From the Guidelines
Vulvovaginal candidiasis (VVC) can be effectively treated with over-the-counter antifungal medications like miconazole (Monistat) or clotrimazole (Gyne-Lotrimin) applied as vaginal creams, suppositories, or tablets for 1-7 days depending on the formulation strength, as recommended by the 2021 Centers for Disease Control and Prevention guidelines 1.
Causes of VVC
The causes of VVC include:
- Overgrowth of Candida fungus, normally present in the vagina, due to factors like antibiotic use, pregnancy, diabetes, or compromised immunity 1
- Imbalance of the vaginal microbiome
- Hormonal changes
Treatment of VVC
The treatment of VVC depends on the severity and frequency of the infection.
- For mild to moderate infections, a 3-day treatment is typically sufficient, while more severe cases may require the full 7-day regimen 1
- Oral fluconazole (Diflucan) 150mg as a single dose is also effective and available by prescription 1
- For recurring VVC, maintenance therapy with fluconazole 150 mg weekly for 6 months is recommended 1
Prevention of VVC
Preventive measures include:
- Wearing cotton underwear
- Avoiding prolonged wet clothing
- Maintaining good hygiene without using scented products
- Avoiding douching and scented hygiene products
- Avoiding tight-fitting clothing that can worsen symptoms
Important Considerations
- Symptoms should improve within 2-3 days, but complete the full course of medication to prevent recurrence
- If symptoms persist after treatment, recur frequently, or if you're pregnant, see a healthcare provider for proper diagnosis and treatment
- VVC can occur concomitantly with other sexually transmitted diseases, and treatment of all pathogens present is warranted 1
From the FDA Drug Label
A vaginal yeast infection is a common condition caused by an overgrowth of yeast (Candida) that may normally live in the vagina. Women who are pregnant or diabetic, taking antibiotics, birth control pills or steroids, or who have a weakened immune system are more likely to get repeated yeast infections that may not clear up easily with proper treatment. Some medical conditions can weaken the body's normal ability to fight infection One of the most serious of these conditions is infection with the human immunodeficiency virus (HIV - the virus that causes AIDS). The causes of repeated yeast infections include:
- hormonal changes occurring a few days before the monthly period
- use of antibiotics
- use of some birth control pills
- pregnancy
- diabetes
- clothing – wearing tight layers or moist clothing in the genital area
- weakened immune system – some drugs (such as chemotherapy or steroids) and medical conditions can weaken the body’s normal ability to fight infection.
Treatment for vaginal yeast infections includes antifungal medications such as fluconazole or miconazole. To lower your chances of getting another yeast infection:
- Try to keep the genital area cool and dry
- Wear cotton underwear and loose-fitting clothes
- Change out of damp clothes or a wet bathing suit as soon as possible
- Talk with your doctor about any drugs you are now taking
The causes of vulvovaginal candidiasis (vaginal yeast infection) include:
- Hormonal changes
- Antibiotic use
- Birth control pills
- Pregnancy
- Diabetes
- Tight or moist clothing
- Weakened immune system The treatments for vulvovaginal candidiasis (vaginal yeast infection) include:
- Antifungal medications such as fluconazole or miconazole To prevent repeated vaginal yeast infections, women can try to keep the genital area cool and dry, wear cotton underwear and loose-fitting clothes, and talk with their doctor about any drugs they are taking 2.
From the Research
Causes of Vulvovaginal Candidiasis
- The incidence of fungal infections is growing, with 45% of all vaginal infections caused by Candida albicans or other Candida species 3
- It is strongly believed that fungal infection is not sexually transmitted disease, but rather the route of transmission is oral and it is estrogen-dependent 3
- 20-55% of women have asymptomatic vaginal colonization with Candida species, and 7 out of 10 women suffer from yeast infection at least once in a lifetime 3
Treatments of Vulvovaginal Candidiasis
- Local treatment is the first line of choice in cases of acute vaginal yeast infection, with an 84-90% success rate 3
- Antifungal agents such as fluconazole, itraconazole, and clotrimazole are used to treat vaginal candidiasis 4, 5, 3, 6
- A single oral 150-mg dose of fluconazole has been shown to be effective in treating vulvovaginal candidiasis, with a cure rate of 81.6% and an eradication rate of 85.9% 4, 7
- Treatment-related side effects are generally few and minor, with the most common being diarrhea and nausea 4, 7
- For recurrent vulvovaginal candidosis, a long-term prophylactic maintenance regimen with antifungals may be necessary, and oral fluconazole is often recommended as the first-line treatment 5
Comparison of Treatment Options
- A study comparing single-dose oral fluconazole with 3-day intravaginal clotrimazole found that fluconazole was more effective in the long term and relieved symptoms more rapidly 4
- Another study comparing oral itraconazole, oral fluconazole, and intravaginal clotrimazole found that oral itraconazole and fluconazole were effective and had few side effects 6
- A phase 3 study in Japan found that a single oral 150 mg dose of fluconazole was effective and well-tolerated in Japanese subjects with vulvovaginal candidiasis 7