Candida vulvovaginistis or, more commonly known as vulvovaginal candidiasis, is one of the most common infections among women. So, if you have had candidiasis, have, or have ever in your life, do not worry, it is very normal, you just have to go to a gynecological consultation to receive the appropriate treatment.
This is a common infection of the vulva and vagina caused by the fungus Candida. According to studies, 3 out of 4 women suffer from vulvovaginitis once in their lifetime, 40-50% of whom experience at least a second episode. It is also a major cause of vulvovaginal itching and discharge, although 10-20% of patients are asymptomatic.
Given the frequency of this infection, it is important to disseminate information and to know how it can be treated. In the article I explain the types of effective treatments that exist to deal with the various types of candidiasis.
As I mentioned, vulvovaginitis is a very common infection, however, not all women are affected in the same way. Depending on the frequency of the episodes, the symptoms presented and the patient’s condition, three types of infection are distinguished:
Sporadic episodes: <3 episodes/year
Mild to moderate symptoms
Possible Candida Albicans infection
Healthy non-pregnant patient
Recurrent episodes: >3 episodes/year
Candida infection other than C. Albicans, C. Glabrata
Pregnant patient, with poorly controlled diabetes, immunosuppression, etc.
Recurrent episodes: >4 episodes/year
Obtaining vaginal cultures
Less common candida infection
Caused by a persistent vaginal reservoir or an infection of identical susceptible C. albicans strains.
Once candidiasis has been diagnosed, the appropriate treatment must be chosen for each patient. This takes into account the type of infection: uncomplicated (90% of cases), complicated (10%) or recurrent.
There are multiple types of oral and topical treatments and, although both methods have a clinical cure rate of over 90%, the choice depends on patient preference, with patients generally opting for oral treatment.
Now, what is the difference between oral and topical treatment? Oral drugs have more side effects (gastrointestinal intolerance, headache, skin rashes…) than topical drugs (possible local irritation or burning). In addition, oral therapy takes one or two days longer to relieve symptoms than topical therapy.
The type of candidiasis the patient has should also be taken into account when choosing the treatment.
When the non-pregnant patient presents with an uncomplicated infection, oral antifungal treatment is usually resorted to. One dose of the drug should be sufficient and symptoms should disappear within 2 to 3 days.
During this short period of treatment, sexual intercourse can be practiced and the treatment of sexual partners is not indicated.
If the patient is pregnant or breastfeeding, the drug is not administered due to the risk of harm to the fetus.
In case the patient presents a complicated infection, an oral treatment of 2 or 3 sequential doses every 3 days, or a topical therapy of 7 to 14 days can be chosen.
When the patient is pregnant and presents severe symptoms, topical treatment is applied vaginally for 7 days. The application of oral drugs may increase the risk of miscarriage or have a negative impact during birth.
When the patient presents 4 or more episodes of candidasis in the same year, she should be treated as a recurrent infection. This requires a 4-stage treatment:
First. Initial treatment. Administration of 3 doses of antifungal drugs every 3 days.
Second. Maintenance treatment. After the initial phase, maintenance therapy is continued with 1 dose per week for 6 months.
Third. Drug discontinuation test. The treatment is interrupted to check whether the infection remits in a prolonged manner or if, on the contrary, it relapses again.
Fourth. Treatment of relapse. If it relapses soon after, the initial 3 doses are resumed and maintenance therapy is continued, this time for one year.
Finally, for patients with recurrent candidiasis, an autovaccine can be used. Uromune®which consists of the application of an individualized individualized vaccine.
In integrative gynecology practices repeat infections are addressed from a comprehensive women’s perspective. Integrative treatment is based on 3 fundamental pillars:
It is essential to know the woman’s lifestyle and apply the necessary changes in her nutrition. This, together with regenerative treatments and the latest technology on the market, guarantees the disappearance of infections and the recovery of the patient’s quality of life.
Soy la doctora Bárbara Fernández del Bas, ginecóloga especialista en sexología, ginecología integrativa, funcional y medicina antienvejecimiento. Gracias a mi formación, la aproximación a mis pacientes siempre es de forma global. Soy consciente de que somos más que mamas, útero y ovarios. Somos un todo. Por eso, siempre busco los últimos avances científicos para ponerlos a disposición de toda mujer que los necesite