From the Guidelines
For vaginal itching, the most effective treatment is an antifungal medication, with oral fluconazole (150mg single dose) being a highly effective option, as supported by the 2009 update by the Infectious Diseases Society of America 1.
Treatment Options
The following are some of the treatment options available:
- Over-the-counter antifungal creams like clotrimazole, miconazole, or tioconazole can be applied directly to the affected area once daily for 1-7 days, depending on the specific product and concentration.
- Oral fluconazole (150mg single dose) is another option for yeast infections, as recommended by the Infectious Diseases Society of America 1.
- For non-fungal causes, hydrocortisone cream (1%) can help reduce inflammation and itching.
- Antihistamines like diphenhydramine may also provide relief from itching.
Important Considerations
It's essential to note that:
- Scented soaps, douches, and tight-fitting synthetic underwear can worsen symptoms and should be avoided.
- If symptoms persist beyond a week, are accompanied by unusual discharge, odor, or pain, or if you're pregnant, it's crucial to see a healthcare provider as the itching may be caused by bacterial vaginosis, sexually transmitted infections, or other conditions requiring different treatment.
- Most vaginal itching is caused by disruption of the normal vaginal pH or microbiome, which these medications help restore, as stated in the 2009 update by the Infectious Diseases Society of America 1.
Diagnosis and Classification
According to the 2009 update by the Infectious Diseases Society of America 1, vaginal candidiasis (VVC) can be classified as either uncomplicated or complicated, and diagnosis should be confirmed by a wet mount preparation with use of saline and 10% potassium hydroxide to demonstrate the presence of yeast or hyphae.
Recurrent VVC
Recurrent VVC is defined as ≥4 episodes of symptomatic VVC within 1 year and is usually caused by azole-susceptible C. albicans, as stated in the 2009 update by the Infectious Diseases Society of America 1. After control of contributing factors, such as diabetes, induction therapy with 10–14 days of a topical or oral azole should be followed by a suppressive regimen for at least 6 months. The most convenient and well-tolerated regimen is once weekly oral fluconazole at a dose of 150 mg, which achieves control of symptoms in >90% of patients, as recommended by the Infectious Diseases Society of America 1.
From the FDA Drug Label
If you have: • vaginal itching and discomfort for the first time. You may need a different treatment.
When using this product: • mild increase in vaginal burning, itching or irritation may occur
Directions for using the External Vulvar Cream Use the cream twice daily, for up to 7 days as needed.
Stop use and ask your doctor if: • symptoms do not get better in 3 days • symptoms last more than 7 days
The medication for vaginal itching is miconazole nitrate. It is available as a vaginal insert and external vulvar cream. The cream can be used twice daily for up to 7 days as needed. However, if symptoms do not get better in 3 days or last more than 7 days, you should stop use and ask your doctor. If you are experiencing vaginal itching and discomfort for the first time, you may need a different treatment, so it is recommended to ask a doctor before use 2.
From the Research
Medication Options for Vaginal Itching
- Vaginal itching can be caused by various conditions, including bacterial vaginosis, vulvovaginal candidiasis, and trichomoniasis 3
- Treatment for vaginal itching depends on the underlying cause, with options including:
Effectiveness of Medications
- A study comparing oral metronidazole, metronidazole vaginal gel, and clindamycin vaginal cream for bacterial vaginosis found similar cure rates for all three treatments 4
- A combination vaginal tablet consisting of clotrimazole and metronidazole was found to be effective in treating candidal vaginitis 6
- Clotrimazole has been shown to be effective in treating uncomplicated and complicated vulvovaginal candidosis, with high cure rates and minimal adverse reactions 5, 7
Treatment Considerations
- Treatment should be directed at the underlying cause of vaginal itching 3
- Patients with coexisting conditions, such as vulvovaginal candidiasis and bacterial vaginosis, may require combination therapy 6
- The choice of medication and treatment duration should be individualized based on the patient's specific needs and medical history 3, 5