Why does thrush appear?
Candida fungi are present in small quantities in many healthy women and do not cause problems. The disease develops when the balance is disturbed: the number of lactobacilli decreases or local protection weakens, and fungi begin to actively multiply.
That is why thrush is not a disease that is “infected”, but a condition that develops under certain conditions. Understanding this changes the approach: it is important not only to kill the mushrooms, but also to eliminate what allowed them to multiply.
- Taking antibiotics - by destroying bacteria, they make room for fungi; the most common reason
- Diabetes mellitus and elevated glucose levels
- Pregnancy and hormonal changes
- Taking hormonal contraceptives and glucocorticoids
- Decreased immunity, HIV infection
- Wearing synthetic tight underwear
- Panty liners without regular changes, long-term wearing of a wet swimsuit
- Douching and aggressive hygiene products
- Excess sweets in the diet
- Chronic stress and lack of sleep
Symptoms
- White, thick, curd-like discharge, often in flakes
- Severe itching in the area of the external genitalia and vagina
- Burning sensation that gets worse in the evening and after a hot bath
- Redness and swelling of the mucous membrane and skin of the vulva
- Pain and burning when urinating
- Pain during intercourse
- Cracks and small erosions with severe inflammation
- Increased symptoms before menstruation
- Sour odor or lack thereof - unlike vaginosis
Diagnostics
- Examination by a gynecologist - typical picture: swelling, redness, white deposits
- Smear microscopy - detection of fungi and mycelial elements
- Culture to determine the type of fungus and sensitivity to drugs is mandatory for relapses
- Femoflor - assessment of the state of the microflora as a whole
- Blood glucose and glycated hemoglobin - in case of recurrent course, mandatory
- Screening for STIs - excluding comorbidities
- Examination of the thyroid gland and assessment of the immune status in case of persistent progression
Cultures are especially important in recurrent episodes. Some cases are caused not by ordinary Candida albicans, but by other species that are resistant to standard drugs. Without typing, such treatment will be ineffective regardless of the number of courses.
Treatment
- Local antifungal drugs: suppositories, vaginal tablets, creams - for a common episode
- Systemic antifungal drugs in tablets - for severe symptoms and relapses
- In case of recurrent form - long-term maintenance regimen for several months
- Selection of drug based on culture results when standard therapy is ineffective
- Compensation for diabetes - without this treatment will be temporary
- Restoration of vaginal microflora
- Treatment of concomitant bacterial vaginosis
- Cancellation or correction of provoking drugs together with the prescribing physician
- Special regimens during pregnancy - only local medications approved by a doctor
- External itching relievers as a supplement
Should my partner be treated?
Thrush is not a sexually transmitted infection, and routine treatment of the partner is not required - it does not reduce the frequency of relapses in the woman.
- The partner is examined and treated if he has symptoms: redness of the glans, itching, plaque, discomfort
- If a man has recurrent balanoposthitis, his sugar level must be checked
- Using a condom during treatment reduces irritation and discomfort
- If the partner has no symptoms, preventive treatment is not prescribed
Relapse Prevention
- Loose-fitting cotton underwear, avoiding constant wearing of thongs
- Do not wear a wet swimsuit for a long time
- Change panty liners regularly or stop using them regularly
- Refusal of douching and aggressive hygiene products with fragrances
- Limiting sweets and fast carbohydrates
- Glucose control
- Taking probiotics during a course of antibiotics - discuss with your doctor
- Do not self-prescribe antibiotics
- Normalization of sleep and reduction of stress levels
- See a doctor for recurring episodes instead of self-medication
Where to get examined in Tashkent
For accurate treatment in case of relapses, culture with fungal typing, microflora assessment and glucose level testing are needed.
In Tashkent, such examination and treatment are carried out at the UROLOGIC COMPLEX medical center and at the Tashkent Medical Park clinic.
If thrush comes back more than four times a year, the most useful step is not to buy new suppositories, but to get a culture and check your blood sugar. Very often this is where the cause is discovered. Clinic contacts are below.
