Mycosis vaginalis, also known as vulvovaginal candidiasis, is a common vulvovaginitis caused by Candida. Foreign data show that about 75% of women have suffered from mycosis vaginalis at least once in their lifetime. Mycosis vaginitis is plaguing women! How do you get mycosis vaginalis? What are the symptoms of mycosis vaginalis? How can mycosis be prevented and treated? The PH level in the vagina is normally less than 4.5, and the general PH level is between 3.8 and 4.4. The pH of the vagina with Candida infection is mostly between 4.0 and 4.7. The increased acidity of the vagina is conducive to the reproduction of Candida and causes Candida infection. Candida is a conditionally pathogenic organism, which grows in the vagina of about 30% of healthy women, but does not cause symptoms. Symptoms of vaginitis only occur when the systemic and local vaginal immunity is reduced. Common causes include pregnancy, diabetes mellitus, high use of immunosuppressive drugs and broad-spectrum antibiotics. In addition, prolonged use of oral contraceptives, wearing tight fitting underwear or pads, poor personal hygiene habits (such as washing underwear and socks together, unclean sex and inappropriate butt wiping habits), and over-cleaning can all create a breeding ground for mold growth. The main manifestations of mycosis are vulvar itching, burning pain in the vulva, painful intercourse and painful urination, and in some cases, increased vaginal discharge. Patients with mycosis vaginalis tend to have vulvar itching, and the degree of itching is the greatest among all kinds of vaginal inflammatory diseases, and in severe cases it is very painful to sit and lie down. Mycosis vaginalis is characterized by white thick curd or bean curd-like leucorrhea. On examination, one can find redness and swelling around the vulva, often with scratch marks, very shallow blistering papules, thickened mucous membranes near the labia and clitoris, flushed and eroded skin surfaces in contact with each other, and even tiny white pustules in individual patients, and in severe cases, epidermal ulcers and enlarged local lymph nodes. The diagnosis of typical mycosis is not difficult, but the most common clinical method of wet film examination can only detect 70-80% of mycosis. If there are symptoms and the wet film examination is negative for several times or if the case is persistent, fungal culture can be used to confirm the diagnosis of Candida infection. The fungal culture method has a high positive detection rate and can provide a drug sensitivity test report, which can provide a strong basis for later treatment. The treatment of mycosis vaginalis should be individualized according to the extent of the patient’s disease and personal immunity. When there is abnormal leucorrhea or vulvar itching, self-medication and unregulated medication should not be used, in order to avoid increasing the drug resistance of Candida. For simple mycosis vaginalis, the efficacy of local and systemic medication is similar, and most of the symptoms are reduced or disappear after 2-3 days of medication. Among the common antifungal drugs on the market, azoles are more effective than mycoplasma. For such patients, a shower bath with warm boiled water is recommended to rinse the vulva. More than 4 episodes of mycotic vaginitis in a year is called recurrent mycotic vaginitis. Patients in this category should first be examined and the causative agent removed, and should be checked for other infectious diseases such as AIDS, trichomoniasis or bacterial vaginosis. The choice of antifungal drugs is basically the same as for simple mycosis fungoides, but the duration of treatment should be extended. If fungal cultures are available, it is best to be able to choose the medication based on drug sensitivity testing. Douching of the vulva and vagina with 4% soda is generally recommended for such patients. Patients during pregnancy and lactation should choose their medications carefully, with local treatment and oral azole drugs prohibited. Clotrimazole suppositories and dacrynic suppositories can be used. In the author’s clinical experience, the therapeutic effect of Dakine suppositories during pregnancy is slightly better than that of clotrimazole suppositories, but many obstetricians in China still have some doubts about the safety of using Dakine during pregnancy. For unmarried women infected with mycosis fungoides, they can also choose to use local medication. Don’t worry about the effect of medication on the hymen, it will not hurt the hymen if it is done correctly. In the author’s clinical experience, the medication for unmarried female patients is done in the outpatient clinic with the assistance of a doctor, and oral medication is recommended for the very few patients with particularly small hymenal orifices. When the symptoms of vulvar itching disappear or the leucorrhoea pattern improves, many patients think that everything is fine and thus let down their guard against mycosis fungoides. In fact, mycotic vaginitis is very difficult to cure completely, and it can easily reoccur if you are not careful. Many women are tormented by it repeatedly until they are exhausted. Most of these patients do not take the right treatment, but often use medication according to their previous wrong experiences, such as stopping medication immediately when symptoms disappear, abusing vaginal suppositories, relying solely on proprietary Chinese medicine, washing the vulva and vagina with various cleansers, blindly using anti-inflammatory drugs or using a lot of antibiotics. Therefore, patients with mycosis vaginalis must be strictly followed up and receive standardized treatment according to the physician’s instructions. Patients with mycosis vaginalis do not require routine treatment of their partners. However, about 15% of men have glansitis after contact with female patients. Candida screening and treatment should be performed on symptomatic men to prevent repeat infection in women. In addition, antifungal treatment for partners is also generally recommended for patients with recurrent mycosis fungoides. Mycosis fungoides does not affect sexual life. However, condom use is recommended for contraception during treatment to avoid cross infection. For severe mycosis vaginalis, temporary avoidance of sexual intercourse is recommended to improve the efficacy of the treatment. For patients with mycosis fungoides, it is very important to carry out effective prevention along with active treatment. For patients with diabetes, they should actively control their blood sugar and eat less sugary and stimulating foods. Wear loose and breathable underwear, preferably made of natural fabrics such as cotton. When symptoms of vulva scratching occur during the use of sanitary napkins, do not continue to use the same brand of sanitary napkins, preferably without pads, and women with a lot of secretions should change their underwear regularly. It is advisable to wash the panties separately, expose them to the sun after ironing or disinfect them with blowing air at high temperature. Proper cleaning, in the absence of special circumstances, try to avoid the use of disinfectant lotions, drug lotions, etc. It is recommended to wash the vulva with water, and to limit the number of times. When wiping the vulva after defecation, you should wipe from front to back. Avoid long-term and heavy use of antibiotics, especially broad-spectrum antibiotics. Patients who are prone to recurrent mycosis vaginalis are advised to avoid the use of birth control pills and to use other contraceptive methods such as condoms and birth control rings. Although mycosis vaginalis is not a fatal disease, it afflicts countless women patients. Starting with an emphasis on prevention and receiving standardized treatment as early as possible can enable many women to walk away from mycosis fungoides!