Candidiasis, also known as thrush, occurs for a variety of reasons. Becoming an impetus to its development can be treated with broad-spectrum antibiotics, human immunodeficiency syndrome and other conditions in which the immune system ceases to act properly, chronic infections, lack of personal hygiene, metabolic disorders. These causes also include unhealthy diet.
A diet high in fast carbohydrates contributes to the creation of yeast-like fungi that are favorable for reproduction by increasing the sugar content in the blood, urine, and other organic excreta. If the host's body is weakened, the symptoms of candidiasis will not take long to wait.
What will the article tell you?
Most often, candidiasis affects the mucous membranes of the genital and oral cavity. Its characteristic features are difficult to confuse with something. It:
- Appearance on the mucous membranes, as well as in the large skin folds whitish, looks like cottage cheese plaque, because of which the disease got its name. This plaque is easily scraped off, it has an unpleasant sour smell.
- Itching, burningwith deep lesions - the appearance of bubbles filled with liquid. In the case of the accession of a secondary bacterial infection, often accompanying candidiasis, the fluid inside the bubbles becomes purulent, and weeping eroded areas are formed.
- Urination, if the process involves the urethra, pain in the lower abdomen, clouding of urine in candidal cystitis.
- Diarrhea, increased flatulence with intestinal candidiasis. Its distinctive feature is an admixture of whitish lumps and threads in the feces.
- Candidomycids - Allergic rashes caused by the waste products of the fungus.
Depending on what caused the disease, measures to get rid of it may vary. In case of violations of the body's resistance to the patient, immunomodulating agents will be required, if the fungus began to multiply while taking antibiotics - it is necessary to replace the drug with one of the softer analogues and restore the natural microflora using prebiotics.
An important part of the treatment of thrush is diet. In some cases, it is enough to normalize the diet in order to forget about all its unpleasant manifestations forever.
Diet for candidiasis
Carbohydrates are divided into slow and fast. Slow, or complex carbohydrates, such as glycogen, starch, are broken down by the body for a long time, providing it with energy for a long time. Fast carbohydrates - sucrose, fructose, glucose - are absorbed almost immediately.
The insidiousness of fast carbohydrates lies in the fact that they are necessary for man, due to which the sweet taste is recognized by most people as definitely pleasant, but harmful in excessive quantities. Candidiasis development is only one of many health problems that are threatened by an unbalanced diet with a high sugar content.
So the very first and The main requirement for a diet for thrush is the restriction or complete elimination of foods that contain significant amounts of carbohydrates. This list includes:
- Chocolate, sweets, marmalade, ice cream,
- Carbonated drinks on natural sugar,
- Sweet tea and coffee
- Grapes, persimmon and other very sweet fruits,
- Baking, especially white bread.
It is also not recommended to use a disturbing acid-base balance in the body and creating a beneficial environment for the reproduction of food fungus. These are smoked and pickled products, spicy seasonings, soy sauce and other sour sauces, mayonnaise. Cheese with mold, kvass, beer, yeast pastries should also be excluded from the diet.
What should be eaten with thrush?
First of all, these are porridges and legumes, black bread, fresh pastries - a source of slow carbohydrates, which provide the body with energy, without causing a sharp increase in blood sugar and not feeding fungi that cause thrush.
Fresh and steamed vegetables are also very good for the body, and many of them, such as onions, garlic, parsley, dill, help fight candida, being natural antiseptics.
In no case do not forget about meat products. This is an important source of protein and other substances necessary for the body. It is best to choose lean meats such as beef, chicken, turkey, and offal: liver, kidney, tongue, and cook them with a small amount of seasoning, baking or boiling.
Another essential ration item for treating candidiasis is dairy products. Many believe that they are harmful for thrush, but in fact, cottage cheese, kefir, savory yogurt, ryazhenka, tan are recommended for use by specialists. The fact is that all these dishes and drinks contain a large amount of lactobacilli and bifidobacteria, which are an important part of a healthy human microflora. In the event that dysbacteriosis has become one of the causes of candidiasis, fermented milk products are simply necessary.
It is also necessary to consume a sufficient amount of clean water: lack of fluid in the body leads to dry mucous membranes and makes them vulnerable to fungal infections.
Lomexin for candidiasis
In order to quickly get rid of the symptoms of the disease and destroy the colonies of the fungus on the mucous membranes, skin and intestines, both local preparations and means of general exposure are used.
In milder forms of candidiasis, it is preferable to use local preparations: sprays, ointments, creams. They are less toxic and have less contraindications. However, if the diet, careful hygienic measures, treatment of the affected areas of the mucous membranes and skin do not have a significant effect, and also when internal organs are affected by candidiasis, the use of tablets and capsules with a general effect is necessary.
With one of the most common forms of candidiasis, vulvovaginal candidiasis, the most convenient and effective are vaginal suppositories. Candles Lomeksin from thrush, reviews of which on the Internet confirm their effectiveness, possess not only antifungal, but also antibacterial action, due to what help and from the secondary infection, often accompanying candidiasis.
Candles from thrush Lomeksin are also used in the treatment of other inflammatory diseases of the genital organs: trichomoniasis, streptococcal, staphylococcal infections, but are ineffective against virus-induced diseases. Lomexin does not require a long course of use for thrush - usually one candle is enough to get rid of the symptoms of candidiasis. If necessary, you can use it again, but it must be at least three days after the first use of the tool.
The candle is inserted vaginally, after thorough washing, with clean hands. The best thing enter it at night before bed.
Lomeksin - candles from thrush, reviews of which are mostly positive, but they should not be used without consulting a specialist. In some cases, they cause manifestations of individual intolerance, such as itching, burning, urticaria, and are also contraindicated during pregnancy and lactation and in childhood.
Comprehensive treatment, including diet, healthy lifestyle and drug therapy, will help to forget about thrush.
Mechanism of action
Penetrating into the human body, the components of "Lomexin" proceed to therapeutic action. The active substance is sent to the fungus and attacks it from two sides. The drug destroys the cell membranes of the fungus and thereby provokes its self-destruction. Under the influence of the fungicide, the fungus loses the ability to attach to the walls of the vagina, and this, in turn, leads to a stop in the production of enzymes that contribute to the transformation of the thrush into a chronic form.
The constituent drugs accumulate in the focus of the fungus and continue to act in it for a long time. It is this feature of Lomexin that allows you to use it only once. It is extremely rare that a repeated procedure may be required, for example, if the patient has a thrush that is chronic. However, doctors recommend to continue using the drug for another 2 months, treating the vagina 1 time per week to consolidate the results of treatment and finally get rid of candidal colpitis.
Indications and contraindications
It is recommended to use antifungal agent "Lomeksin" for the treatment of the following pathologies:
- vaginal trichomoniasis,
- pityriasis versicolor
- inguinal ringworm,
- candidiasis of the skin.
Like any other drug, Lomexin has contraindications for use. Doctors do not prescribe an antifungal drug to children under 12 years old. It is not recommended to treat thrush "Lomeksinom" women in position and nursing mothers. The restriction to receive acts individual intolerance to the components of the drug and an allergy to the main component of the medication. With extreme caution, “Lomexin” is prescribed to elderly women due to incipient disruption of the liver.
Method of use "Lomeksina" and doses for thrush
Before you start using Lomexin cream or intravaginal capsules for the treatment of thrush, the patient should consult with your doctor to determine the feasibility of such treatment. If there are no restrictions on the use of this antifungal agent, the doctor prescribes safe dosages and sets the duration of the therapeutic course. Treatment of thrush with capsules is as follows:
- Wash hands and genitals.
- Take a prone position and bend your knees.
- Insert the capsule into the vagina to the maximum possible depth.
It is recommended to carry out the procedure before bedtime. After the introduction of candles do not get up and do not go to the toilet until the morning. Usually one tablet is enough to get rid of the fungus of the genus Candida, which develops thrush. However, if the expected effect was not followed, you should repeat the introduction of the capsule after 3 days. If “Lomexin” was chosen for the treatment of thrush in the form of a cream, then the patient will need to measure with a dispenser 5 g of the substance and place them in the vagina. The procedure is carried out in the evening, and in case of a severe course of the disease - also in the morning time. Course duration is 7 days.
In order to prevent re-infection of candidiasis from the sexual partner, he should undergo treatment. Representatives of the stronger sex should be applied cream "Lomeksin" on the prepuce and the glans penis. Course duration is 7 days. For the period of treatment should refrain from intimate intimacy.
Pregnancy and HB
There is no exact information about the effect of the active component "Lomexin" on the fetus in the womb. That is why doctors do not recommend the use of this medication for the treatment of thrush during pregnancy. The components of "Lomeksina" easily penetrate into breast milk, so when breastfeeding to use it against candidiasis should be with extreme caution.
Start using "Lomexin" should be immediately, as menstruation ended. At the time of treatment is not recommended to have sex, and the therapeutic course must pass both sexual partners. If, after 3 weeks of regular use of the drug, there is no improvement, then you should re-examine and clarify the presence of candidiasis.
Contraindications and harm
Despite the fact that Lomeksin acts therapeutically, do not forget that, like other drugs, it can cause side symptoms and harm the body. The tool is contraindicated to apply in children. The dosage of the medication is intended for adults and unwanted symptoms occur when the drug is administered to the child.
Fenticonazole is part of Lomexin and is a substance of local action. Because of this, with a long-term administration of the drug or when taken in large doses, a woman has local side reactions - itching and burning of the genitals, at the injection site - irritation, redness, pain. Sensitization may develop. In simple words, allergic reactions occur. Symptoms are a rash on the external genitals, between the legs, redness, rarely - urticaria. The same symptoms occur when the individual intolerance of the body to the components of the drug.
The use of suppositories during the period of menstruation was also contraindicated. This is due to the fact that during menstruation the acid balance of the vagina changes. Absorption of the active substance for this reason may not occur and in this case, the desired therapeutic effect does not occur. In addition, the components of the drug can react with the discharge and cause discomfort.
Do not enter the capsules and for the reason that the selection can simply wash off part, and even all the medicine from the walls of the vagina. In this case, the medicinal action will not follow, and the disease will become chronic. In addition, some patients complain that after the introduction of candles, periods pass a little differently than before use.
Candles Lomeksin: instructions for use
Apply the dosage prescribed by the attending gynecologist. During the period of treatment it is desirable to refrain from sexual contact until the healing of the vaginal mucosa. For prophylactic purposes, treatment is prescribed to both partners.
Before using suppositories, you should take care of personal hygiene. It is good to change bed and underwear for the night. Candles Lomeksin with candidiasis is introduced immediately before bedtime, after which during the night you should not go to the toilet.
Having carefully washed her hands and genitals, the woman lies on her back, bends her legs and inserts a candle deep into the vagina - intravaginally. The introduction is carried out once. In the absence of the expected therapeutic effect, as well as if a relapse occurred, the use of a candle is carried out after 3 days.
In the treatment of diseases caused by vaginal trichomonas, as well as other gram-positive flora, the candle is administered in a day. If you can not remove the symptoms and get rid of candidiasis - after 10 days, a second course of treatment.
Can I use during pregnancy and during lactation?
Due to the fact that Lomeksin entered the pharmaceutical market relatively recently, the side effects on pregnant and lactating mothers are not fully understood. The use of fenticonazole in the first trimester of pregnancy is contraindicated. But with an accuracy of 100% you can use Candiston.
During this period, the female body becomes very sensitive to the substances of the drug. In the remaining trimesters, as well as during lactation, no side effects were identified. Use of the drug is allowed with extreme caution, preferably under the supervision of a doctor or obstetrician.
Price and where to buy?
You can get the drug in specialized pharmacies, as well as in pharmacies of the city. One has only to go and ask. A woman does not have to bother to search for the nearest pharmacy, as many offer to order medicine on the Internet, there you can also get acquainted with the price of the product, choose the method of payment and delivery. As a rule, a choice is given: it will be a courier delivery, or the woman will pick up the order by herself at the pharmacy or postal center.
To date, the price for suppositories Lomeksin varies from 350 to 700 rubles, depending on the dosage. Average cost (mg / rubles):
Lomexin for candidiasis: reviews
Many ladies, having received an appointment for treatment, are in no hurry to immediately run to the pharmacy and buy medicine. On personal experience, no one wants to check the safety of treatment, and therefore, first of all, they read responses on thematic blogs and forums about Lomeksin candles from thrush. Reviews they get a variety. On the websites, the girls write that in one course of treatment they managed to get rid of unwanted symptoms, recover from vaginal candidiasis or trichomoniasis. Subsequently, neither one nor the other disease no longer bothered.
Despite possible adverse reactions, pregnant women and mothers who are breastfeeding also write about their use; under certain circumstances, doctors still prescribe Lomeksin for them. This can be explained by the fact that it is better to undergo treatment with a strong drug and shorten the period of treatment.
Not every woman responds positively to Lomeksina. Complaints are due to the fact that after use, there are unpleasant symptoms in the form of redness, burning in the vaginal area, incomprehensible discharge. Some girls did not help the drug at all - the symptoms returned a couple of days after the second injection. In single reviews it was said that the cost of a course of treatment is quite expensive. On this account, manufacturers say the following: the drug, though expensive, but effective.
Девушкам, будущим мамам и вообще всем представительницам слабого пола стоит не забывать о том, что самолечение может негативно сказаться на организме.
Как действует препарат
Ломексин – это противогрибковый препарат, который помогает вылечить молочницу всего за одно применение. В отличие от иных препаратов, лечащих кандидоз, Ломексин отличается уникальным строением молекул. Thanks to this property, the main active element is sent to the causative agent of the disease and acts on it from two sides:
- violates the integrity of the membrane of fungal spores, which ultimately causes the self-destruction of microorganisms,
- The medicinal composition of the drug limits the ability of the fungus to attach to the vaginal mucosa, and this leads to the cessation of the production of enzymes leading to the development of the advanced form of candidiasis.
A feature of Lomexin in the treatment of thrush is that the drug is able to linger in the focus of the fungus and remain there for a long time. This period is enough to prevent recurrence of the disease.
But besides the antifungal effect, Lomexin has an antibacterial effect on the urogenital system, preventing the development of pathogenic microflora - trichomonads, staphylococci, streptococci, etc.
Lomexin is of several types:
- soft vaginal capsules, with a dosage of 200 mg - are available in blisters of 3 and 6 pieces,
- soft vaginal capsules, in dosages of 600 mg, in blisters of 1 and 2 pieces each,
- Vaginal 2% cream in tubes with dispensers - 30 and 78 g each.
Capsules are vaginal tablets that have a thick beige suspension inside. The main active ingredient of Lomexin is fenticonazole nitrate. Auxiliary substances are paraffin, white petrolatum and lecithin.
Before applying Lomeksin for thrush, you need to wash your hands and genitals. To make the treatment more effective, you should follow the instructions for use of the drug:
- The introduction of the drug in the form of a capsule is carried out lying in bed, before going to bed;
- The candle is inserted as far as possible into the cavity of the vagina - after its introduction, it is advisable not to get out of bed so that the drug does not leak out.
- If a cream is chosen as a medicine for therapy, then 5 g of the substance that was measured by the dispenser is injected into the vagina in the evening.
Most often, to cure candidiasis, it is enough to apply Lomeksin once. If the desired result was not achieved, it is possible to repeat the treatment after 10 days.
Indications for use
Given the fact that Lomeksin does not penetrate the hematopoietic system, gynecologists safely prescribe this drug for the treatment of various diseases. The main indications for appointment are:
- vaginal candidiasis,
- vaginal white discharge, which appeared as a result of the development of dangerous microflora of the genital organs,
- candidiasis attacking the skin,
- ringworm of the groin area.
Fenticonazole, which is part of Lomexin, has powerful antifungal components that inhibit the growth and reproduction of the fungus of the genus Candida and other microorganisms.
During pregnancy and lactation
Since Lomeksin is quite new, its effect on the body of pregnant and lactating mothers has not yet been fully studied. It is not particularly recommended to use these candles in the first trimester of gestation when the body is sensitive to various medical formulations.
In addition, Lomeksin is able to get into the mother's milk, so during feeding it is necessary to use it with extreme caution, carefully weighing all the risks for the baby and the benefits for the woman.
To be treated with this drug during pregnancy and lactation is necessary only under the obligatory supervision of a specialist. A competent specialist will select safe candles for pregnant women to cure thrush and its unpleasant manifestations.
Interaction with other drugs
In Lomeksina, the main active substance is so small that there is practically no negative effect from its use. However, the fat-containing components found in the medicine can damage the latex layer of the contraceptive.
Until now, there have been no cases of reduced efficacy of Lomexin, as well as its negative effect when combined with other drugs.
However, it is worth knowing that this tool has side effects, which include:
- itching and burning in the vaginal cavity,
- mucosal allergy
- urticaria in the groin area - the skin becomes reddish and blisters appear on it, resembling a nettle burn.
If the treatment is chosen correctly, then these allergic manifestations will pass on their own and there is no need to stop Lomexin. However, we should not forget that if you follow the rules of prevention of thrush, treatment may not be necessary.
Composition, release form
The active substance of the vaginal cream is a derivative of imidazole - fenticonazole nitrate. The main component has antifungal, antibacterial action. Additional ingredients: purified water, disodium edetate, glycerin, fatty acids, macrogol ester, lanolin, propylene glycol, almond oil, cetyl alcohol.
The product is made in the form of a cream with a uniform consistency of white. Packed in aluminum tubes for 78 g. The drug has a light texture, approximately 5 g of the drug is used at a time. For the introduction of the cream inside there is a special applicator.
It has antifungal, antiseptic, anti-inflammatory action. Effective against yeast, gram-negative, gram-positive bacteria, the simplest microorganisms. It is actively used in gynecology in case of diseases caused by Candida fungi, yeast, and chlamydia.
After applying the drug, the active substance is absorbed by the tissues of the genital organs, the mucous membrane of the vagina. It acts locally, practically does not enter the general bloodstream, which reduces the likelihood of side effects. The therapeutic effect begins for 20 minutes. Lomexin destroys the cell membranes of pathogens, leads to death. The level of pathogenic microflora gradually decreases, the number of lactobacilli increases, which contributes to the restoration of the vaginal microflora. Unpleasant symptoms are eliminated, the inflammatory process stops.
The duration of therapy depends on the complexity of the disease. The cream is prescribed as an independent remedy for the treatment of gynecological diseases or in combination with other drugs.
Lomeksin cream is widely used for fungal diseases in gynecology, dermatology. Indications for use are:
- genital candidiasis,
- infections of the genital tract caused by yeast, fungi of the genus Candida, protozoa,
- vaginal trichomoniasis,
- skin lesion fungi.
In gynecology, it is advisable to use the drug in the presence of itching in the vagina, external genital organs, burning, cheesy discharge, problems with urination.
Is it possible to apply from thrush?
Candidiasis is one of the most common diseases in gynecology. Provocateurs are fungi of the genus Candida, with which fenticonazole nitrate successfully copes. Lomeksin cream can be used for thrush acute, chronic form.
With minor manifestations of candidiasis, the remedy is applied to the external genitalia several times a day. When thrush accompanied with cystitis, a significant violation of the microflora, abundant secretions should be introduced into the vagina with an applicator.
The duration of therapy depends on the complexity of the disease, an average of 10 days. To improve the effectiveness of the drug is recommended to follow a diet, improve immunity, give up bad habits. At the time of treatment should refrain from sexual activity, in parallel to treat a partner in order to avoid mutual infection in the future.
Lomexin is intended for external use, the external genitals are treated, or injected with the applicator into the vagina. The procedure should be done twice a day after prior washing. With minor manifestations of candidiasis, the drug is injected into the vagina once a day before bedtime.
The most comfortable posture is lying down or crouching slightly. After the introduction of the drug is recommended for 5-10 minutes to lie down so that the active ingredients have time to be distributed. In the first times of use, it is possible to increase the burning sensation, which is not a reason to stop therapy. This initial body reaction indicates the onset of action of the active component. Unpleasant sensations should disappear within 5 minutes.
When applied externally, the cream is applied with a thin layer with your fingers, after washing your hands with soap and water.
When using the applicator, perform the following actions:
- Remove the cap, substitute the applicator.
- Squeeze out 5 g of cream, disconnect the applicator.
- Enter into a vagina, squeeze out against the stop.
- Carefully remove the applicator, rinse with warm water.
Therapy is carried out until the complete disappearance of the painful symptoms, an average of 10 days. The specialist may extend the treatment for another week if necessary.
- At the time of therapy should stop sex life.
- In parallel, you need to conduct therapy of the sexual partner, even if he has no unpleasant symptoms.
- It is forbidden to drink alcohol, in order to avoid the appearance of side effects. Most often there is nausea, headache.
- You can not hold therapy for more than 20 days. If the condition does not improve within 5 days of active use, you should seek help from a specialist.
- For the period of menstruation stop using the cream, continue at the end of menstruation, if necessary.
If the instructions are followed, no side effects occur, the therapeutic effect occurs within a few days. Parallel use of other drugs to enhance the therapeutic effect in the form of tablets is permitted.
Treatment in men
In most cases, candidiasis in men is hidden. If a partner has a vaginal infection, thrush, a man should be treated, even in the absence of painful symptoms. Cream Lomeksin - an excellent tool for the prevention and treatment of the initial stage of thrush.
Be sure to use the drug in the presence of the following symptoms:
Be sure to use the drug in the presence of the following symptoms:
- redness of the head of the penis,
- cheesy discharge,
- pain during intercourse,
- violation of urination.
Men should apply a thin layer of cream twice a day for treatment, once before bedtime for the purpose of prevention. Refrain from intercourse should be at least a week, provided that the partner is also undergoing treatment.
The drug is well tolerated, does not cause side effects when used properly. Irritation, aggravation of unpleasant symptoms occurs in the presence of individual intolerance. Relapses occur when using the product longer than the specified period. Application within a month without interruption is dangerous violation of the microflora of the vagina, the development of thrush, inflammatory processes. Rarely, headache, nausea, vomiting. Unpleasant symptoms in most cases disappear on their own after stopping the use of the cream, does not require special treatment.
Pharmacy sales terms
The cream is actively implemented through a network of pharmacies, prescription. However, you can freely purchase Lomexin at an online pharmacy without a prescription. One of the most affordable tools for the price, the cost of a tube with a capacity of 78 g is about 22 rubles. Keep the drug should be away from sunlight. The shelf life is 3 years from the date of manufacture.
Analogs of Lomexin
The pharmacy has a wide range of antifungal agents for the treatment of gynecological diseases. The action is similar - the destruction of the cell membrane of pathological microorganisms.
- Ginesol. The active ingredient is miconazole. It has antibacterial action, antifungal, anti-inflammatory. The indication is vulvovaginal candidiasis, secondary infections in gynecology caused by the pathogenic microflora. Cream using an applicator is introduced into the vagina 1-2 times a day. In the first days, irritation of the mucous membranes, discomfort at the place of introduction of the applicator. It is contraindicated to use in case of individual intolerance, pregnancy in the first trimester, children under 12 years. It should be used carefully in diabetes, pregnancy, feeding.
Gynofort. Antifungal drug in the form of a cream. The active ingredient is butoconazole nitrate. The indications for use are inflammatory processes in the female genital organs, caused by the multiplication of pathogenic microflora. It is recommended to inject 5 g of the product using the applicator 1 time per day before bedtime. The cream is not used in pediatrics, is prohibited in the presence of allergy to active ingredients. During pregnancy, appointed under the strict supervision of a specialist.
- Candibene. Antifungal and antiseptic cream acts on the basis of clotrimazole. The tool destroys the pathogenic microflora, stops the inflammatory processes. The cream is actively used to treat fungal infections in gynecology, urology, and dermatology. The cream is inserted into the vagina with an applicator at bedtime. At one time, 5 g of the drug is administered. The course is 3 days, by decision of a specialist can be extended up to 2 weeks. Contraindicated use in the first months of pregnancy, children under 12 years old, with individual intolerance to the components.
The question of replacing one drug with another should be discussed with a specialist.
You can leave your comments and results of treatment of thrush with Lomeksin cream in the comments below, they will be useful to other users!
“Treated Lomeksin thrush with cream. My course lasted 10 days. Cadidosis appeared constantly after menstruation. The drug was recommended by a gynecologist. Found in the first pharmacy. At first, there was a burning sensation, itching intensified, but the next day the symptoms of thrush began to disappear. After a full course of therapy for 2 years, candidiasis after menstruation does not bother me. ”
“The cream did not meet my expectations. I experienced a terrible itch that did not stop for 2 hours. After application it became even worse. Perhaps it was an individual intolerance, but she really hoped for this remedy. ”
1. Briefly about pathology
The cause of vulvovaginal candidiasis (IHC, VVC) are fungi of the genus Candida. Most often they belong to the species C. albicans.
Candida infection of the vulva and vagina is usually accompanied by the following symptoms:
- 1 White, cheesy or creamy discharge from the genital tract.
- 2 Itching and burning in the vagina, the vulva area. These symptoms may be aggravated after hygiene procedures, use of intimate hygiene products, during sexual intercourse.
- 3 Violation of urination - pain, frequent urge.
- 4 Morbidity during intercourse - dyspareunia.
- 5 Edema and hyperemia of the vaginal mucosa, less vulva.
The course of vulvovaginal candidiasis can be acute (sporadic cases) and chronic recurrent (more than 4 episodes per year).
Uncomplicated thrush in women is usually characterized by mild or moderate severity of the disease.
In the case of a complicated form, the cause is C. non-albicans, this infection is characterized by frequent relapses and a severe course (most often against the background of diabetes mellitus, immunosuppression, and other associated diseases).
In treating thrush in women, an integrated approach, the elimination of risk factors and the normalization of lifestyle and nutrition are important.
2. Groups of antimycotics used to treat thrush
According to international recommendations, drug therapy is carried out for women who have complaints and symptoms of candidal infection. Candidacy does not need therapy. The exception is pregnant women, they are recommended antimycotics for any identification of candida (the risk of complications of pregnancy and the postpartum period, the risk of infection of the newborn).
To eliminate thrush in women, use 2 main groups of antifungal agents (polyenes and azoles - imidazoles, triazoles):
- 1 Polyenes (Natamycin, Nystatin (more often in combination preparations)).
- 2 Imidazoles (Clotrimazole, Miconazole, Econazole, Butoconazole).
- 3 Triazoles and their derivatives (Fluconazole, Voriconazole, Itraconazole).
According to the principles of evidence-based medicine, clinical guidelines, recommendations and treatment regimens are developed for such patients. Consider the main foreign recommendations and compare them with ours, Russian.
3. CDC (2015) Recommendations
In 2015, the Centers for Disease Control and Prevention (USA) updated the recommendations for the treatment of vaginal candidiasis.
According to these recommendations, uncomplicated infection of the vagina requires the appointment of a short course of antimycotics.
Preference is given to azoles (fluconazole, clotrimazole, miconazole), which in this case are more effective than nystatin. This approach allows to stop the 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 the recommendations of the CDC, 2015
Если симптомы кандидоза сохраняются после курса терапии или в течение последующих 2 месяцев развивается рецидив, то у пациентки выполняется забор материала для посева на питательную среду с целью уточнения доминирующего вида кандид и определения их чувствительности к известным антимикотикам.
Механизм развития и патогенез рецидивирующего вульвовагинального кандидоза изучен не полностью. Многие пациенты не имеют явных предрасполагающих факторов, которые могли бы приводить к хронизации инфекции.
In chronic thrush, Candida non-albicans (in about 10–20% of cases), which are insensitive to basic drugs, are more often detected.
When C. albicans recurs, therapy includes several courses of antimycotic drugs:
- 1 Initial course - a short course with the use of local or systemic drugs from the group of azoles. For the best clinical effect, some doctors suggest extending the use of local azoles to 7–14 days or administer fluconazole orally, orally according to the regimen - 1, 4, 7 days of therapy at a dosage of 100, 150 or 200 mg respectively.
- 2 Supporting course. For 6 months, fluconazole is taken once a week at a dose of 100-150 mg. If this is not possible, then local azoles are prescribed in discontinuous courses. This therapy is effective, but in 30-50% of women relapses occur after drug withdrawal.
For Candida non-albicans, the optimal treatment regimen has not been established. It is proposed to use local or systemic drugs from the group of azoles (except fluconazole), for 1-2 weeks. In case of relapse, boric acid can be used (600 mg vaginal gelatin capsules) for 14 days once a day. This scheme leads to recovery in 70% of cases.
In pregnant women, azoles can be used in the form of vaginal suppositories or vaginal cream. Taking medication inside is unacceptable.
6. Russian recommendations (2013)
The recommendations of Russian experts are slightly different from foreign ones. Their main differences:
- 1 Inclusion of basic thrush therapy of another drug from the polyene group, natamycin (Pimafucin).
- 2 Use of natamycin in chronic recurrent thrush and infection due to 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. Auxiliary 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 Correction of nutrition for thrush, the exclusion of products that promote the growth and reproduction of fungi. Undesirable products include sugar and sweet foods, and baked yeast pastries. Diet therapy of thrush is discussed in more detail in this section.
- 2 Vaginal candidiasis is often combined with intestinal dysbiosis. This confirms the need for an integrated approach in the treatment of vaginal candidiasis. The scheme can be supplemented by taking natural probiotics - fermented milk products containing lactobacilli and bifidobacteria.
- 3 Thrush against the background of pronounced vaginal dysbiosis, gardnerelleza requires the appointment of complex drugs, such as neo-penotran, polygynax, terginan. Their effect is to eliminate inflammation, affecting anaerobes, gardnerella and fungi.
- 4 We cannot recommend preparations for the restoration of the vaginal microflora (gynoflor, vaginorm, ecofemin) until a sufficient number of studies on their effectiveness have been performed.
- 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 We cannot recommend immunomodulators, dietary supplements, homeopathy due to the lack of evidence base. In our opinion, a healthy lifestyle, a balanced diet, physical activity fully replace these groups of drugs.
- 7 Methods of traditional medicine, herbal treatments are distracting and have a placebo effect. They should not be used on women.
8. The problem of resistance to antimycotic candidates
The problem of the resistance of Candida fungi to antimycotic agents is no less relevant than the resistance of bacteria to antibiotics. Resistance to drugs of the azoles group develops most frequently, low sensitivity to the azoles of C. non-albicans is of particular importance. The explanation lies in the mechanism of action of drugs in this group.
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.
Sustainability is acquired in several ways. C. albicans is characterized by the accumulation of the ERG11 gene mutation, which is associated with the coding of the ergosterol synthesis enzyme. It ceases to bind to the azoles, but forms bonds with the natural substrate lanosterol. The latter during the reaction turns into ergosterol.
Another mechanism is associated with the removal of drugs from the cell using ATP-dependent carriers.
Resistance to azoles - cross, that is, it develops to the drugs of the whole group. In this case, the use of polyenes is possible.
9. Evaluation of the effectiveness of treatment
The criteria for the effectiveness of treatment are the following indicators:
- 1 Full recovery, vagina sanitized: no clinical symptoms, signs of inflammation, laboratory tests (smear for flora, real-time PCR, culture of the culture medium) confirm the absence of the fungus.
- 2 Improvement: a decrease in the severity of symptoms of the disease, objective signs.
- 3 Relapse - the appearance of new symptoms of thrush, the detection of a fungus by smear microscopy 2-4 weeks after a course of therapy.
In the acute form, control is prescribed 14 days after the last dose of drugs.
10. Prevention of relapse
To prevent the recurrence of vaginal candidiasis, factors that create favorable conditions for the growth and reproduction of Candida fungi should be excluded.
- 1 Mycoses develop in a warm and humid environment. This is facilitated by wearing tight clothing made of synthetic, poorly breathing fabrics. It is better to choose cotton, comfortable underwear. Change of linen should be daily.
- 2 Daily sanitary pads retain moisture and heat, form an environment that promotes the growth of fungus. Frequent change of them allows to eliminate these disadvantages.
- 3 It is necessary to observe the balance in the use of different food groups, give preference to vegetables, fruits, cereal porridge, dairy products, lean meat. Sweet and flour limit to a minimum.
- 4 You can not use antibiotics without a doctor's prescription, you can not extend the course for a longer period than recommended by the doctor. Antibacterials can be combined with fluconazole (150 mg) in women with a history of vulvovaginal candidiasis.
- 5 Glucocorticoids with long-term use also contribute to the growth of fungal flora. You can not use them without a doctor's prescription.
- 6 Antifungal drugs can not be used without the advice of a doctor, as is the case with antibiotics, this leads to the development of resistance in Candida fungi.
- 7 CDC does not recommend treatment of the sexual partner in women with thrush.
- 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 of the genital and urinary systems.
The information presented in the article is intended to become familiar with the current trends in medicine and cannot replace the in-person consultation of a specialist. It can not be used for self!
Experience with lomexine patients with vulvovaginal candidiasis
L.S. Logutova, N.V. Zarochentseva, N.V. Dub, N.S. Menhikova
Moscow Regional Research Institute of Obstetrics and Gynecology
Key words: acute vulvovaginal candidiasis, treatment, lomexin.
Key words: acute vulvovaginal candidiasis, treatment, lomexine.
At present, in many countries of the world, including Russia, there has been an increase in vaginal infections, which firmly occupy a leading place in the structure of obstetric-gynecological morbidity. One of the most common reasons for women to see a doctor is damage to the mucous membrane of the vagina and external genital organs, caused by yeast-like fungi - vulvovaginal candidiasis (IHC) [3, 6, 10].
IHC is a disease of the mucous membrane of the vagina, caused by a fungal infection and often extending to the mucous membrane of the external genitalia, which can lead to the most diverse lesions, ranging from vulvitis to the development of urethritis, cystitis, bartholinitis, endocervicitis with subsequent complications in the form of candidosis endometres. the development of menstrual dysfunction .
The keen interest of European and American doctors to the study of fungal diseases is due to a significant increase in their frequency in recent years. This is due to a sharp increase in the number of risk factors for the development of mycoses against the background of the introduction of new medical science into practice, as well as environmental change. One of the main reasons for this is an increase in the number of immunodeficiencies on the background of environmental degradation, malnutrition, frequent stress, pharmacological boom with uncontrolled use of drugs: first of all, antibacterial drugs and hormonal contraceptives [5, 10].
By 25 years, more than half of modern women at least once diagnosed “vaginal candidiasis” [6, 8]. According to foreign studies [3, 12], 75% of women of reproductive age suffer at least one episode of vaginal candidiasis, and 50% - and repeated. In pregnant women, this disease occurs in 30–40% of cases, and may reach 45–50% before delivery [6, 12].
In America, over 100 million women and girls suffer from IHC. The frequency of vulvovaginal candidiasis in Russia over the past 10 years has increased almost 2 times and amounted to 30-45% in the structure of infectious lesions of the vulva and vagina . The carriage of yeast-like fungi on the mucous membrane of the vagina of non-pregnant women reaches 11–12.7% [7, 8].
The causative agents of candidiasis - yeast-like fungi of the genus Candida - comprise more than 180 species. These are conditionally pathogenic microorganisms widespread in the environment. As saprophytes, they inhabit the skin and mucous membranes of healthy people. Mushrooms of the genus Candida - blastospores, multiply by budding, are aerobes. In addition to C. albicans, other representatives of this genus are pathogenic for humans: C. tropicalis, C. pseudotropicalis, C. crusei, C. parapsilosis, etc. C. albicans is the most important in the occurrence of the disease, being its causative agent in 85–90%. When examining women at risk of developing sexually transmitted diseases, the most commonly isolated strains were C. albicans (89.3%), followed by C. glabrata (2.7%), C. parapsilosis (1.2%) and Saccaromyces cerevisiae ( 0.4%). Some authors have noted a tendency to increase the frequency of infections caused by other (non-albicans) Candida species.
With IHC, a clear correlation is determined between the degree of adhesion of the fungi to the vaginal epithelium and the symptoms of vulvovaginal candidiasis ; in its chronic recurrent course, it is not possible to identify any condition that clearly predisposes to infection.
Factors contributing to the development of IHC:
- physiological: pregnancy, menstruation,
- mechanical: intrauterine device, synthetic underwear, first sexual contact, traumatic damage to vaginal tissues,
- endocrine: diabetes, hypothyroidism,
- iatrogenic: antibiotics, immunosuppressants, hormones, chemotherapy, radiation therapy,
- immunodeficiencies: conditions associated with immunodeficiency,
- other: allergic diseases, hypovitaminosis, chronic diseases of the genitals, chronic diseases of the gastrointestinal tract.
Features of the course of volvovaginal candidiasis:
- high frequency,
- long flow
- frequent recurrence of the process,
- possibility of distribution to other organs and systems with the development of generalized forms,
- high resistance of pathogens to antimycotic drugs.
The trigger for the development of the disease is not a change in the properties of the fungus, but a decrease in the resistance of the host organism . In the development of candidiasis, the following stages are distinguished: attachment (adhesion) of fungi to the mucosal surface with its colonization, introduction (invasion) into the epithelium, overcoming the epithelial barrier of the mucous membrane, getting into the connective tissue of its own plate, overcoming tissue and cellular defense mechanisms, penetration into the vessels , hematogenous dissemination with lesions of various organs and systems. When IHC infection is often localized in the surface layers of the epithelium of the vagina. At this level, the infection can persist for a long time due to the emergence of dynamic equilibrium between fungi that cannot penetrate into the deeper layers of the mucous membrane, and the macroorganism that inhibits their aggression, but is not able to completely eliminate the pathogen. Violation of this balance leads to either exacerbation of the disease, or to remission or recovery .
Protective factors of the microorganism:
- the normal composition of the vaginal microflora,
- local antifungal and antimicrobial factors
- the immune system as a whole.
The main clinical forms of IHC:
- Candidate carrier (absence of clinical appearances in laboratory detection of a yeast-like fungus in small quantities),
- acute IHC (pronounced inflammatory changes of the mucous membrane, accompanied by abundant characteristic “curd-like” white hair, with a disease duration of not more than 2 months),
- chronic (recurrent) IHC (with a disease duration of more than 2 months, secondary elements in the form of infiltration and tissue atrophy prevail on the mucous membrane) is a form of complicated course of urogenital candidiasis, which is characterized by four or more episodes of proven infection per year,
- recurrent IHC is a special variant of the course of the chronic form of the disease, rather frequent (at least 4 times a year) occurrence, alternating with periods of remission,
- persistent IHC is a variant of chronic candidiasis (the symptoms of the disease persist permanently with varying degrees of severity, subsiding only after treatment).
According to the guidelines for the management of patients with pathological discharge from the vagina of the International Union for the Control of Sexually Transmitted Infections (IUSTI) [2, 11], depending on clinical manifestations, microbiological characteristics, immune factors of the body and treatment response can be divided into uncomplicated and complicated [2, 11].
Uncomplicated IHC (diagnosed with all criteria) include:
- sporadic or infrequent VVC,
- light or medium hard IHC,
- IHC, caused by C. albicans,
- IHC in patients with a normal immune response.
Complicated IHC (diagnosed with at least one criterion) is divided into:
- recurrent IHC,
- IHC severe
- candidiasis not caused by C. albicans,
- IHC in patients with a depressed immune response (for example, in cases of decompensated diabetes mellitus, treatment with glucocorticoids, pregnancy).
Approximately 10–20% of women have a complicated IHC, which requires an analysis of diagnostic and therapeutic aspects.
Diagnosis of vulvovaginal candidiasis includes:
- vaginal smear microscopy — budding cells, pseudomycelium, and yeast-like fungus spores (correct collection of material is important),
- native smear microscopy after treatment with 10% KOH solution,
- culture method (seeding vaginal contents on artificial nutrient media: the environment Sa-buro, rice agar),
- DNA diagnostics (PCR),
- serological diagnosis - determination of antibodies during systemic infection (titers more than 1: 160).
The criteria for diagnosing vulvovaginal candidiasis is an updated version of the recommendations issued by IUSTI in 2001 (level of evidence - III, degree B) .
These include the following:
- the absence of odor (in the KOH test) is an indirect sign, since candidiasis and bacterial vaginosis or trichomoniasis usually do not occur simultaneously, but this cannot serve as a reliable diagnostic criterion,
- the presence of spores or mycelium of yeast-like fungi in the analysis of a native smear of vaginal secretions (sensitivity 40–60%),
- the presence of spores or mycelium of yeast-like fungi during the staining of a smear of vaginal secretions Gram (sensitivity up to 65%),
- positive result of a culture study on Candida. If possible, it is necessary to distinguish the belonging of bacteria to the species C. albicans or to other species; when sowing directly on Saburo's medium, the results should be classified as weak, medium or intensive growth, since this correlates with specificity,
- Repeated culture of the same non-C. albicans species may indicate the presence of another Candida species (usually C. glabrata), possibly indicating a reduced sensitivity to antifungal agents.
In Russia, there is also an increase in vaginal infections, which occupy a leading place in the structure of obstetric and gynecological diseases, there is a tendency to an increase in the frequency of recurrences of IHC, which may be due to both insufficient etiotropic treatment and reduced sensitivity of yeast-like fungi to antimycotic drugs. Despite the development of the pharmacological industry and a huge selection of antimycotic drugs, the problem of IHC treatment does not lose its relevance.
Лекарственные средства, применяемые для лечения ВВК должны отвечать следующим требованиям :
- иметь широкий спектр действия,
- обладать избирательным противогрибковым (фунгицидным или фунгистатическим) действием,
- иметь минимальную частоту выработки резистентности у возбудителей,
- быть хорошо совместимыми с препаратами других фармакологических групп,
- быть нетоксичными даже в случае длительного применения,
- хорошо всасываться из желудочно-кишечного тракта,
- длительно действовать,
- be affordable.
In recent years, 4 groups of antimycotic drugs have been used in the treatment of genital candidiasis:
- polyene series drugs: nystatin, levorin, natamycin,
- imidazole series drugs: ketoconazal, clotrimazole, miconazole, sertaconazole,
- triazol preparations: fluconazole, itraconazole,
- Others: griseofulvin, flucytosine, nitrofungin, dekamin, iodine preparations, etc.
According to V.N. Prilepskaya , treatment of uncomplicated vulvovaginal candidiasis should be carried out as follows (level of evidence - II, grade A).
In vaginal candidiasis, intravaginal and oral therapy are equally effective. Treatment with azole antimycotics, regardless of how they are used (orally or topically), allows you to alleviate the symptoms and get negative bacteriological results at the end of therapy in 80-90% of patients. During pregnancy, only topical agents should be used. In general, standard single-dose treatment is as effective as long-term courses of therapy.
Oral medications include:
- fluconazole 150 mg once,
- Itraconazole 200 mg 2 times a day for one day.
Intravaginal treatment includes:
- clotrimazole, vaginal tablets, 500 mg once daily or 200 mg once daily for 3 days,
- miconazole, vaginal suppositories, 100 mg daily for 7 days,
- econazole, vaginal suppositories, 150 mg for 3 days.
There are a number of other oral and intravaginal medicines. It has not been proven that the additional use of local drugs for the treatment of vulvitis improves the results of intravaginal treatment to any extent, however, some patients prefer to use them. In cases where significant discomfort is caused by itching, rapid relief of the condition can be achieved with hydrocortisone for topical use. Emollients can also have a positive effect. When using oral antifungal drugs, it is wise to topically apply a moisturizer: it has a lower cost and less likely to cause irritation. It should be noted that creams and suppositories can be made on an oil basis and break the strength of latex condoms and diaphragms. For more information, patients and medical specialists can find in the instructions for use of condoms.
Women who have been diagnosed with IHC are not always able to make a diagnosis themselves in the future. In this regard, any woman with persistence of symptoms after the use of non-prescription drugs or recurrence of symptoms observed for 2 months after treatment should undergo an outpatient examination. OTC drugs are often used unnecessarily or incorrectly, which can lead to a delay in the elimination of other causes of vulvovaginitis and adverse clinical outcomes.
Given the wide range of Candida strains that are causative agents of the disease, as well as their resistance to a significant amount of antimycotic drugs, the use of triazole derivatives is promising.
Lomexin (fenticonazole) is a broad-spectrum antifungal drug for topical use in gynecology, it has a local fungicidal and fungistatic effect. It has antibacterial and anti-inflammatory effect. Inhibits the synthesis of ergosterol, which regulates the permeability of the cell membrane of fungi. Active against yeast fungi of the genus Candida spp. (including Candida albicans) and gram-positive bacteria (Staphylococcus aureus, Streptococcus spp.), as well as against Trichomonas vaginalis. Unlike other known azole compounds, fenticonazole inhibits the biosynthesis of Candida spp.
Lomexin is an original antifungal drug with a unique dual mechanism of action:
- it is an innovative preparation for local treatment of vulvovaginal candidiasis with a wide spectrum of action,
- has a unique dual mechanism of antifungal action, a short course of two-step therapy,
- has a long anti-relapse protection,
- long exposure in the outbreak.
The increased interest in this drug is due to the fact that it meets all the criteria that determine the ideal drug for the treatment of surface fungal infections and has:
- wide spectrum of action,
- efficacy at low concentrations,
- more pronounced fungicidal than fungistatic effect,
- efficacy in topical administration
- high affinity for the epithelial cells of the vulva and vagina,
- well tolerated
- lack of sensitizing effects,
- action that does not provoke the development of resistance,
- dosing regimen to increase compliance,
- prolonged protective effect - the drug penetrates the mucous membrane, locally creating a high concentration there, which lasts up to 72 hours, which makes it possible to use it once.
The purpose of the study is to evaluate the effectiveness of the treatment of patients with acute vaginal candidiasis using the Lomeksin vaginal cream.
Material and methods
Under the supervision there were 30 women of reproductive age (from 21 to 52 years) who applied for acute vulvovaginal candidiasis.
The treatment consisted of carrying out applications of 2% vaginal cream lomexin for 7 days.
Criteria for inclusion in the study:
- the presence of a confirmed diagnosis of IHC according to clinical and laboratory methods in patients who have confirmed their readiness to follow the doctor’s instructions and who have given free written consent,
- use of an adequate method of contraception by patients.
Exclusion criteria were:
- acute or chronic (acute) disease of the pelvic organs,
- STIs (gonorrhea, trichomoniasis, chlamydia),
- the patient has a mental illness that does not allow an assessment of the effectiveness of therapy,
- women during pregnancy and lactation,
- individual intolerance to the components of the drug,
- a history of drug dependence or persistent alcohol use.
Results and discussion
A history of 10 (33.3%) patients had diseases predisposing to the development of candidiasis: diabetes mellitus - in 2 (6.6%), thyroid disease - in 3 (10%), bronchial asthma - in 1 (3, 3%), gastrointestinal diseases - in 6 (20%), obesity - in all 10 (33.3%). The provocative factors for the development of IHC were the wearing of synthetic underwear in 13 (43.3%) patients now and in 18 (60%) patients in the history of antibiotic therapy for urogenital infection.
Disruptions of the menstrual cycle were observed in 28 (93.3%) patients, among them polycystic ovary syndrome - in 8 (28.5%), mixed-type hyperandrogeny - in 9 (32.1%), hyperprolactinemia - in 2 (6.7 %), metabolic syndrome - in 10 (35.7%), perimenopausal disorders - in 7 (23.3%), the usual miscarriage in pregnancy - in 5 (16.6%), the use of combined oral contraceptives (COCs) in the previous year - in 12 (40%), use of IUD - in 4 (13.3%).
In connection with the identified hormonal disorders, all the examined patients used various hormonal preparations:
- KOK - 12 (40.0%) patients,
- utrozhestan intravaginally used 4 (13.3%) patients,
- Dufaston - 2 (6.7%),
- Metipred - 5 (16.7%),
- hormone replacement therapy - 7 (23.3%).
It is known that estrogens can increase the content of glycogen in epithelial cells, increase the avidity of the vaginal epithelium towards fungi, and have a direct stimulating effect on the growth of fungi. Therefore, hormonal disorders in the hypothalamic-pituitary-ovarian system (menstrual disorders, neuro-endocrine syndromes, hormone-dependent diseases - myoma, endometriosis), as well as somatic pathology are risk factors for the development of acute IHC.
The main complaints of patients:
- vaginal discharge, white, thick or flaky, cheesy, membranous - in 30 (100%) patients,
- burning and itching of the vulva and vagina - in 25 (83.3%) patients,
- 6 (20%) patients reported burning and itching of the perianal region,
- dysuric phenomena disturbed 4 (13.3%),
- dyspareunia - 3 (10%),
- hyperemia, swelling of the vulva, vaginal mucosa were observed in almost all patients.
The main complaints of patients (heavy discharge, burning and itching in the vagina, pain during intercourse, pain during urination) and clinical symptoms of acute IHC (hyperemia, swelling of the mucous membrane, the presence of characteristic whiter) were evaluated on a 3-point scale: 0 points meant no symptoms, 1 point - a mild degree of expression, 2 points - moderate manifestations and 3 points - a severe degree of the disease. 12 (40%) patients complained of moderate whites, accompanied by itching, which were assessed with 2 points, 18 (60%) patients had pronounced symptoms of the disease, corresponding to 3 points. This did not always correspond to the clinical manifestations of IHC. During a gynecological examination, inflammatory changes in the mucous membrane of the vagina and vaginal part of the cervix moderate (2 points) were observed in 14 (46.7%) patients, severe (3 points) - in 16 (53.3%) cases. It should be noted that in the present observation there were no patients with a subjective and clinical assessment of the symptoms of candidal vaginitis corresponding to 0 and 1 points, which is more characteristic of a candidate host.
Microscopic examination of vaginal smears in all women revealed yeast-like fungi of the genus Candida, culture analysis revealed their presence in an amount of 5 x 10 3 - 5 x 10 7> 7 CFU / ml.
Against the background of the treatment, the overwhelming majority of patients (29–96.7%) noted the disappearance of the symptoms of the disease already on the 1st day after taking the drug. Mild clinical manifestations of candidal vaginitis 7 days after treatment were determined only in 1 (6.6%) patient. Allergic reactions when using candles was not a single woman.
After treatment 10 days after microscopic and cultural studies of the vaginal contents, yeast-like fungi were found in insignificant amounts only in 1 (3.3%) patient.
Thus, 7–10 days after treatment, the clinical efficacy in patients was 96.7%, mycological eradication - 96.7%. Therapeutic efficacy at 1 and 3 months was 96.7%.
Thus, IHC therapy should be comprehensive, phased, include not only etiotropic treatment, but also the elimination of predisposing factors and the treatment of associated diseases. The introduction of modern highly effective antifungal drugs such as lomexin (fenticonazole), into clinical practice allows to increase the effectiveness of treatment of patients with acute IHC and reduce the number of relapses of the disease.
1. Lomexin is highly effective in treating patients with acute vulvovaginal candidiasis, which has developed against the background of various hormonal disorders.
2. The high affinity of lomexin in the form of a cream for the epithelial cells of the vulva and vagina provides patients with good tolerability and a long lasting protective effect.
Cream Lomeksin - a great assistant in the treatment of thrush! Cream Lomeksin application, price, instructions + complex treatment, which helped me to get rid of thrush for a long time
Cream Lomeksin became my real savior. Thanks to him, I have not been bothered by the thrush for over a year!
During the reception of capsules for the restoration of microflora, I had a side effect in the form of thrush. I immediately ran to my doctor and she processed everything, processed Lomeksin cream there, and prescribed further treatment. Itching significantly decreased already in the near future.
The doctor also said that it is worth buying Lomexin cream for my partner, for prevention. Also, they will be able to use me further if I feel the approach of thrush. I followed her advice.
- Lomeksin cream costs around 500 rubles. (+/- 50 rubles.)
- I also bought Lomeksin and Diflucan vaginal plugs.
The composition of cream Lomeksin:
There was no dispenser in my cream box! Although it is indicated that it should be.
Indications and instructions for use:
The partner used the cream according to the instructions 7 days 1 time, for the night. No side effects were noticed.
I also used this cream several times, as I felt that a thrush could start soon. Included with the cream there is no applicator for putting the cream inside, so I used a regular disposable syringe without a needle. But the cream can be entered using a finger.
The cream is odorless, does not stain the linen, does not leave stains. It comes out in small portions throughout the day.
I also started using Vagisil gel for intimate hygiene - and the thrush hasn't bothered me for more than a year! All this is the result of Lomexin treatment, both candles and cream., The use of the drug with fluconazole. Plus, timely prevention with a cream.
My other reviews on preparations for thrush:
The composition and principle of operation
The main substance, which is part of Lomexin, is fenticonazole nitrate. Available in the form of vaginal capsules and cream. In addition to candidiasis (thrush), the drug is successfully used to treat vulvovaginitis, colpitis, and infections caused by microbial and fungal pathogens.
The effectiveness of the tool lies in its action; it breaks the cell membrane of the fungal pathogen, thereby destroying it. The drug does not allow the fungi to gain a foothold on the vaginal mucosa, creating the conditions for its removal. Lomexin has excellent antibacterial and anti-inflammatory properties. Reviews of this drug are mostly positive, because at the initial stage of the disease, one application is sufficient, although it is expensive.
Capsules release 600 mg or 1000 mg, as additional substances they contain paraffin, lecithin and petrolatum. The cream is used for both internal and external use. In addition to the main substance in its composition has:
- almond oil,
- propylene glycol,
The cream can be used for insertion into the vagina or externally for partners who need to be treated at the same time as a woman in order to prevent re-infection.
Store the tool should be in a dark, cool place, tightly closed.
How to use the drug
Candles (capsules) of Lomexin are gently inserted deep into the vagina, it is more convenient to carry out the procedure while lying on your back, and you should bend your legs at the knees. Tablets (capsules) have an ovoid, elongated shape, so it is easy to inject them. Conduct a single application, the dosage of which must be prescribed by a doctor. In some cases, it is recommended to re-use the drug after 3 days. The procedure is best carried out before bedtime, so that overnight the medicine will fully work. It is desirable that a woman did not get up until the morning, otherwise the medicine from the vagina will flow out.
The cream can be inserted into the vagina using the included applicator. The drug is administered once or twice a day. The course of treatment can last up to 6 days, depending on the severity of the disease. After each use, the applicator should be washed with warm water using soap and dried. A man applies the cream on clean dry genitals, on the foreskin and glans penis, up to 2 times a day. Repeated treatment can be carried out in 10 days.
Despite the positive qualities, Lomeksin has some contraindications for use:
- It can not be used to treat thrush women during pregnancy and breastfeeding.
- It is not recommended to use the drug and those who have individual sensitivity to its components.
- It is undesirable to use this tool and children up to 12 years of age.
- You can not use the drug during the menstrual cycle, the treatment is carried out after its completion.
If its use causes discomfort to the patient in the form of irritation or burning, it should be discontinued and consult a doctor.
It is advisable at the time of treatment to stop sex or use protection. But it is worth remembering that the fatty components may damage the latex contraceptive (condom or diaphragm), so it is better to use another way. Using the drug Lomeksin from thrush on the prescription of a doctor and following all his recommendations, you can quickly get rid of the disease and prevent its recurrence.