Most of the fair sex knows about the symptoms of thrush. I must say that men, this disease also does not pass by. Meanwhile, the pathogen of thrush is a resident of our normal microflora.
Thrush (vulvovaginal candidiasis) is a fungal infection that is caused by microscopic yeast-like fungi of the genus Candida (most commonly found Candida albicans), and is characterized by inflammation of the mucous membrane of the vulvar ring, vagina, urethra, and perineum and buy diflucan online. These mushrooms belong to conditionally pathogenic microorganisms (that is, they are part of the normal microflora of the mouth, vagina and colon of almost all healthy people), therefore, for the development of this disease, it is important not only the presence of fungi of this genus, but their reproduction in a very large number, and this, most often, occurs with a decrease in immunity.
Doctors call thrush and candidal colpitis, and vulvovaginal mycosis, and urogenital candidiasis, and genital fungus, but the essence does not change, it is one and the same pathological process.
Unfortunately, thrush is a very common disease among the female population. More than 75% of women all over the planet have suffered this disease at least once in their lives, and a third of them who have received adequate therapy get sick again (there is a relapse of the disease).
Factors contributing to the spread of thrush
- wearing synthetic, fitting underwear (for example, the well-known “thong”) – damage to the mucous membranes in places of friction, drift of microflora from the anus into the vagina.
- Use of daily sanitary pads.
- Unnatural sex (anal, oral) – a violation of the normal microflora of the vagina, contributing to the development of thrush.
- Diabetes mellitus – strong changes in the immune system, frequent urination, obesity (usually associated with diabetes), difficulties with personal hygiene, ulceration of the mucous membranes of the urogenital tract – contribute to the development of thrush.
- Treatment with broad spectrum antibacterial drugs – kill not only the pathogenic microorganisms that caused the disease (for example, pneumonia), but also the conditionally pathogenic microorganisms inhabiting our gastrointestinal tract and the genital tract: the fungal flora grows very well in the “empty” place – there is a thrush.
- Pregnancy – during pregnancy, the immune defense is reduced so that the fertilized egg is not perceived by the body as a foreign body, therefore future mothers are more susceptible to any infections, including candidiasis.
- The use of high-dose oral contraceptives (containing 30 or more micrograms of ethinyl estradiol), intrauterine contraceptives (spiral), spermicides, diaphragms (for contraception) – weakening the local protective barrier in the vagina.
- The use of glucocorticosteroids is a factor in metabolic changes in organs and tissues that contribute to the development of thrush.
Vulvovaginal candidiasis (thrush) is not a sexually transmitted infection, despite the fact that sexual partners have the same strains of fungi. Most likely, this pathology can be associated with a defect in the immune system at different levels (decrease in general or local immunity). Candida carrying is not a disease, since in a healthy person these opportunistic microorganisms are present.
Thrush is classified into:
- Acute candidiasis.
- Recurrent (chronic) candidiasis.
Manifestations of thrush:
- Itching and burning in the vagina and in the region of the external genital organs, aggravated during sleep, after water procedures, after sexual intercourse, during menstruation.
- Bleach – abundant or moderate cheesy discharge from the genital tract from white to gray-yellow, odorless.
- Painful intercourse.
- Painful (with rezya) and frequent urination.
- Swelling and redness of the mucous membranes of the external genital organs, traces of scratching (maceration of the skin and mucous membranes).
All of the above signs of thrush can be, as well as part of them (the disease is erased, without any complaints from the patient).
What is required for the diagnosis of thrush (candidiasis)?
The patient has complaints about itching, cheesy discharge from the genital tract, impaired urination, symptoms of local inflammation in the external genitalia (edema, redness, maceration), laboratory data: microscopy of vaginal smears – detection of yeast-like fungi and pseudohyphae, pH of the vagina 4 -4,5, aminotest negative (when alkali is added to the vaginal discharge – there will be no smell of stale fish), when sowing discharge from the vagina on the appropriate nutrient media, fungi grow (healthy Referring can estimate their species, quantity, sensitivity to a particular antimicrobial product). There are additional (and expensive) methods for confirming the diagnosis of vulvovaginal candidiasis – immunofluorescent diagnosis (“CandidaSure”), compliment binding reactions, immunological studies and rapid methods. They are based on the most common reaction of an antigen-antibody, that is, a pathogenic microorganism (antigen), our immune system produces a defense (antibody): the antibody binds to the antigen, neutralizing the latter. This complex (antigen-antibody) can be identified by these diagnostic methods, or only the antibody is recognized.
Treatment for thrush
It is carried out only under the supervision of a specialist, self-treatment of thrush is fraught with the transition of the acute form of candidal colpitis to chronic, with frequent exacerbations and difficult cure.
Stages of treatment of thrush:
- Combating predisposing factors (rational antibiotic therapy, maintenance and protection of the immune system, personal hygiene)
- Diet (carbohydrate restriction)
- Rejection of bad habits.
- Drug local treatment of thrush (choose one drug):
- Butoconazole, 2% cream 5 g, single-place.
- Ketoconazole, suppositories 400 mg, 1 candle x 1 time per day for 3 or 5 days.
- Diflucan, inside 150 mg once (Fluconazole).
- Itraconazole, by mouth 200 mg x 2 times a day for 3 days or 200 mg (Irunin) x 10 days tablets, which are inserted deep into the vagina.
- Sertaconazole, 300 mg (1 suppository) once.
- Clotrimazole, 100 mg (1 tablet in the vagina) for 7 days.
- Miconazole: 100 mg vaginal suppositories (1 suppository) for the night of 7 days.
- Nystatin: vaginal tablets of 100,000 units (1 candle) daily x 1 time, before going to bed, for 14 days.
Drug treatment of chronic thrush:
- systemic antimycotics (itraconazole, 200 mg orally, 2 times a day, 3 days or Diflucan, 150 mg 1 time per day for 3 days) and
- local therapy with azole preparations (most often within 14 days)
- ketoconazole (nizoral) – Apply at 400 mg / day for 5 days;
- Clotrimazole (Kanesten) —Applied as vaginal tablets, 200–500mg for 6 days;
- miconazole – 250 mg each, 4 times a day, 10-14 days.
- Bifonazol – 1% cream, 1 time per day at night, 2-4 weeks;
- Diflucan – 50-150mg 1 time per day, from 7 to 14 days;
- Itraconazole (orungal) – 200 mg 1 time / day., 7 days.
Despite the high efficacy of topical treatment of thrush in many patients after 1-3 months, relapse occurs (exacerbation). This is due to taking antibiotics that alter the normal vaginal microflora, concomitant diabetes, taking oral contraceptives, pregnancy (increased glycogen level in the vaginal epithelium is a good breeding ground for fungi), an increase in the number of infected patients more pathogenic (and more resistant to traditional methods of treatment ) species of fungi – C.pseudotropicalis, C.glabrata, C. parapsilosis.
Is it necessary to treat the patient’s spouse for thrush?
Thrush is not a sexually transmitted disease, and most often it is not necessary to treat a spouse. But there are situations when a man has clinical manifestations (symptoms of itching, irritation and scratching on the penis, white discharge, aggravated after sexual contact) with a confirmed diagnosis of candidiasis in a woman. In this case, the treatment of thrush is the same as for a woman. Only the treatment is carried out not by topical preparations, but for oral administration (Pimafucin, 100 mg x1 tablets 4 times a day for 10 days).
Usually, a man does not have the symptoms of this disease, even if the woman is ill and is undergoing treatment. If the symptoms of thrush in a man occur, it is imperative to examine his body as a whole to exclude infections that significantly reduce immune surveillance (such as HIV (AIDS), hepatitis B and C, acute leukemia).
What to do to prevent recurrence of thrush
In order to prevent a relapse (exacerbation) of the disease, you must use:
- systemic antimycotics (itraconazole, 200 mg orally or fluconazole, 150 mg on the first day of menstruation for 6 months, that is, 6 courses);
- therapy with local drugs 1 time per week for 6 months (drugs that are used in candles for vaginal use).
Control treatment for thrush
- In the case of the acute form of thrush, monitoring of treatment is carried out 7 days after the end of treatment (smears and crops are tested for sensitivity to microbiological microflora)
- In chronic candidal colpitis, the evaluation of the effectiveness of treatment is performed during the 3rd menstrual cycle on the 5th – 7th day of the cycle (as the bleeding from the genital tract stopped after the menstrual period, smears and sensitivity cultures are passed).
In special cases, for example, treatment of thrush in pregnant women – use local antifungal drugs, such as: Natamycin 100mg (Pimafucin) 1 candle at night for 3-6 days (the drug is allowed for use in pregnant women even in the first trimester of pregnancy, that is, up to 12 weeks), or clotrimazole on 1 vaginal tablet (100 mg) x1 times a day at night, for 7 days (the drug is allowed for use in pregnant women with only 13 weeks of pregnancy).
If a sick patient is a child, then thrush is treated according to the following scheme: fluconazole 2 mg per 1 kilogram of body weight of the child; the entire dose is taken once orally with a small amount of water.
However, in describing in detail the drugs for the treatment of candidiasis of the vagina (thrush), their dosing regimens and courses of treatment, it is necessary to understand that all treatment should be monitored by a doctor. After all, the clinical picture (symptoms of the disease) typical for thrush, is characteristic of many more pathological processes in the vagina, for example: bacterial vaginosis, atrophic (blue) colpitis, bacterial vaginitis, chronic cervicitis, leukoplakia or vulvar (vagina) krauz, chlamydia cervicitis, adnexitis , gonorrhea, so the question of treatment should be only in the doctor’s office, under careful laboratory and clinical control of the patient’s cure.
The main component in the composition of the drug
Diflucan is based on fluconazole, which affects most fungi, including the fungus that causes thrush. The drug affects the process of production of cytochrome, which is part of the cell wall of the fungus, and is involved in metabolic processes. As a result, there is a general inhibition of the colony of the fungus and its weakening. Under the influence of the drug, the fungus stops multiplying and dies. After the medication is complete, the mucous microflora is quickly restored without the need for special formulations.
Side Effects of Diflucan
Side effects after taking this drug is a rarity. In some cases, patients may experience the following short-term effects:
- stomach upset;
- some changes in taste perception.
All side effects after the use of the drug are in an extremely short time. In most cases, the discomfort disappears 40–60 minutes after taking the drug. Extremely rare side effects can persist for 4 hours. Diflucan does not lead to health-threatening disorders, and especially life, and therefore it can be used even for patients with cancer and AIDS, as well as for treating young children.
How to take Diflucan to eliminate thrush
In order for the drug to have the maximum therapeutic effect, you should be aware of how and in what dosage to use it. If the rules of treatment are violated, there is a risk that the therapeutic effect will not be sufficiently strong, and the thrush will return again after a short period of time.
In the event that the disease arose for the first time, for its treatment a single administration of Diflucan at a dosage of 150 mg is required. Candles can also be given instead of capsules, but this is less common. They are also used once. Within 7 days after treatment, you should refrain from sex, as you should give time to recover the microflora of the vaginal mucosa. During this period, even sexual contact with a condom can provoke repeated development of thrush.
When the disease has a tendency to regular recurrence, then it is treated only with diflucan capsules (150 mg), which are taken 2 times with an interval of 3 days and after – once a month for six months. In this case, it is possible to cope with thrush completely.