Could the increase in vaginal candidiasis be a side effect of my body adjusting to Inosicare (inosine pranobex) and testosterone therapy?

Vaginal Yeast Infection After Starting Inosicare and Testosterone Therapy

The increase in vaginal yeast (candidiasis) you're experiencing is likely related to the testosterone therapy you've started, as hormonal changes can alter vaginal flora and create conditions favorable for yeast overgrowth. 1, 2

Relationship Between Hormones and Vaginal Yeast

Testosterone therapy can influence your vaginal environment in several ways:

• Testosterone can be converted to estrogen in the body, and estrogen is known to promote conditions favorable for Candida growth 2
• Hormonal fluctuations can alter the vaginal pH and microbiome balance 1
• Research shows that reproductive hormones, particularly estrogen, can reduce the ability of vaginal epithelial cells to inhibit Candida growth 2

Inosicare (inosine pranobex) is primarily an immunomodulator used for viral infections 3, and while it's less likely to directly cause yeast infections, any medication that affects immune function could potentially influence susceptibility to opportunistic infections like candidiasis.

Management Recommendations

Immediate Treatment Options:

For uncomplicated vaginal candidiasis (which represents about 90% of cases):

• Use a topical azole medication such as:

  • Clotrimazole 1% cream (5g intravaginally for 7-14 days)
  • Miconazole 2% cream (5g intravaginally for 7 days)
  • Butoconazole 2% cream (5g intravaginally for 3 days) 1, 4

• Alternatively, a single oral dose of fluconazole 150mg is effective for uncomplicated cases 1

Monitoring and Follow-up:

• If symptoms resolve within 7 days, no follow-up is necessary 1
• If symptoms persist or recur within 2 months, seek medical evaluation 1

Special Considerations

If This Becomes Recurrent:

If you experience ≥3 episodes in 12 months (defined as recurrent vulvovaginal candidiasis or RVVC) 4:

1. Initial control: 14-day course of topical azole or oral fluconazole
2. Maintenance therapy: Fluconazole 150mg weekly for 6 months 1, 4

Important Cautions:

• Oil-based creams and suppositories may weaken latex condoms and diaphragms 1
• Self-diagnosis of yeast infections is often inaccurate; if symptoms persist despite treatment, seek professional evaluation 4
• The interaction between testosterone therapy and vaginal microflora is complex and may require ongoing management 2, 5

Prevention Strategies

While continuing testosterone therapy:

• Wear breathable cotton underwear
• Avoid douching and scented hygiene products
• Consider probiotics to support healthy vaginal flora
• Monitor for recurrence as your body adjusts to hormone therapy

This initial yeast infection may be transient as your body adjusts to the hormonal changes from testosterone therapy. However, if symptoms persist or recur frequently, you may need to discuss with your healthcare provider about adjusting your hormone dosage or implementing a prophylactic antifungal regimen.