From the Guidelines
To prevent vulvovaginal candidiasis, women with recurrent infections (4 or more per year) should consider taking weekly fluconazole 150 mg for 6 months, as recommended by the Infectious Diseases Society of America 1. This approach is supported by high-quality evidence and is the most effective strategy for preventing recurrent vulvovaginal candidiasis. Some key points to consider in preventing vulvovaginal candidiasis include:
- Maintaining good genital hygiene by keeping the area clean and dry
- Wearing breathable cotton underwear
- Avoiding douching, scented feminine products, and tight-fitting clothing that can create a warm, moist environment favorable for yeast growth
- Considering probiotics containing Lactobacillus species after antibiotics to help restore normal vaginal bacterial balance
- Maintaining good blood sugar control for diabetic women, as elevated glucose levels can promote yeast overgrowth
- Urinating and gently washing the genital area after intercourse for those who experience infections after sexual activity
- Avoiding unnecessary antibiotic use when possible, as antibiotics kill beneficial bacteria that normally keep yeast in check.
According to the most recent and highest quality study, the recommended regimen for preventing recurrent vulvovaginal candidiasis is weekly fluconazole 150 mg for 6 months 1. This regimen has been shown to achieve control of symptoms in >90% of patients and is the most convenient and well-tolerated option. Other options, such as clotrimazole vaginal suppositories (500 mg weekly), may also be considered, but fluconazole is the preferred choice due to its high efficacy and safety profile.
It's worth noting that the diagnosis of vulvovaginal candidiasis can be made clinically, but it's essential to confirm the diagnosis with a wet-mount preparation or culture to rule out other causes of symptoms 1. Additionally, treatment of vulvovaginal candidiasis should not differ based on HIV infection status, and identical response rates are anticipated for HIV-positive and HIV-negative women 1.
In terms of specific treatments, the Centers for Disease Control and Prevention recommend various intravaginal and oral agents, including fluconazole, clotrimazole, and miconazole, for the treatment of vulvovaginal candidiasis 1. However, the choice of treatment should be based on the severity of symptoms, the presence of underlying medical conditions, and the patient's preferences.
Overall, preventing vulvovaginal candidiasis requires a comprehensive approach that includes maintaining good genital hygiene, avoiding factors that promote yeast growth, and considering prophylactic antifungal therapy for women with recurrent infections. By following these recommendations and using the most effective treatment options, women can reduce their risk of developing vulvovaginal candidiasis and improve their overall quality of life.
From the FDA Drug Label
Ask your healthcare provider for tips on what you can do to help prevent vaginal yeast infections The FDA drug label does not answer the question of how to prevent vulvovaginal candidiasis.
From the Research
Prevention of Vulvovaginal Candidiasis
To prevent vulvovaginal candidiasis, several strategies can be employed:
- Avoiding certain risk factors such as uncontrolled diabetes, immunosuppression, and the use of antibiotics, glucocorticoids, and oral contraceptives 2
- Maintaining good hygiene and avoiding certain habits of hygiene, clothing, and sexual practices that may predispose to VVC 2
- Using probiotics, which have been shown to have a negative correlation with the rate of recurrence of VVC 3
- Considering the use of antifungal medications such as fluconazole, ketoconazole, clotrimazole, and oteseconazole, which have been demonstrated to reduce the risk of mycological recurrence 3
Treatment and Prevention of Recurrent Vulvovaginal Candidiasis
For the prevention of recurrent vulvovaginal candidiasis, a combined treatment approach may be effective:
- Using a combination of systemic antimicrobial drug therapy with oral fluconazole and topical drug therapy using metronidazole and clotrimazole 4
- Adding adjuvant oral probiotic therapy to the treatment regimen 4
- Treating individuals with fluconazole, which has been shown to reduce the risk of mycological recurrence and the number of episodes of VVC recurrence 3, 5
Non-Pharmacological Interventions
Non-pharmacological interventions may also be effective in preventing VVC: