Is it possible to get rid of chronic thrush forever? Chronic candidiasis - can it be cured? What does chronic thrush lead to?

Chronic thrush is a phenomenon that often occurs in women. After all, it often happens that candidiasis is asymptomatic, a woman is undertreated, or the infection is discovered in a partner who had no idea about it and regularly returned it to the lady. This situation is complicated and requires long-term treatment. But not everyone knows how chronic thrush in women should be treated.

What is the problem

Chronic candidiasis in women is a disease characterized by periodic exacerbations. The title “chronic” thrush is awarded if it appears at least 4 times a year or occurs at least once every three months. True, this is provided that the woman does not use antibiotics for an unrelated disease.

Please note: burning and itching, which recur occasionally and do not cause constant discomfort, are quite normal for some time after the end of the course of antibacterial therapy and are not chronic thrush.

Signs of a chronic process may include:

• Occurring periodically and without any reason, the appearance of itching in the intimate area, accompanied by small discharge, for example, before menstruation or during a cold;
• Evening itching, which manifests itself against the background of an accumulation of leucorrhoea at the vaginal opening - this is usually noted before taking a bath or shower;
• Painful sensations during intimacy;
• The presence of itching or pain in the partner after sex;
• The appearance of pain in the lower abdomen.

Symptoms of chronic thrush can appear either together or separately. It is important to understand that such moments cannot be ignored, because... Despite its apparent harmlessness, chronic thrush in a woman can lead to quite serious complications. For example, the infection easily spreads to the intestines, to the bladder, and through the urinary tract to the kidneys. In addition, infertility and cycle failure are not uncommon. This means that it must be fought.

General principles of therapy

Chronic thrush, the symptoms of which in women are quite clear, requires complex treatment. Therefore, doctors often outline a list that, at first glance, is not particularly suitable or targeted. However, you should not neglect it - this treatment regimen for chronic thrush in women has been verified and justified based on the experience of many women.

So, the diagram will look like this:

1. Taking special antimycotic drugs - after all, the main causative agent of pathology is Candida fungus;
2. The use of means to strengthen the immune system - it has been proven that most often thrush recurs precisely when the body’s defenses are reduced; it simply does not have enough internal capacity to fight pathological microorganisms;
3. Medicines responsible for restoring normal microflora in the vagina - beneficial microorganisms will fight pathogenic ones and restore the tissue around them many times faster;
4. Vitamins are general strengthening agents.

The choice of medications, even vitamins, is entirely the prerogative of the doctor. He makes the necessary appointments based on examination and laboratory tests. A visit to a specialist is mandatory, because... Often the signs of chronic thrush in women are erased and blurred.

Sexual activity will also have to be included in the treatment regimen. Thrush is not a sexually transmitted disease. However, the risk of infecting a partner is still present. This means that condoms should be used, and if possible, at least for the period of the active phase of treatment, sexual intercourse should be completely avoided. In addition, the partner also needs to be checked. After all, in men, thrush is often asymptomatic, but he can pass it back to a woman quite quickly and easily.

The tests that the lady must undergo include:

Please note: you should not expect a quick cure. In a short time, you can only pacify acute thrush. If the disease has become chronic, it will take several months to heal.

A consultation with a doctor is also necessary because the doctor will be able to refer you for a study on the sensitivity of fungi to certain drugs, and this will make the therapy better and more targeted.

How to eat for more effective treatment

Chronic thrush in women, the treatment of which requires a lot of effort and time, also forces the woman to change her diet. Special therapeutic nutrition, as various studies have proven, helps to cope with pathology many times more effectively. Special diets for patients with candidiasis began to be offered back in the 90s of the last century. With their help, you can reduce the severity of symptoms and cope with the disease in general. After all, the correct selection of products ensures that fungi do not receive nourishment and lose their strength.

The basic principles of nutrition for thrush require inclusion in the diet:

1. More ordinary clean water - at least one and a half liters per day;
2. Grain products are a source of fiber, which normalizes digestion, relieves flatulence and ensures better functioning of the intestines, where, as is known, up to 80% of human immunity is formed;
3. Vegetables and fruits are an excellent source of vitamins;
4. Fermented milk products - such products help the microflora work more harmoniously and quickly become populated with healthy bacteria;
5. Meat and poultry, as well as fish - they provide the body with the necessary amount of microelements;
6. Nuts and seeds - such products help increase the amount of energy, but you can consume no more than 5 tablespoons per day, because they contain a large amount of fat;
7. Fats and oils - their amount should not exceed 1 tsp. per day.

Chronic vaginal candidiasis often leads to a woman feeling tired and exhausted even while resting. The diet helps alleviate her condition and restore the joy of life.

Please note: you should not immediately quit the diet as soon as the doctor has diagnosed a cure for the pathology. For a few more months after recovery, it is worth adhering to such healthy dietary principles in order to completely deprive the mushrooms of their food supply.

What foods can you eat?

First of all, doctors recommend including foods that boost immunity in a woman’s diet. After all, it is failures in it that cause the activation of fungi. As a result, the list of foods allowed for thrush is as follows:

• Salads from fresh vegetables with vegetable oil dressing;
• Lean meat, preferably cooked either as stew or boiled;
• Kefir, cottage cheese, fermented baked milk, sour cream;
• Vegetables and fruits - you should choose those that neutralize the acidic environment;
• Spicy spices such as cloves, cinnamon and bay leaves.

What to give up

Treatment of chronic candidiasis in women with diet also includes a list of strict prohibitions. The following are included in the blacklist:

1. Various sweets, including rolls, candies, sweet drinks and soda;
2. Bakery products containing yeast;
3. Alcoholic drinks;
4. Blue cheeses;
5. Marinades in the form of sauces;
6. Yogurts with fillings – these drinks contain a lot of sugar.

The calorie intake for thrush does not exceed 2000 kcal. And this is an excellent nutrition option for a healthy lifestyle. With its help, with the right layout, it is quite possible to lose weight.

To make it more clear, you can give an example of a daily menu for such a food system. So, for breakfast you can use oatmeal, ideally cooked in water and without added sugar. It can be supplemented with fruits, nuts and berries. You can complement the dish with sugar-free compote. For lunch, you can treat yourself to natural yoghurt and an apple. For lunch, you can prepare vegetable soup, fresh vegetable salad and stewed fish. You can complement everything with a cup of tea without sugar. For an afternoon snack, an excellent solution would be a soft-boiled egg with low-fat yogurt and orange. For dinner, you can make a vegetable stew and complement it with a piece of baked chicken.

Drugs

When asked how to treat chronic thrush in women, they usually mean drugs that can quickly minimize the active activity of fungi. As experts note, the following drug options are used for the treatment of candidiasis:

• Antibiotics from the polyenoic group: these include levorin, nystatin, natamycin;
• Various imidazole derivatives: these include the well-known clotrimazole, ketoconazole, isoconazole, etc.;
• Thiazole derivatives are fluconazole (by the way, doctors most often prescribe drugs based on this active substance for the treatment of candidiasis);
• Salts - for example, dequalinium chloride;
• Terbinafine.

Antibiotics from polyenes

Such remedies are antifungal drugs that are classified as natural medicines. Such active substances act on the cell membrane, destroying it quickly, as a result of which the internal filling of the cell dissolves very quickly. When used orally, such drugs are not toxic and are not absorbed into the skin.

It is worth remembering that when treated with such drugs, unwanted side effects may develop, such as:

1. Allergy;
2. Nausea;
3. Vomit;
4. Stool disorder;
5. Stomach ache.

Today, doctors call such remedies obsolete. Only nystatin does not lose its position. Based on it, candles such as Terzhinan and Polizhinaks were produced.

Derivatives of imidazole and thiazole

This active substance acts on ergosterol, a structural component of the fungal cell membrane. This leads to the same violation of the integrity of the membrane, dissolution of the cell contents and death of the fungus. Such drugs can be used both internally and locally. The following are considered systemic:

• Ketoconazole;
• Itraconazole, etc.

By local means, i.e. those used in the form of ointments and suppositories are:

1. Econazole;
2. Miconazole, etc.

Econazole

The advantage of such options is the fact that the fungus does not develop any resistance to them. It is worth preparing for the appearance of some side effects - these are especially common during the use of azole-based drugs. In this case, you may find:

• Nausea and other disruptions in the digestive system;
• Dizziness and headaches;
• Convulsions;
• Allergy;
• Peeling of the skin.

One of the most popular drugs from this group is Clotrimazole. It is mainly produced as vaginal tablets, gels or ointments. Its advantage is the fact that it acts precisely, because it must be applied directly to the site of inflammation. At the same time, it has a long-term accumulative effect - its concentration can remain for 3 days after use.

The scheme for using the tool is as follows:

1. If in tablets, you need to insert 1 tablet into the vagina per day. Course 7 days. At the same time, you need to lubricate the skin of the genital organs with cream;
2. If in the form of a vaginal gel, it should be administered in the amount of 1 applicator per day at night deep into the vagina. Course 6 days;
3. If in the form of candles, take 1 piece before bed for 6 days.

Among others from this group, drugs such as Gino-travogen, Econazole, Santequin, Ketodin, Livarol and others are prescribed.

This active substance is one of the most frequently used. It is found in such drugs as Diflucan, Mikosist, Fluzak, Mikomaxi, etc. Available in various forms - capsules, solutions, gels.

It is widely prescribed for candidiasis of any localization. And he does a very good job of solving the problem of how to cure chronic thrush in women. For vaginal candidiasis, the drug is taken in a dosage of 150 mg once, and then 1 tablet once a month for a course of 4-12 months - this will reduce the frequency of relapses.

Dequalinium chloride

Typically, this active ingredient is found in the drug in tablet form. The mechanism of action on the fungus is quite standard - it, like any other means, acts on the membrane, destroying it. Vaginal tablets are placed in the vagina once a day for 6 days in a row. A shorter course cannot be used, because this will result in untreated symptoms and a high risk of regular relapses.

Terbinafine

Preparations with this active ingredient are usually available as tablets, creams and gels, as well as skin sprays. Such products are highly effective in killing fungi, and can also simply inhibit their growth. The treatment regimen is prescribed by the doctor depending on the severity of the situation and the severity of the thrush case.

It is important to understand that in any case, average treatment regimens should not be adopted. All treatment should be prescribed only by a doctor who is familiar with the test data and was able to see for himself how the situation is progressing. Chronic thrush often requires not only basic treatment - it must be treated prophylactically and after. And it is better not to ignore these events. After all, each time it will be more and more difficult to get rid of the pathology.

Traditional medicine is often used as a means of therapy - it is quite in demand among women, and, most importantly, doctors have nothing against it. But only if it is used as an addition to the main treatment regimen, and not instead of it.

Common treatment methods include:

• Baths;
• Douching;
• Tamponing with oils and herbs, etc.

Various remedies can be used as therapeutic agents. For example, one of the popular options is regular honey. Its high effect is due to its antibacterial properties. But here it is important to understand that honey must be natural and not contain sugar. After all, the latter is an excellent environment for the proliferation of pathological microorganisms. A honey solution for douching is prepared from 1 part honey and 10 parts water - you need to take warm and boiled water. It is worth carrying out the procedure every day. The course is at least 14 days.

Herbs are often used for therapy. Chamomile, string, and calendula are especially effective in the fight against thrush. They are steamed, and then washed, sat in baths with them, or used for douching. Alternatively, herbal tea can be used for therapeutic purposes. To do this you will need to take:

1. Chamomile;
2. Calendula;

All herbs are taken in equal proportions. They should be mixed thoroughly, and then a couple of tablespoons should be brewed in a thermos with boiling water. The decoction is infused overnight, after which you should start drinking 1/3 glass three times a day half an hour before meals.

An herbal wash can be used. The recipe for one of the remedies has been tested for years and shows good results. This collection cannot be used internally, but it is 100% suitable for washing. To prepare it you need to take:

• Chamomile;
• Calendula;

The proportions are the same. For half a liter of water, 1 tbsp is required. such a collection. Pour fresh boiling water over the herb and let it sit for about half an hour. The infusion must be filtered and used warm for hygienic treatment of the genitals or for the douching procedure.

Iodine and soda are widely used in the treatment of chronic thrush in women. The recipe lasts for several days. In the first one, pour warm water into a bowl and add soda - proportion 1 tsp. per liter of water. Next, the lady should sit in the basin and sit for about half an hour. On the second day, dilute the soda again according to the same principle, but additionally add iodine - proportions: 1 tsp. per liter of water. And again you need to sit for half an hour. The procedure for such baths must be repeated daily until recovery occurs.

It is recommended to continue treatment with folk remedies, as well as diet and therapy with official medications, even after complete recovery for some time. This will be an excellent solution and will ensure the highest quality prevention of fungal disease.

11.04.2017

Yeast-like fungi Candida are normally present in the vagina of all healthy women, without compromising their health.

In case of weakened immunity due to acute respiratory viral infections, long-term use of antibiotics and hormones, an unbalanced diet, the vaginal microflora is disrupted, as a result of which the fungus begins to actively multiply, causing candidiasis.

A woman does not always have the time and desire to see a gynecologist; some prefer to independently treat thrush using means advertised on TV. As a result, choosing the wrong drug provokes the transition of the disease from an acute to a chronic form. This recurrent form is difficult to treat.

The situation becomes especially dangerous when the disease is incorrectly diagnosed. Diseases such as genital herpes, sexually transmitted diseases, and inflammation of the urinary system have similar symptoms to thrush.

Therefore, the first step in solving the problem should be contacting a specialist (venereologist, gynecologist), diagnosis and competent prescription of a treatment regimen.

If a woman has previously suffered from acute thrush, the symptoms will be familiar to her. In particular, these are:

1. Redness of the mucous membrane and itching in the genital area.
2. Pain and burning during urination and sexual intercourse.
3. Vaginal discharge with a cheesy consistency.

Treatment of thrush in a chronic form will be difficult and lengthy when compared with getting rid of the disease in an acute form. When treatment for chronic thrush in women is prescribed, drugs are selected individually in order to have a comprehensive effect on the fungus (inside and outside).

Recurrences of thrush are provoked by factors:

• abuse of sweet foods;
• metabolic disorders and diabetes;
• being in a stressful situation;
• antibiotic treatment, uncontrolled use of oral contraceptives;
• genital herpes, chronic diseases of the intestines and urinary system;
• incorrectly selected medications during the treatment of thrush.
  

What medications help with chronic thrush?

Chronic thrush, as mentioned above, takes a long time to cure. The key to success will be the correct choice of drugs. Listed below are the main medications that doctors prescribe for chronic candidiasis.

Flucostat is a Russian-made drug based on fluconazole. Available in the form of capsules with white powder of 50 and 150 mg. Prescribed for candidiasis of various localizations, mycosis, to increase immunity and prevent fungus. Contraindications for use include: age under 3 years, allergies to the composition of the drug, taking heart medications.

Prescribe with caution for liver and kidney diseases, and alcohol abuse. Pregnant women are prescribed the drug only if they have chronic thrush. If you take flucostat uncontrolled, side effects may occur: abdominal and head pain, vomiting, indigestion, convulsions, allergies, hallucinations, heart failure.

Diflucan is another popular drug for the treatment of candidiasis based on fluconazole. Available in injections, powders and capsules of 50 – 150 mg. The drug effectively inhibits the spread of the fungus, quickly defeating the disease.

Among the contraindications of Diflucan are the following: age under 18 years, allergies to components, arrhythmia, liver and kidney diseases. The drug is not recommended during pregnancy. The following adverse reactions are possible: nausea and vomiting, malfunction of the gastrointestinal tract, migraine, allergies, dizziness, anaphylactic shock, changes in taste.

Pimafucin is approved for the treatment of candidiasis during pregnancy and breastfeeding. Clinical trials have proven the safety of the drug. Pimafucin is available in the form of a local cream, vaginal suppositories and tablets taken orally. A contraindication to the use of the product is an allergy to the components (natamycin, sodium, starch, benzoates, wax, polysorbate, etc.). An overdose of tablets may cause diarrhea, vomiting, and disruption of the digestive tract. Pimafucin cream is excellent for treating fungus on the nails and skin, and diaper rash in children.

Clotrimazole is prescribed for fungal infections, streptococcus and staphylococcus. Compared to other drugs, it is inexpensive. Available in the form of cream, vaginal suppositories, solution. Contraindications include intolerance to clotrimazole. Allergic reactions may occur, which quickly disappear on their own. The drug is not prescribed during the first trimester of pregnancy, and for breastfeeding, clotrimazole is used only as prescribed by a doctor.

Livarol can be used by pregnant women starting from 13 weeks of gestation. The drug contains ketoconazole. Available in the form of vaginal suppositories. Given the release form, an overdose is impossible. The possibility of using livarol during breastfeeding is discussed with your doctor. Side effects may include: skin rash, burning sensation in the vagina. The drug is not prescribed for children under 12 years of age or for those who may be allergic to the components.

Hexion is an effective antiseptic that is prescribed for the treatment of chronic thrush and vaginitis, and the prevention of sexually transmitted infections. Hexicon vaginal suppositories contain polyethylene coside and chlorhexidine bigluconate. Suppositories can be used during pregnancy and lactation. It is not advisable to combine it with sodium-based cosmetic hygiene products. Adverse reactions may occur: itching and burning in the vagina, slight bleeding. Side effects disappear after treatment ends.

Terzhinan is a complex drug that does not harm the vaginal mucosa. In addition to the treatment of chronic thrush, it is prescribed before childbirth and operations. Release form: vaginal tablets. Before use, the tablets are soaked in water.

During the first trimester of pregnancy, the drug is not prescribed, during other trimesters - at the discretion of the doctor. Contraindications include intolerance to nystatin, neomycin sulfate and ternidazole.

A doctor prescribing medications for thrush must take a comprehensive approach to the disease. For this, in addition to antimycotic drugs, a complex of vitamins and probiotics are prescribed. During therapy, you need to stop taking antibiotics, oral contraceptives, maintain hygiene and abstain from sexual intercourse.

After completing the course of treatment, the doctor will prescribe a laboratory test of the microflora, which should confirm a decrease in the number of Candida fungi.

If the result is successful, medications are prescribed to help normalize the microflora - acylact, bifidumbacterin, etc. In the treatment of chronic thrush, physiotherapy is often used - darsonvalization, SMT, magnetic therapy, electrophoresis, laser therapy.

Causes of recurrence of chronic thrush

Reasons why the disease can progress in a woman’s body:

• chronic diseases of the pelvic organs;
• liver and kidney diseases;
• genital herpes;
• unbalanced diet, characterized by a deficiency of vitamins, a predominance of baked goods and sweet dishes;
• unprotected sexual relations with unverified partners;
• the presence of caries, periodontal disease in the mouth;
• pregnancy, disruption of the endocrine system.

If thrush is caused by chronic diseases, you need to treat the cause while simultaneously taking medications for the fungus.

The difficulty of treating thrush is that if the doctor’s recommendations are not followed, it constantly returns.

Common causes of relapse:

• incorrect choice of medications, addiction of the fungus to a particular drug;
• the presence of several pathogens in the vagina that cause similar symptoms. If you do not differentiate them before starting treatment, then during therapy it will not be possible to get rid of health problems, since the cause will remain;
• incorrect dosage of the medicine leads to the fact that the effect on the fungus becomes ineffective, time is lost and the disease enters the chronic stage;
• the patient independently completes treatment as soon as the symptoms of thrush stop bothering her. This is a common mistake when treating any disease. In fact, the absence of obvious symptoms does not mean that the body has been rid of fungi;
• incorrect diagnosis. A common case is when herpes is confused with thrush; as a result, the disease remains in the body, and another disease is treated.

You can get rid of thrush only if you strictly follow your doctor's instructions. In the future, you should adhere to the lifestyle recommended by your doctor to avoid re-infection.

Insidious disease. Even with ideally selected treatment and strict adherence to the doctor’s recommendations, it is not always possible to completely defeat it. Often thrush goes into a chronic stage, and then it is almost impossible to get rid of it.

Chronic is called candidiasis, exacerbations of which occur 4 times a year or more often. In many women, relapses of this disease appear again within 2-3 months after treatment. And some even suffer monthly - thrush bothers them in the middle or end of the menstrual cycle. According to statistics, almost a quarter of women regularly struggle with this disease. Men are also diagnosed with thrush, but much less frequently.

It is not by chance that candidiasis acquires a chronic form. As a rule, predisposing factors contribute to this:

• weakened immune system;
• constant stress;
• smoking;
• chronic diseases or infections in the body;
• problems with the kidneys or liver;
• hormonal disorders (diabetes mellitus, pregnancy, ovarian inflammation, etc.);
• genital infections;
• unbalanced diet, lack of any vitamins;
• excessive consumption of eubiotics - beneficial lactic bacteria, the excess of which provokes thrush;
• digestive disorders and intestinal diseases.

Among the prerequisites, we also note improper hygiene of the genital tract, regular unprotected sex with a carrier of the disease. Frequent hypothermia, which contributes to the emergence of many diseases, cannot be ruled out. If candidiasis appears for the first time, but is not treated, then it also develops into a chronic form.

Symptoms

Unlike the acute form, the chronic form of candidiasis occurs more smoothly. However, there are a number of signs that will help you identify this disease:

1. Periodic itching and other discomfort in the intimate area.
2. Brittle or peeling nails.
3. White coating on the tongue due to colds and other infections.
4. Whitish copious discharge after intimacy.

In some women, the symptoms are more obvious and do not differ from the acute form of the disease. Thrush manifests itself as thick, cheesy discharge, an unpleasant odor, and decreased libido.

In men, thrush manifests itself somewhat differently: swelling of the mucous membrane of the penis and foreskin, burning sensation, problems with erection. Some complain of pain during intimacy. And, unlike women, men experience increased libido during candidiasis.

Diagnostics

It is not difficult to identify thrush - sometimes a visual examination and analysis of the symptoms of this disease are enough. However, the doctor must take a microflora smear, which will reveal the presence of pathogenic bacteria. They can also take a microflora culture - it will help to find out which of the 150 types of Candida fungus provoked the disease. This will help in treating the disease - the doctor will select the most effective medicine in each specific case. If necessary, additional research is carried out. For example, tests for STDs. If there is a suspicion that thrush has developed against the background of other diseases, the patient is sent for diagnosis to a specialized specialist - an endocrinologist, therapist or immunologist.

Risks

A common misconception is that thrush is not dangerous and is treated only because it causes some discomfort. This is a misconception that can lead to serious health problems.

For women, the risk is primarily related to reproductive function:

• problems arise with conceiving and bearing a child;
• the risk of infectious diseases of the genital area increases;
• Pregnant women have a high risk of premature birth;
• recovery after childbirth is slower;
• the infection can be transmitted to a newborn, and curing a baby is much more difficult;
• decreased libido and lack of pleasure during sexual intercourse;
• the possibility of infection spreading to other parts of the body - colonies of the fungus can settle in the oral cavity, on the mucous membrane of the eye and even on internal organs;
• there is a possibility of developing neuropsychiatric conditions.

Some doctors are sure that thrush leads to adhesions in a woman’s body. And this provokes various diseases of the genitourinary area. If at the same time a woman catches an infectious or cold disease, her condition will be more severe. In addition, due to the Candida fungus, PMS and menstruation are more difficult and are often accompanied by severe pain.

In men, untreated thrush also causes unpleasant consequences. Firstly, pleasure during sexual intercourse decreases. At the same time, problems with potency cannot be ruled out. Secondly, candidiasis creates favorable conditions for the appearance of other infections. The fungus can settle on other organs or “take over” the intestines. Thirdly, latent thrush reduces immunity, therefore increasing susceptibility to many diseases. In addition, male candidiasis often indicates systemic disorders in the body. This is a dangerous symptom that should never be ignored.

Treatment of chronic thrush

Chronic candidiasis is treated comprehensively. This means receiving:

• antifungal medications;
• immunostimulants;
• drugs that normalize microflora;
• vitamin complexes.

The doctor decides which drugs will be more effective based on a previous examination. If it is possible to identify a type of Candida fungus, then medications to which these fungi are sensitive are selected. Since in chronic thrush the disease affects not only the genitourinary area, long-term treatment is required. It may last for several months.

Drug therapy

The basis of treatment is an antifungal drug. It can take any form - ointments and gels, vaginal tablets, capsules. Medicines are taken internally to rid the body of fungal colonies on other organs. This is an effective technique, which, however, is fraught with side effects, since it increases the load on the liver and urinary tract.

Local medications are designed to quickly relieve a sick person from unpleasant symptoms: discharge, itching, redness. Your doctor will determine how long to take these medications and in what dosage.

Typically, one of the following drugs is prescribed:

• Pimafucin. It contains an antibiotic that is effective against Candida fungus - natamycin. The product is available in the form of ointments, tablets, and suppositories. The main advantage of Pimafucin is safety, so it is most often prescribed to pregnant women.
• Nystatin. Perhaps the most effective remedy for recurrent thrush, since fungal strains cannot develop immunity to this medicine and die. However, it should be understood that the drug affects not only pathogenic microflora, but also beneficial ones.
• Livarol. These are vaginal suppositories containing ketoconazole. You will need a course of 10 doses to get rid of chronic candidiasis. However, the medicine has a fairly large list of side effects.
• Terzhinan. A universal drug used in the treatment of many diseases of the genital area. Suitable for treating thrush during pregnancy.
• Fluconazole. This is a capsule taken orally. The medicine is prescribed to women and men

Since exacerbation of thrush usually indicates a decrease in immunity, vitamins are prescribed in addition to drug therapy. It is especially important to pay attention to vitamins B, A, E, C. The doctor also prescribes general strengthening agents, for example, tincture of echinacea or ginseng. Since thrush is a violation of the body's microflora, medications are needed to restore it. For this purpose, they take Linex, Gynoflor, Acipol, etc.

Folk remedies

Chronic thrush cannot be cured with folk remedies alone, but their use is justified in some cases and doctors often recommend certain methods to their patients.

• Soda- it must be added to baths and used when washing.
• Douching- for this purpose, infusions of various herbs are used. Chamomile, calendula, St. John's wort, oak bark - these medicinal herbs have anti-inflammatory and restorative effects.
• carrot juice- it should be taken internally, as it strengthens the immune system and increases the body's resistance to thrush. The juice is also used for douching.

Douching is dangerous during pregnancy, so it is allowed to be performed only with the consent of a doctor!

Diet

Patients suffering from recurrent thrush should pay attention to their diet. It is necessary to limit the intake of products that create a favorable environment for the proliferation of lactic acid fungi.

Therefore, you should temporarily abandon:

• alcohol;
• yeast baking;
• sweets;
• smoked and pickled products;
• blue cheeses.

Some drinks also contribute to the proliferation of Candida fungi: soda, lemonade, kvass, strong coffee and tea. Of course, you don’t need to completely eliminate all of these from your diet, but you should reduce their quantity. Some products, on the contrary, should be included in your menu: garlic, onions, natural yoghurts, poultry, fish, cereals, seeds.

Men with thrush are recommended to eat a high-calorie diet. The menu should be dominated by fish, unsweetened fruits, stewed or boiled meat, and vegetables. You should also eat cottage cheese - it contains a large amount of protein, which increases the body's resistance to Candida fungus.

An obstetrician-gynecologist talks about the course of chronic thrush, symptoms and treatment in this video.

Dear friends, hello!

Today we will talk to you about thrush.

Do people often come to you with this problem?

I hear your unanimous “yes”!

Certainly! Going to the pharmacy is much easier than dragging yourself to the clinic, taking a coupon, waiting a week or more... And no one cares that “there” everything itches, itches and burns.

And if the female doctor’s advice is “douche with baking soda and chamomile” or “insert a tampon soaked in kefir” (this is not fiction), then I would like to say a lot of “warm” words to him.

What kind of rubbish is this - thrush? Where does it come from? What should you find out from a customer who asks you for something for thrush? How is this infection finally treated? Why does it sometimes not go away? What to offer in the complex?

Shall we figure it out?

How do mushrooms enter the body?

We already talked about mushrooms once. But this was a conversation about mycoses and skin.

Among other pathogens of mycoses, I mentioned to you yeast-like fungi of the genus Candida.

They are the cause of thrush.

We can acquire them in the course of our lives, or we can receive them as a gift from our mother at birth, if she was visited by thrush just before giving birth.

In the first case, vulvovaginal candidiasis, as thrush is otherwise called, can be contracted through direct contact with a sick person, including sexual intercourse, through a shared towel.

In the second case, when passing through the birth canal, the fungi enter the baby’s skin, settle on the oral mucosa, penetrate the body with amniotic fluid and become permanent residents of the large intestine and vaginal mucosa.

Vaginal residents

However, mushrooms are not permanent and not the predominant representatives of the vaginal fauna. Now I wrote this word and thought: I wonder why, when we talk about microbes, they say microFLORA? After all, “flora” is plants, and “fauna” is animals. Or are microorganisms more like plants?

The main inhabitants of the vagina are lactobacilli. They make up more than 90%.

Bifidobacteria and opportunistic microbes also live here in minimal quantities: gardnerella, mycoplasma, streptococci, staphylococci, anaerobes, etc.

Lactobacilli perform a very important function: they protect the vagina from external microorganisms, restrain the excessive reproduction of “neighbors” and prevent them from going all out.

The vaginal epithelium is a multilayer structure. Like the stratum corneum of the skin epidermis, young epithelial cells are born in the lowest layer, which divide, mature, move to the upper layers, and then desquamate.

The epithelial cells of the vagina contain glycogen. Lactobacilli break it down to form lactic acid. This maintains the acidic environment in the vagina at a level of 3.8-4.5, which protects it from pathogenic bacteria.

This makes it clear why you can’t use douching with a soda solution, which doctors love to recommend. Soda alkalizes the vagina and provokes gynecological problems.

And in general, any douching is harmful, because... wash away beneficial microbes, disrupt the ratio of good and conditionally bad bacteria. There are fewer good ones, but a holy place is never empty, so it is filled with those very conditionally pathogenic bacteria that were just waiting for this to begin to multiply.

In addition, soda dries out the mucous membrane, and dry mucous membrane is vulnerable. Therefore, a decrease in symptoms after this treatment method is the calm before the storm. The thrush will play out with renewed vigor, and other bad kids will join the mushrooms. Bacterial vaginosis will develop.

What does the first day of the cycle have to do with it?

You may have seen in doctors' prescriptions that for recurrent thrush they are prescribed on the first day of menstruation.

Do you know why?

The vaginal epithelium is hormone dependent. Estrogens help its cells accumulate glycogen and, therefore, break it down to release lactic acid. They also ensure the adhesion of lactobacilli to vaginal epithelial cells.

But in the first days of the cycle there is little estrogen.

During this period, a large number of destroyed endometrial cells and blood cells enter the vagina, and the environment here shifts to the alkaline side (pH increases to 5.0-6.0).

Therefore, the risk of getting thrush at the beginning of the menstrual cycle increases.

What causes vulvovaginal candidiasis?

Why is vaginal candidiasis called “thrush”?

Because the discharge in this disease resembles sour milk.

So, the most common factors that provoke the appearance of thrush:

1. . They destroy not only harmful, but also beneficial microbes, including those in the vagina, i.e. lactobacilli. There are fewer of them, they cannot fulfill their protective function, and the fungi begin to multiply intensively.
2. . During pregnancy, vaginal candidiasis occurs 2-3 times more often.

Sometimes thrush is a marker of pregnancy, when the test still shows nothing, but the fungus is already right there!

This is explained, firstly, by a physiological decrease in immunity during this period in order to reduce the activity of the immune system, which regards the fetus as a foreign body that needs to be expelled.

Secondly, hormonal changes occur, as a result of which there is too much glycogen in the vaginal cells, and this is also bad. Lactobacilli do not have time to break it down, and it provokes the proliferation of fungi.

1. Violation of hygiene rules. This is the use of tampons, which sometimes remain in an intimate place all day, collecting all representatives of the vaginal fauna. This also includes excessive use of antiseptic products not intended for intimate hygiene. They, like antibiotics, destroy everyone, without understanding who is right and who is wrong.

Keep this in mind and tell customers that tampons need to be changed every 2 hours!

Some gynecologists are not only against tampons, but also against panty liners, because they interfere with oxygen access to the intimate area.

1. Swimming pools. Chlorinated water dries out the mucous membrane, which leads directly to vaginal dysbiosis.
2. Clothes and some toiletries. These are tight trousers and jeans that pinch and rub in intimate places, disrupting blood circulation and reducing local protection. The same applies to thongs.

We already talked about the journey of microorganisms through thongs from point K (intestines) to point B (vagina).

Let's add here panties made of synthetic materials that retain heat and moisture, which is why mushrooms grow as if after rain. So, away with lace sexy lingerie, long live the good old hebeshechki!

1. Thrush is often brought from warm countries. Firstly, climate change is for the body, as a result of which it decreases. Secondly, this means increased humidity in an intimate area if you spend the whole day in a wet swimsuit.
2. Hypothyroidism. As you know, the thyroid gland regulates ovarian function. With its hypofunction, hormonal disturbances in the reproductive system are ensured. Little estrogen means little glycogen in the vaginal epithelium. There is little glycogen, lactobacilli have nothing to break down. There is nothing to break down - lactic acid is not formed in the required amount. Lactic acid is not formed - the acidic environment in the vagina is not maintained.
3. Love for sweets. It turns out that mushrooms have a terrible sweet tooth. Therefore, during the treatment of candidiasis, doctors advise giving up sweets and starchy foods. For the same reason, thrush often visits.
4. Combined hormonal. They are included in this blacklist because they create a lower level of estrogen in the female body than natural.
5. Estrogen-containing hormonal preparations for HRT. Here is the other extreme: there is a lot of estrogen, the level of glycogen in the cells increases, it draws water onto itself, the mucous membrane loosens, the pH shifts to the alkaline side. In 20% of women, glucose tolerance changes.
6. Glucocorticosteroids, immunosuppressants – i.e. drugs that reduce immunity.

How does thrush manifest?

It is not difficult to recognize thrush.

The following complaints may occur:

1. Itching, burning, discomfort in an intimate place, which intensifies in the evening.
2. White cheesy discharge without odor. People call them “beli”.
3. Pain during sexual intercourse.
4. Burning when urinating.

Thrush also occurs in men, and then white plaques, redness, and swelling appear on the genitals. The remaining complaints are the same as in women, but they are less pronounced.

To confirm the diagnosis of candidiasis, a smear is taken and a culture is done.

What forms of thrush exist?

There are 2 forms:

1. Acute candidiasis. Lasts no more than 2 months.
2. Chronic candidiasis. Lasts more than 2 months.

Chronic candidiasis is divided into 2 types:

• Recurrent – ​​symptoms go away completely after treatment, but exacerbations occur at least 4 times a year.
• Persistent – ​​symptoms are constantly present to varying degrees. After treatment they subside somewhat.

What questions should the buyer ask?

When you are asked to give something for thrush, you do not need to immediately offer an antimycotic. Talk to the customer. Why did she think it was thrush?

Questions could be:

1. Did your doctor give you this diagnosis?
2. How does the disease manifest? Is there itching, burning, or pain when urinating? What kind of discharge? (interested in color, consistency). White, curdled ones are thrush. If others, then the big question is what it is. Possibly an STD, and it makes no sense to recommend Fluconazole.
3. Is this your first time, or have you already had similar symptoms? If you have already had thrush, find out how often exacerbations occur.

The fluconazole treatment regimen depends on the severity of symptoms and the frequency of exacerbations.

Now some of you are reading these lines and thinking:

- Yeah, the line is halfway across the pharmacy, and I’m going to be interested in the discharge?

In order not to embarrass the customer and not to embarrass yourself, it is better to go out to her in the hall with the words: “I’ll come out to you now, I need to clarify something,” then, taking her aside, ask her these questions, since without this your recommendations may not be entirely literate.

General treatment regimen for thrush

The treatment regimen depends on several factors:

1. Acute or chronic process?
2. Is it just thrush? Often fungi are combined with other representatives of opportunistic flora, so the task becomes more complicated.
3. How severe are the symptoms?
4. Are there any concomitant diseases?

Comprehensive treatment of thrush includes:

1. Systemic antimycotic.
2. Local antimycotic.
3. After the course of treatment - a vaginal eubiotic to restore vaginal flora.
4. For chronic thrush -.

Fluconazole and Itraconazole are most often used for systemic therapy.

Treatment regimen for thrush with Fluconazole

There are different treatment regimens for Fluconazole, but the most logical one seems to me to be the following:

1. Light discharge, minor itching and discomfort, or new-onset thrush:

Fluconazole 150 mg once for both men and women.

1. Itching, burning, discomfort, heavy discharge, 1-4 episodes of thrush per year:

Woman: Fluconazole 150 mg twice with an interval of 72 hours.

Man: 150 mg once.

1. Recurrent thrush (more than 4 episodes per year):

Woman: 150 mg three times with an interval of 72 hours. Then 150 mg once a week for 6 months.

Man: 150 mg once.

If Fluconazole is ineffective, see a doctor for examination!

If the diagnosis of candidiasis is confirmed, the doctor may prescribe, for example, Itraconazole 200 mg 2 times 1 day or 200 mg 1 time per day for 3 days.

Other

We influence mushrooms in their habitat

For local treatment, if the symptoms are definitely thrush, in my opinion, it should be a single drug: Pimafucin, Livarol, Zalain, Clotrimazole, Ginezol 7, Ginofort.

For women, most often these are suppositories or vaginal capsules/tablets, for men - cream.

The duration of treatment is different for each drug.

The average duration of use of the cream for a man is 7-10 days.

As for combined remedies (Terzhinan, Polygynax, Klion D, etc.), using them for thrush is like cutting your finger and at the same time smearing it with iodine. With the antifungal component we will destroy the fungus, and with the other, beneficial microbes, while reducing local immunity, which in itself is the cause of thrush.

They are usually prescribed for combined fungal and bacterial infections.

You ask: But how can you recognize her?

Firstly, a bacterial infection is manifested by “colored” discharge (yellowish-greenish).

Secondly, unpleasant smell.

Third, it can give in the stomach, deterioration in general health.

And then, most likely, you need Macmiror, Flagyl or a broad-spectrum antibiotic inside. Plus a combined local remedy such as Terzhinan or Polygynax.

Restoring microflora

Food for thought. In the instructions for such drugs, candidiasis is listed as a contraindication, but doctors prescribe them in the complex treatment of thrush. How to understand this?

I haven't found any clear explanations for this. Moreover, opinions are divided as to which environment Candida mushrooms reproduce best in: some say that it is acidic (which I do not agree with), others say that it is alkaline. If we assume that they like an acidic environment, then how can we explain their existence in the large intestine, where the environment is slightly alkaline?

And yet: why are these drugs contraindicated for candidiasis?

I believe that firstly, because of the excipients. For example, in the drug Acylact it is written that bacteria are cultivated with the addition of sucrose-milk medium, and mushrooms, as you now know, love sweets.

Secondly, against the background of candidiasis, the affected cells of the vaginal epithelium contain little glycogen, so lactobacilli will not have enough nutrient substrate, and candidiasis will only get worse.

But after the end of antifungal therapy, with negative smears for the fungus, these drugs will come in very handy.

What do you think about this?

Understanding immunity

For recurrent candidiasis, the doctor may prescribe Viferon, Genferon, Polyoxidonium in suppositories, etc.

We take proper care

And ideally, especially with recurrent thrush, it is good to use a special intimate care product that will maintain an optimal environment in the vagina (for example, Lactacid).

During treatment:

1. Use only cotton linen.
2. Avoid thongs, tight trousers and jeans.
3. Eliminate sweets and starchy foods from your diet.
4. You should abstain from sexual intercourse during this period.
5. Both need treatment.

Why is thrush treatment often ineffective?

I found 5 reasons for this:

By the way, if a woman has doubts that it is thrush, you can offer her the FrauTest Candida.

What can you do for thrush during pregnancy?

Pimafucin: suppositories, tablets. The rest is all with some reservations.

That's all I wanted to tell you today.

How did you like this article, friends? If you want to add something, comment, or ask questions, write in the comments box.

If you are not yet a blog subscriber, you can become one right now. To do this, you need to fill out the blog subscription form, which is at the end of each article and in the right column. If anything is unclear, here are the instructions. A few minutes after subscribing, you will receive valuable information for your work by email.

If suddenly there is no letter, please check your spam folder. Perhaps it got there. If it’s not there, write.

And I say goodbye to you until we meet again on the “” blog!

With love to you, Marina Kuznetsova

Despite the successes of modern medicine in the development of drugs, diagnosis and identification of risk factors for candidal infection, the problem of treating vulvovaginal candidiasis (thrush) in women is still relevant.

Over the past 20 years, the number of candida carriers, women with asymptomatic, chronic recurrent thrush, and women infected with Candida non-albicans has been growing; drug therapy in these groups is the most complex and requires care and high qualifications of the attending physician.

Fungi of the genus Candida themselves can develop resistance to drugs and react poorly to measures taken, including due to the formation of persistent biofilms on the surface of the vaginal epithelium.

We will devote this material to the features of acute and chronic recurrent vulvovaginal candidiasis (thrush) in women.

• Show all

  1. Briefly about pathology

  Vulvovaginal candidiasis (VVC) is caused by fungi of the genus Candida. Most often they belong to the species.

  Candidal infection of the vulva and vagina is usually accompanied by the following symptoms:

  1. 1 White, cheesy or creamy discharge from the genital tract.
  2. 2 Itching and burning in the vagina, vulva area. These symptoms may intensify after hygiene procedures, the use of intimate hygiene products, and during sexual intercourse.
  3. 3 Impaired urination - pain, frequent urge.
  4. 4 Pain during sexual intercourse - dyspareunia.
  5. 5 Swelling and hyperemia of the vaginal mucosa, less commonly the vulva.

  Preference is given to azoles (fluconazole, clotrimazole, miconazole), which in this case are more effective than nystatin. This approach makes it possible to relieve symptoms in 80-90% of patients who correctly completed the course (treatment regimens for uncomplicated thrush in Table 1).

  

  Table 1 - Treatment regimens for vaginal candidiasis (thrush) in non-pregnant women according to CDC recommendations, 2015

  If the symptoms of candidiasis persist after a course of therapy or a relapse develops over the next 2 months, then the patient is sampled for culture on a nutrient medium in order to clarify the dominant type of candida and determine their sensitivity to known antimycotics.

  The mechanism of development and pathogenesis of recurrent vulvovaginal candidiasis has not been fully studied. Many patients do not have obvious predisposing factors that could lead to chronic infection.

  In chronic thrush, Candida non-albicans is more often detected (in approximately 10-20% of cases), which are insensitive to basic drugs.

  In case of relapse C. albicans therapy includes several courses of antifungal drugs:

  1. 1 Initial course - a short course using local or systemic drugs from the azole group. For a better clinical effect, some doctors suggest extending the use of local azoles to 7-14 days or prescribing fluconazole orally according to the regimen - 1, 4, 7 days of therapy at a dosage of 100, 150 or 200 mg, respectively.
  2. 2 Maintenance course. For 6 months, fluconazole is taken once a week at a dose of 100-150 mg. If this is not possible, then topical azoles are prescribed in intermittent courses. This therapy is effective, but 30-50% of women experience relapses after discontinuation of medications.

  For Candida non-albicans, the optimal treatment regimen has not been established. It is proposed to use local or systemic drugs from the azole group (except fluconazole) for 1-2 weeks. In case of relapse, the use of boric acid (vaginal gelatin capsules 600 mg) is allowed for 14 days once a day. This scheme leads to recovery in 70% of cases.

  Azoles can be used in pregnant women in the form of vaginal suppositories or vaginal cream. Taking medications internally is prohibited.

  4. Program DGGG, AGII and DDG (2015)

  According to this provision, a situation where a woman with a normal immune status has Candida fungi detected in a smear, but has no symptoms, does not require treatment (exception: pregnant women).

  Acute vaginal candidiasis, according to these recommendations, is treated with the following drugs:

  1. 1 Local therapy with nystatin preparations for a course of at least 6 days.
  2. 2 Local therapy with drugs based on clotrimazole, econazole, miconazole, etc.
  3. 3 Systemic therapy (fluconazole, itraconazole orally).
  4. 4 Cyclopiroxolamine vaginal cream, vaginal suppositories, course for at least 6 days.

  All of the above options have approximately the same effectiveness for acute vaginal candidiasis. Cure rates (clinical and laboratory) are up to 85% a week after completion of the course and 75% after 1-1.5 months.

  In pregnant women, the use of imidazoles is more effective than polyenes (comparisons were made with nystatin). In case of asymptomatic carriage, preventive treatment is recommended 6 weeks before the expected date of birth. Its purpose is to prevent infection of the newborn.

  For chronic thrush, two-stage treatment is proposed:

  1. 1 Initial course (relief of symptoms, normalization of laboratory parameters).
  2. 2 Maintenance therapy - local (clotrimazole) or systemic (fluconazole).

  European guidelines for the management of women with abnormal vaginal discharge - IUSTI/WHO (2011) J Sherrard, G Donders et al. include treatment regimens for vulvovaginal candidiasis, trichomoniasis and bacterial vaginosis.

  Treatment regimens for thrush in non-pregnant women recommended by IUSTI/WHO are presented in Table 2 below.

  

  Table 2 - Regimens for the use of antifungal drugs in non-pregnant women, recommended by IUSTI/WHO (2011) for the treatment of acute vaginal candidiasis

  For thrush that occurs with severe itching, you can use ointments and gels with hydrocortisone. Patients receiving oral antimycotics (fluconazole, itraconazole) can use moisturizing creams (emollients).

  Treatment for chronic thrush includes:

  1. 1 Elimination of predisposing factors, correction of concomitant diseases.
  2. 2 Initial course - 10-14 days.
  3. 3 Maintenance therapy involves the prescription of antifungal drugs once a week, a course of 6 months.
  4. 4 Avoiding the use of soap and using moisturizing creams (emollients) will help cope with dry skin of the vulva.
  1. 1 Inclusion of another drug from the group of polyenes - natamycin (Pimafucin) into the basic therapy of thrush.
  2. 2 The use of natamycin for chronic recurrent thrush and infection caused by C. non-albicans.

  

  Table 3 - Treatment regimens for acute and chronic thrush in non-pregnant women according to Federal clinical guidelines. To view, click on the table

  7. Supportive therapy

  Auxiliary therapy for thrush can eliminate concomitant infections of the reproductive system, normalize the vaginal microbiota, and improve the general condition of the woman’s body.

  1. 1 Correction of nutrition for thrush, exclusion of foods that promote the growth and reproduction of fungi. Undesirable foods include sugar and sweet foods, rich yeast baked goods. Diet therapy for thrush in more detail.
  2. 2 Vaginal candidiasis is often combined with intestinal dysbiosis. This confirms the need for an integrated approach in the treatment of vaginal candidiasis. You can supplement the regimen by taking natural probiotics – fermented milk products containing lactobacilli and bifidobacteria.
  3. 3 Thrush against the background of severe vaginal dysbiosis, gardnerellosis requires the prescription of complex drugs, for example, neo-penotran, polygynax, terzhinan. Their effect is to eliminate inflammation, act on anaerobes, gardnerella and fungi.
  4. 4 We cannot recommend drugs for restoring vaginal microflora (gynoflor, vaginorm, ecofemin) until a sufficient number of studies have been carried out on their effectiveness.
  5. 5 It is important to eliminate foci of chronic infection in the body, if any. In the presence of diabetes mellitus, dynamic observation and therapy by an endocrinologist is required.
  6. 6 We cannot recommend immunomodulators, dietary supplements, or homeopathy due to the lack of evidence. In our opinion, a healthy lifestyle, balanced nutrition, and physical activity fully replace these groups of drugs.
  7. 7 Traditional medicine methods and herbal treatment are distracting in nature and have a placebo effect. They should not be used in women.

  8. The problem of candida resistance to antimycotics

  The problem of resistance of fungi of the genus Candida to antimycotic agents is no less relevant than bacterial resistance to antibiotics. Resistance to drugs of the azole group develops more often than others; the low sensitivity to azoles of C. non-albicans is of particular importance. The explanation lies in the mechanism of action of drugs in this group.

  By inhibiting enzymes associated with cytochrome P 450, the drug disrupts the synthesis of ergosterol, a component of the cell membrane of the fungus. This is how the fungistatic effect develops.

  Resilience is acquired in several ways. C. albicans is characterized by the accumulation of mutations in the ERG11 gene, which is associated with encoding the enzyme for ergosterol synthesis. It no longer binds to azoles, but forms bonds with the natural substrate lanosterol. The latter is converted into ergosterol during the reaction.

  Another mechanism is associated with the removal of drugs from the cell using ATP-dependent transporters.
  Resistance to azoles is cross-resistance, that is, it develops to drugs of the entire group. In this case, it is possible to use polyenes.

  9. Evaluation of treatment effectiveness

  The criteria for the effectiveness of treatment are the following indicators:

  1. 1 Complete recovery, the vagina is sanitized: there are no clinical symptoms, signs of inflammation, laboratory tests (, culture on a nutrient medium) confirm the absence of fungus.
  2. 2 Improvement: reduction in the severity of symptoms of the disease, objective signs.
  3. 3 Relapse - the appearance of new symptoms of thrush, detection of the fungus by smear microscopy 2-4 weeks after the course of therapy.

  In the acute form, control is prescribed 14 days after the last dose of medication.

  10. Prevention of relapse

  To prevent relapse of vaginal candidiasis, factors that create favorable conditions for the growth and reproduction of fungi of the genus Candida should be eliminated.

  1. 1 Mycoses develop in warm and humid environments. This is facilitated by wearing tight clothing made of synthetic, poorly breathable fabrics. It is better to choose cotton, comfortable underwear. Linen should be changed daily.
  2. 2 Daily sanitary pads retain moisture and heat, creating an environment that promotes the growth of fungus. Changing them frequently can eliminate these shortcomings.
  3. 3 You should maintain a balance in the consumption of different food groups, give preference to vegetables, fruits, cereal porridges, fermented milk products, and lean meats. Sweets and flour are limited to a minimum.
  4. 4 You cannot use antibiotics without a doctor’s prescription, and you cannot extend the course for a longer period than the doctor recommended. Antibacterial agents can be combined with fluconazole (150 mg) in women with a history of vulvovaginal candidiasis.
  5. 5 Glucocorticoids, when used over a long period of time, also promote the growth of fungal flora. They should not be used without a doctor's prescription.
  6. 6 Antifungal drugs should not be used without the advice of a doctor, as in the case of antibiotics, this leads to the development of resistance in fungi of the genus Candida.
  7. 7 The CDC does not recommend treatment of sexual partners for thrush in women.
  8. 8 It is recommended to visit a gynecologist at least once a year in the absence of complaints, as needed if there are any symptoms from the reproductive and urinary systems.

  The information presented in the article is intended to familiarize you with current trends in medicine and cannot replace a face-to-face consultation with a specialist. It should not be used for self-medication!