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Hi Dr. Jen. I subscribed to you because you’ve helped me understand vaginal health well. I suffer from recurrent vulvovaginal candida as a 21 year old woman with no other health conditions. It started a year ago after an episode of BV and getting a copper IUD (that I got removed immediately after). I do all the right things: cotton underwear, avoid douching/fragrance, only wash with water, etc… I’ve already undergone long-term therapy this year, and I am about to again because the infection returned. Is there any advice you can offer me, please? The gynecologists in my area are not super helpful. Please and thank you.

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The first this is what does the culture show? If you have candida albicans on culture and it is sensitive to fluconazole long term oral suppressive therapy is the treatment. Some women have to stay on it longer term. If you haven't had a culture and sensitivity testing (meaning the lab checks what medications can actually work) then you need that. I address a lot of this in The Vagina Bible so you may find more information for your particular situation there.

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You should see a vulvovaginal specialist, or follow @jillkrapf on instagram. I had the same issue that started at 21 with a mirena IUD but was good for a little over a year after 6 months longterm therapy with fluconazole and also had my mirena taken out and switched to OCP. I had to really advocate for myself with doctors; I did just have my first YI last month since being clear for over a year, but hopefully it will not return.

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