Vaginal infections are usually treated with medication. The choice of vaginal or oral medication to treat an infection is based on:
* The effectiveness of the medications.
* Your preference.
* Your response to previous treatment(s).
* Whether you have recurring infections.
* The type of yeast causing the infection.
* The side effects from treatment.
* Whether you have underlying conditions, such as diabetes, or are pregnant.
Nonprescription vaginal medications
Creams or suppositories inserted into the vagina are the treatment of choice for occasional yeast infections. They may also be used to prevent recurring infections. Nonprescription vaginal medications can be tried if you have had a previous vaginal yeast infection and are certain your present symptoms are the same as during the previous infection.
The risk of self-treatment is that your symptoms may be caused by another vaginal infection, such as a sexually transmitted disease (STD), that requires different treatment. If you may have been exposed to an STD, it is best to discuss your symptoms with your health professional before using a nonprescription medication. Your health professional may recommend testing for STDs if you have risk factors for these diseases.
Vaginal medications are recommended for women with impaired immune systems because a single short-term dose of oral medication does not cure their yeast infections. Women with HIV who have a vaginal yeast infection should follow the same treatment regimens as women without HIV.
Boric acid in gelatin capsules inserted into the vagina has been used to treat recurrent yeast infections not caused by Candida albicans that have not responded to other medications.
Prescription oral medications
Medications taken orally are used to treat recurring vaginal yeast infections that have not responded to vaginal medications. A single oral dose of fluconazole is being used more often now for first-time and recurrent yeast infections.
Yeast infections during pregnancy
Vaginal yeast infections may occur during pregnancy, likely caused by the high hormone levels. If you are pregnant, don't assume you have a yeast infection until it is diagnosed, and don't use nonprescription medications without discussing their symptoms with your health professional.
Other treatments
Other methods for treating vaginal yeast infections may be considered when medication treatment has failed.
* Douching. Studies on douching with acidic solutions (such as vinegar) or yogurt that contains live lactobacillus culture show that this treatment may have some benefit in relieving symptoms. Douching may be tried first to treat mild infections. However, douching can alter the balance of organisms in the vagina and irritate the cervix, which may increase your risk of pelvic inflammatory disease (PID).
o A yogurt douche can be made by placing 6 Tbsp (88.72 mL) of plain nonpasteurized yogurt containing live lactobacillus culture in a small douche bag with warm water. Douching can be repeated 2 times daily for 3 to 4 days.
* Gentian violet. Application of gentian violet to the vaginal walls to decrease the growth of yeast cells is rarely used now and was primarily used for recurring infections.
Treating sexual partners
A vaginal yeast infection is not a sexually transmitted disease (STD). Health professionals disagree on treating sexual partners.
* There is little evidence that treating sexual partners prevents reinfection.
* Most sexual partners are not treated unless that person has symptoms or is suspected of being a carrier of yeast. Men at high risk of being yeast carriers include those who have diabetes or an impaired immune system or who are not circumcised.
What to Think About
A health professional should diagnose your first vaginal yeast infection. Vaginal infections cannot be diagnosed just by talking with your health professional. A medical history and physical exam are needed.
It is important to complete the entire recommended treatment to cure a yeast infection.
If yeast infections recur, your health professional may evaluate you for other conditions that may be causing your infections. Treatment options other than medication may be considered. If you have been using a nonprescription medication for your vaginal symptoms, be sure to tell your health professional. This information could affect what treatment is recommended.
A Pap test is not a reliable test for vaginal yeast infections. However, some vaginal infections may be found during a routine Pap test and appropriate treatment recommended.
