Signs of candidiasis in women and methods of treatment24.05.2022
Factors that increase the risk of disease
Mushrooms of the genus Candida are opportunistic pathogens. They are found in the composition of the intestinal microflora, in a small amount they live in the vagina. Their growth is successfully restrained by the immune system.
Candidiasis in women occurs with a decrease in immunity
The protective factors are:
- mucosal integrity;
- bactericidal properties of lysine, lysozyme and other enzymes;
- secretion of immunoglobulins A and M;
- acidic environment.
These factors are sufficient to curb the growth of candida. But specific immunity is not developed for yeast fungi. Therefore, their complete destruction is not always possible.
The likelihood of acute inflammation increases in any condition accompanied by a decrease in local or general immunity. An outbreak of candidiasis is possible in the following cases:
- during pregnancy – immunity decreases under the influence of increased progesterone;
- frequent change of sexual partners;
- long-term antibiotic treatment;
- severe chronic diseases;
- hormonal changes;
- violation of personal hygiene;
- improper diet rich in carbohydrates;
- uncontrolled diabetes mellitus;
- taking glucocorticoids, cytostatics;
- use of spermicidal contraceptives.
In women with chronic candidiasis, exacerbations provoke the onset of menstruation, an increase in the amount of sugar in the diet, and constipation.
Vulvovaginal candidiasis is not common in postmenopausal women. This is due to a change in the composition of the vaginal microflora, a decrease in estrogen levels. Glycogen, the main nutrient substrate for lactobacilli and fungi, ceases to accumulate in epithelial cells. Therefore, the growth of candida stops.
Candidiasis in menopause is extremely rare. The exception is women who receive hormone replacement therapy.
Medications artificially maintain estrogen levels, which improves the condition of the vagina and increases the risk of candidiasis.
Forms of infection in women
Depending on the state of immunity and the composition of the microflora of the vagina, candidal infection can occur in three forms:
- asymptomatic carriage – clinical symptoms of infection do not appear, lactobacilli and bifidobacteria predominate in the vaginal microflora, the concentration of fungi is up to 104 CFU / ml;
- candidiasis – manifested by symptoms of vulvovaginitis, during the examination, fungi are determined at a concentration above 104 CFU / ml, combined with lactobacilli. No other forms of microorganisms were found;
- candidiasis is combined with dysbacteriosis – fungi of the genus Candida predominate in the flora, but normal lactobacilli are absent, instead of them there are gardnerella and other anaerobic bacteria, the clinical picture is mixed.
Symptoms may worsen with pregnancy or an abundance of sweets
The disease can occur in acute or chronic form. Acute candidiasis is characterized by the fact that it occurs once and lasts no more than 2 months. Chronic disease is considered to be a disease that recurs 4 or more times a year. In severe forms of the infection, women experience symptoms every month in the days leading up to their period.
Allocate persistent form. This is one of the varieties of a chronic course, the signs of the disease fade away under the influence of drug therapy, but some time after the end of the course they resume again.
Under the influence of waste products of fungi, an inflammatory reaction develops. The tissues swell, the sensation of itching and burning in the vulva, the entrance to the vagina disturbs. An allergic reaction joins the inflammatory process, so the itching becomes unbearable and incessant. Even hygiene procedures do not bring relief.
Discharge appears from the genital tract. They may look like this:
- white in color, sometimes with a yellowish tint, gray color is typical for a combination of candidiasis and bacterial vaginosis;
- consistency – creamy, curdled, with small grains, of varying degrees of density;
- the amount of discharge is moderate to large, may increase before menstruation;
- the smell of secretions is sour, the addition of gardnerellosis makes it look like the smell of rotten fish.
In the chronic course of candidiasis, the symptoms may be unexpressed. There is itching, burning, but the discharge is much less. There may be a feeling of discomfort, aching pain in the lower abdomen.
Inflammation affects sexual relationships. At first, a burning sensation can lead to increased activity, arousal. But during intercourse, not enough lubrication is released, pain appears.
In some cases, sex leads to the appearance of microcracks and postcoital spotting.
The urethra may be involved in inflammation. Therefore, during urination or after it, there are cutting sensations. But the accession of cystitis is not typical.
During a gynecological examination, the doctor may notice the following changes that are characteristic of vulvovaginal candidiasis:
- hyperemic mucous membrane of the vulva, vagina;
- tissue swelling;
- white curdled discharge or plaque on the mucous membrane;
- scratch marks.
In chronic course, atrophy of the mucous membrane, dryness of the vagina is observed.
Diagnosis begins with taking a smear from the vagina. In the acute phase or during an exacerbation of the chronic, fungal cells and mycelial filaments are observed in it. Lactobacilli can survive or die. When combined with bacterial vaginosis, key cells are found.
If candida is not found in the smear, but the woman complains of itching and burning, which is typical for chronic forms, PCR diagnostics should be performed.
The technique allows to detect the DNA of the fungus, and in real-time PCR – to determine the number of pathogens.
Sowing the discharge on a special Sabouraud nutrient medium to obtain fungal growth is used in the case of candidiasis that is resistant to drug therapy, with a chronic relapsing course of the disease.
Treatment of candidiasis
The basis of therapy is antifungal drugs. It is impossible to cure candidiasis using folk methods, douching with decoctions of herbs or ingesting them.
Use 2 methods of therapy – drugs are taken orally or used topically. Systemic therapy has its advantages:
- short course of treatment;
- ease of use;
- impact on all foci of candidiasis in the body.
Treatment is carried out with tablets or vaginal suppositories
It can be combined with local therapy, for which candles, cream, vaginal tablets are used. In this way, side effects can be avoided. The following groups of drugs are used for treatment:
- polyenes – Nystatin, Natamycin;
- imidazoles – Clotrimazole, Miconazole, Butaconazole, Econazole;
- triazoles – fluconazole, itraconazole.
Combined agents are often used, which include antibiotics and antifungal components: Terzhinan, Polygynax.
The treatment regimen depends on the type of drug and the form of pathology. In acute candidiasis, the course lasts no more than 7-10 days if local remedies are used. When using Fluconazole, a single dose is sufficient.
Chronic candidiasis is treated according to the scheme, similar to acute, but after the end of the course, anti-relapse therapy is prescribed for a period of 6 months. It consists in the systematic use once a week of Fluconazole capsules or Clotrimazole suppositories.
Women with chronic candidiasis should be prevented from relapse when taking antibiotics. Cancer patients receiving cytostatics should also take antifungal agents before and after the course of therapy.
Therapy of vulvovaginitis is supplemented by a special diet with the rejection of sweets, starchy foods, alcohol and the transition to fermented milk products. She is prescribed for a period of at least 3 months with a smooth return to the usual diet.
Vaginal candidiasis is dangerous because it leads to a decrease in immunity and creates conditions for the development of other infections. In pregnant women, it can cause premature rupture of the membranes, leading to infection of the fetus. Therefore, treatment is necessary in every case of acute infection.
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