Vaginal yeast infections can be treated with antifungal medicines that are inserted directly into the vagina as tablets, creams, ointments or suppositories. These medications include butoconazole (Femstat), clotrimazole (Clotrimaderm, Canesten), miconazole (Monistat, Monazole, Micozole), nystatin (several brand names), tioconazole (GyneCure) and terconazole (Terazole). A single dose of oral fluconazole (Diflucan Oral) also may be used, although this treatment is not recommended during pregnancy. Treatment of sex partners is not usually necessary, since most vaginal yeast infections are not transmitted sexually. However, if a male sex partner shows symptoms of Candida balanitis (redness, irritation and/or itching at the tip of the penis), he may need to be treated with an antifungal cream or ointment.
Although many medications used to treat vaginal yeast infections are now available without a prescription, you should use these medications only for treating repeat infections, not for your first episode. Any woman who experiences symptoms of a vaginal infection for the first time should visit a doctor. This is important to be sure that the vaginal discharge and discomfort is caused by yeast and not sexually transmitted infections such as gonorrhea, chlamydia or trichomoniasis.
About 5% of women with vaginal yeast infections develop recurrent vulvovaginal candidiasis (RVVC), which is defined as 4 or more vaginal yeast infections in a 1-year period. Although RVVC is more common in women who have diabetes or weakened immune systems, most women with RVVC have no underlying medical illness that would predispose them to recurrent Candida infections. Medical experts still are trying to determine the most effective way to treat RVVC. Currently, most doctors treat this problem with 2 weeks of oral medication, followed by up to 6 months of a lower maintenance dose.
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