I am a pharmacist. When I lived in Miami, I had a regular patient (aka Janet) that would come in and talk with me about her dogs (my favorite subject!) She had been in New York for a few weeks for work. Before she had left for her trip, she had picked up a prescription for Diflucan (fluconazole)-a treatment for a yeast infection.
Janet came into the pharmacy and barely mentioned her new puppy (Charlie). She seemed upset and irritated. She was picking up another Diflucan prescription. So, I asked her what was up.
She was at wits end- she had been treating a yeast infection for about 2 months. At first, she self treated with OTC medications then with her physician. Janet’s physician gave her some prescription creams and then Diflucan.
We talked about all of her concerns…
What the symptoms are…
Symptoms range from none to swollen, red, itchy, irritated vaginal/vulvar tissues, discharge and odor -or any combination.
Even once the infection is cleared up (about 3-5 days) the symptoms can remain for up to 14 days -this is a problem because many women think that they still have an active infection.
We talked about how you get a yeast infection…
All women naturally have a small amount of yeast (candida albicans) in the vagina. The infection occurs when there is too much of the yeast. This can happen anytime -it is usually caused by medications (like antibiotics), injury, stress or other sickness.
Studies show that for some women who get recurring yeast infections, their risk is increased by using panty-hose, panty liners, sexual lubricants and drinking cranberry juice.
How is it treated?…
OTC vaginal creams and suppositories (such as Monistat) -they usually come in 1-day, 3-day and 7-day treatments. I usually recommend a 3-day treatment for most women.
Prescription vaginal creams and suppositories (like Gynazole) -these are not usually any better than the OTC creams.
Helpful Hint: Be careful -the creams can breakdown condoms.
Diflucan (fluconazole) is a prescription oral medication. Usually 1 tablet is taken once (sometimes it is repeated in 3 days). The tricky thing about the pill is that although it often only one tablet, the symptoms still take about 3 days to go away (you can use an OTC cream to help).
Boric acid vaginal suppositories –this is what Janet and I talked about mostly because she had already been through all the other options. She wanted to know why it had to come down to some random treatment she had never even heard of. There are three main reasons
1) There are different kinds of yeast that can cause infections. Most kinds of infections are treated by the normal treatments but there are some yeast infections that can ONLY be treated with boric acid.
2) Sometimes the infection is not caused by yeast but by a bacteria…none of the anti-fungal will help but boric acid can treat yeast and bacteria.
3) Sometimes, when a woman with a yeast infection uses a bunch of different treatments, the vagina just gets “unbalanced” -boric acid corrects the pH and kinda gives the vagina a “re-boot” back to baseline.
The regular dose is 600mg boric acid (in type 0 capsules) inserted vaginally at bedtime for 14 days. They need to be compounded so -you need a prescription and a compounding pharmacy.
Back to Janet- I printed out some info about boric acid that she could show her physician. She had to go back up to New York for another month but she called a couple of times to update me on her progress -she said her doctor looked at her like she was crazy at first but after reading about it gave her the prescription, she went to a compounding pharmacy and all has been good for her.
So that is great…here is the funny part- a few weeks later, I had a woman come to the pharmacy and asked if we have boric acid. I started talking to her about how it needs to be compounded with a specific capsule because yadda yadda yadda…
Her face was frozen in confusion and a bit of fear…I stopped talking and she said, “I…uhhh….just wanted some boric acid powder,” pause while we both looked at each other puzzled. She then continued, “You know…for cleaning.”
Boric acid for cleaning….who knew?!