, causing premature birth. In addition, when the fetus is delivered through the mother’s vagina, it may also be infected by Candida, causing oral candidiasis, such as the commonly known thrush is caused by oral Candida infection. Some infants may also develop perianal Candida dermatitis. Thus, in order to avoid infecting the fetus, pregnant women with mycosis fungoides should be treated actively.
3. Causes other diseases
If mycosis vaginalis is left untreated for a long time, it may cause inflammation upstream and lead to cervicitis and cervical erosion, and if the pathogen enters the uterine cavity, it may cause inflammation of the fallopian tubes and ovaries and pelvic inflammatory disease, which may eventually affect pregnancy.
4. Affect the quality of life
Having mycosis vaginalis will be accompanied by symptoms such as vulvar itching, which will cause a lot of inconvenience and impact on women’s life and work, and will also affect the life of couples.
First of all, it is clear that mycosis vaginalis is not an STD. Mycosis vaginalis is a common gynecological infection that causes a lot of pain to patients due to its special itching and burning discomfort. What is more distressing for women is that mycosis vaginalis always recurs.
Is mycosis vaginalis a sexually transmitted disease? I believe we all know the answer to the question, but mycosis vaginalis is contagious, either directly to each other (men who have sex with the patient) or indirectly (e.g. sharing towels and bath tubs with the patient), which are the ways of transmission of mycosis vaginalis. When a woman has sexual contact with a man with a positive Candida culture, her rate of being infected is 80%.
About 1/2 of men who have sexual contact with a woman with mycosis vaginalis will be infected. In other words, mycosis vaginalis can be transmitted through sexual intercourse, which is why when a woman has this vaginal infection, her spouse should be treated at the same time. Is it possible to be infected by touching the objects of a person with mycosis fungoides? The common toilet seat, bath tub, bath chair, towels, and the use of unclean toilet paper can cause transmission, and mycosis vulvovaginalis can occur when the infected person reaches a certain number of Candida vulvae.
5, affect menstruation
Fungal vaginitis can have an effect on menstruation. For example, it can affect the color of the menstrual period and make the menstrual cycle longer or shorter.
The most common effects of fungal vaginitis on menstruation are discoloration of the menstrual cycle, longer or shorter menstrual cycles, and delayed menstruation. Fungal vaginitis is a stubborn and easily recurring disease, so it is important to have good hygiene habits in daily life. Prevent infection and pay attention to the hygiene and cleanliness of the vulva. Do not have intercourse during menstruation. The actual underwear should be made of cotton, soft and breathable, and should be changed every day, and the vulva should be cleaned every day with Ph4 weak acid formula feminine care solution.
You can choose physical therapy or medication to treat fungal vaginitis in a comprehensive way. For example, herbal douche, nebulization, spectroscopy, drug application, microwave and other treatments can change the vaginal environment and dry out the vagina to speed up the death of fungi. It can also accelerate the local blood circulation and increase the resistance of local epithelial cells to make the inflammation disappear, which is quite effective. Exercise, balanced diet and strengthening your resistance are also important factors to prevent infection with germs. Foods like those with high sugar content should be eaten sparingly. Do not abuse antibiotics, etc.
It is recommended that female patients who are accidentally infected with fungal vulvodynia should actively seek medical attention and cooperate with the doctor’s treatment. It is best to prohibit sexual intercourse during the illness and treatment period. If the recurring attacks are not cured, you should consider the possibility of having diabetes.