Candida albicans is responsible for most vaginal yeast infections. Considered part of the normal vaginal flora, overgrowth of Candida can result in what we call vulvovaginitis, aka a “yeast infection.” Vaginal itching, burning and soreness along with redness are the classic symptoms, and if discharge is present it is classically white, thick and clumpy with little odor.
You may start to manage these symptoms with over the counter creams, but you should place a call to your doctor as we may have better prescription options. Uncomplicated yeast infections usually respond to treatment within a couple of days so if your symptoms are getting worse, call for an appointment.
How can I treat a yeast infection?
- Over-the-counter creams. A variety of topical preparations are available over-the-counter and come in single-dose, and 3- and 7-day regimens. Monistat and Gyne-Lotrimin both come in 3- and 7-day preparations and both work well.
- Creams that require a prescription. Two topical yeast medications require a prescription: Gynazole-1 cream is used as a single dose, one time and you’re done. It’s expensive. Also available by prescription is terconazole (Terazol and Zazole are the brand names) which comes in 3- and 7-day regimens.
- The yeast infection pill. The treatment of choice is a single 150 mg oral fluconazole (Diflucan). Most women consider the pill more convenient than creams applied intravaginally. A cool fact is that a single 150 mg dose of fluconazole maintains therapeutic concentrations in vaginal secretions for at least 72 hours after you take it.
- Pill or cream? In studies, fluconazole and the creams both work more than 90 percent of the time. Again, patients prefer oral treatment over creams.
- Upside of the creams? They are available over the counter and have fewer side effects whereas the fluconazole single dose pill may cause upset stomach, headache and rash.
- Another downside of the anti-fungal pill? The fluconazole single dose pill may take a day or two longer than topical therapy to relieve symptoms.
- Upsides of fluconazole? The generic fluconazole (brand name Diflucan) as a single dose is less expensive than over-the-counter topical antifungals. Also, resistance to fluconazole is not common.