Suggest treatment for chronic yeast infection, irregular discharge and irritation in vulva

Posted on Fri, 19 Jun 2015 in Pregnancy
Question: hello
I have been having a chronic yeast infection for about a year. Symptoms are similar: ichy, irritation at vulva, little pain while having sex, irregular dishcarge (cottage cheese like, but runs clear while ovulating, recently during ovulation also accompanies with little bleeding)
Ive tried priscription like fluconazole or clometrinazol(both viginal insert or oral) , some time it works some time it doesnt. But after menstrual it just comes back.
Im wondering if theres anything that I can do to stop this.
(The reason i know its yeast imfection is because i did a pap smear about 7 months ago while having these symptoms. Everyhing is clear, STD or Bacteria)

Thank you

Answered by Dr. Vjollce Mbiarra 30 minutes later
Brief Answer:
You should try with a Maintenance regimen

Detailed Answer:
Hi dear and thanks for trusting to us.

I understand your health issue and i will try to be helpful.

As you have reported you have a recurrent vulvovaginal candidiasis (RVVC).

First you should do a vaginal swab to identify the infecting organism (Species such as Candida glabrata, Candida parapsilosis and Saccharomyces cerevisiae are responsible for up to 33 percent of recurrent infections.)
and sensitivity of antimycotic agents .

Until you have about one year with RVVC, is best managed using an initial 14-day course of oral azole therapy to induce clinical remission and a negative fungal culture, followed by a six-month maintenance regimen.
6 Maintenance regimens include ketoconazole (Nizoral), 100 mg daily; itraconazole (Sporanox), 100 mg daily; and fluconazole (Diflucan), 100 to 200 mg weekly.

An alternative topical maintenance regimen consists of clotrimazole vaginal suppositories (Gyne-Lotrimin), 500 mg weekly.

An examination and reculture of you after the initial two-week regimen and then at the three- and six-month points in the maintenance regimen will ensure that the antimycotic therapy is effective and that your's symptoms have resolved.

Best regards

Above answer was peer-reviewed by : Dr. Shanthi.E
Follow up: Dr. Vjollce Mbiarra 1 hour later
What does the two week therapy consist of? (Just fluconazol?)
Also am i suppose to take fluconzol for 6 months? Isnt it highly toxic to liver ? Normally im just prescribed with a 150mg single dose
Answered by Dr. Vjollce Mbiarra 20 hours later
Brief Answer:
Is not toxic

Detailed Answer:
Hi dear again and apologize for late reply.

Two weeks therapy consist of any antimycotics that will be sensitive until vaginal swab with will be done .
Hence you should wait for another episode of yeast infection and than have a vaginal swab done .
In this way we can identify the infecting organism and sensitivity of antimycotic agents .
During this time you should stop using all antimycotics treatment.

If vaginal swab was done within this month you can have a maintenance regimen therapy , fluconazole 150 mg weekly for six months.
This dose isn't toxic for your liver.

All the best
Above answer was peer-reviewed by : Dr. Prasad
Follow up: Dr. Vjollce Mbiarra 31 minutes later
Hello .
Im currently an expat living in a country where going to gynecologist is a rather inconvinient task. Is it ok if i go ahead and take fluconazol 150mg everyweek from now?
Answered by Dr. Vjollce Mbiarra 20 minutes later
Brief Answer:
Yes it's ok

Detailed Answer:
Hi dear again.

Yes you can go ahead with fluconazole 150 mg weekly for six months form now.

During this time try and with probiotics and cranberry teas.

All the best and fast recovery.
Above answer was peer-reviewed by : Dr. Prasad
Answered by
Dr. Vjollce Mbiarra

OBGYN, Maternal and Fetal Medicine

Practicing since :2006

Answered : 1572 Questions


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