From the Guidelines
To prevent recurrent bacterial vaginosis (BV) and yeast infections, it is essential to maintain good vaginal hygiene and pH balance, and for recurrent yeast infections, fluconazole 150mg weekly for 6 months can be effective as prophylaxis, as recommended by the Infectious Diseases Society of America in their 2016 update 1.
Key Practices for Prevention
- Wear breathable cotton underwear and avoid tight clothing that traps moisture
- After using the bathroom, always wipe from front to back to prevent introducing bacteria from the rectum to the vagina
- Avoid douching, scented feminine products, and harsh soaps as these disrupt your natural vaginal flora
Treatment Options for Recurrent BV
- Consider boric acid suppositories (600mg inserted vaginally at bedtime for 7-14 days during flare-ups)
- Maintenance therapy with metronidazole gel (0.75%, applied twice weekly for 3-6 months)
- Probiotics containing Lactobacillus species, either orally or vaginally, may help restore healthy vaginal bacteria
Treatment Options for Recurrent Yeast Infections
- Fluconazole 150mg weekly for 6 months can be effective as prophylaxis, as supported by the 2016 update by the Infectious Diseases Society of America 1
- Dietary changes like reducing sugar intake and managing blood glucose if diabetic can help prevent yeast overgrowth It is crucial to consult your healthcare provider before starting any medication regimen, especially if pregnant or breastfeeding. The most recent and highest quality study, which is the 2016 update by the Infectious Diseases Society of America 1, provides the basis for these recommendations, prioritizing morbidity, mortality, and quality of life as the outcome.
From the FDA Drug Label
If you are pregnant, have diabetes, use birth control pills, or take antibiotics you may get yeast infections more often than other women Personal hygiene and certain types of clothing may increase your chances of getting a yeast infection. 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 recurrent BV. For yeast infections, personal hygiene and avoiding certain types of clothing may help prevent them. Additionally, patients who are pregnant, have diabetes, use birth control pills, or take antibiotics may be more prone to yeast infections. It is recommended to ask a healthcare provider for tips on prevention 2.
From the Research
Prevention of Recurrent BV and Yeast
To prevent recurrent bacterial vaginosis (BV) and yeast infections, several strategies can be considered:
- Lactobacilli-containing vaginal probiotics: These probiotics have shown promise in preventing BV, but their effectiveness in preventing yeast infections is less clear 3.
- Antibiotic treatment: For BV, prescription of antibiotics such as metronidazole or clindamycin is recommended 4, 5.
- Oral fluconazole or topical azoles: For yeast infections, treatment with oral fluconazole or topical azoles is effective, although only topical azoles are recommended during pregnancy 4, 6.
- Alternative or complementary treatments: Some alternative treatments, such as boric acid, nystatin, or tea tree oil, may be effective in preventing recurrent yeast infections, but more research is needed to confirm their effectiveness 6.
- Maintaining a healthy vaginal microbiome: Understanding the composition of the vaginal microbiome and its associated variations is key to improving therapeutic management of patients with BV and yeast infections 5.
Factors to Consider
When considering prevention strategies, the following factors should be taken into account:
- Diagnosis: Accurate diagnosis of BV or yeast infection is essential to determine the best course of treatment 4, 5.
- Treatment of sexual partners: In some cases, treating sexual partners may be necessary to prevent recurrence of BV or yeast infections 4, 6.
- Hormonal and nonhormonal therapies: For atrophic vaginitis, hormonal and nonhormonal therapies may be effective in preventing recurrent infections 4.