Sinke asked
Good day. I have been having a yeast infection problem. It comes with different symptoms every time. But this time it comes with an odor and I cant seem to get rid of it. What do you think is the best product to use to get rid of this??
Answer
If you are having recurrent vaginal yeast infections, also known as vaginal candidiasis, you should make an appointment with your doctor so you can be properly evaluated. While initial treatment of vaginal yeast infections generally include over the counter, topical "azole" medications, such as Monistat (miconazole, tioconazole), complicated cases may require prescription drugs such as Diflucan (fluconazole).
All of the over the counter options for treating vaginal yeast infections have similar efficacy. Therefore, if you having recurrent infections, you probably need a prescription systemic anti-fungal. Recurrent vaginal yeast infections are often classified as "complicated vaginal candidiasis", which need longer treatment durations.
Recurrent Vaginal Yeast Infection Treatment
Guidelines vary slightly in regard to the recommended treatment, but one guidelines suggests:
- For women with severe and recurrent symptoms, start with Diflucan (fluconazole) 150 mg every 72 hours for 2 or 3 doses.
- If you have greater than or equal to 4 infections per year, use fluconazole or a topical "azole", like miconazole, for 10 to 14 days and take fluconazole weekly for 6 months.
If you are pregnant, fluconazole is generally recommended to be avoided. Other drug options, like amphotericin B, nystatin or clotrimazole vaginal suppositories are preferred. Alternatively, long term use of a topical anti-fungal (such as miconazole) can be used.
There is also a chance your vaginal yeast infections are not being caused by C.albicans, which is the most common pathogen responsible. Your doctor can determine if an alternate pathogen is causing the problem (e.g. C.krusei and C. glabrata), many of which do not respond to fluconazole. Options to treat non-albicans infections include:
- Boric acid 600 mg vaginally for 14 days
- Nystatin vaginal suppository 100,000 units daily for 14 days
Summary
- If you have recurrent yeast infections, see your doctor.
- When topical over the counter anti-fungal medications don't work (e.g. Monistat), there are a variety of prescription options available to you which your doctor can appropriately prescribe.
