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|How is Vaginitis Treated?
The treatment for vaginitis depends on the cause or type of vaginitis present. This is one of the reasons why a clinical vaginitis diagnosis is important. Specific drugs and remedies work for many cases of yeast infections (antifungal creams and suppositories) while other medications will be necessary to treat bacterial vaginosis or trichomoniasis (antibiotics). Sometimes it is necessary to treat the woman's partner to avoid re-infection. If symptoms do not clear up within a few days of using an over the counter product, do contact your doctor. It may be that you are using the wrong treatment or that the vaginitis is caused by an STD which requires immediate attention.
As this type of vaginal problem is caused by a bacterial infection, treatment is in the form of antibiotics, most commonly: metronidazole (Flagyl), clindamycin (Cleocin) and tinidazole (Tindamax). Although bacterial vaginosis may clear up without medications, it is recommended to be treated to avoid complications.
The Centers for Disease Control (CDC) recommends any one of the following treatment options for non-pregnant women:
1. Metronidazole: 500mg taken orally twice a day for 7 days.
All pregnant women should be treated for this infection as it can lead to pregnancy complications. Treatment will involve the same antibiotics as non-pregnant women but the dosage is different.
Recurrence or Persistent Cases
Bacterial vaginosis recurs in 20 to 40 percent of cases one month after treatment. This may be because the bacterial organisms which caused the infection are still around and the good bacteria (lactobacillus flora) have not yet multiplied. If symptoms recur several times then metronidazole gel is recommended twice a week for 6 months. See vaginitis prevention for information on preventing recurrences.
Over The Counter Options
According to the CDC, neither yogurt therapy nor oral lactobacillus treatment have demonstrated any benefits. However vaginal suppositories containing human lactobacillus strains are currently under study. Another study found that vaginal capsules containing lactobacillus rhamnosus and Lactobacillus gasseri seem to lengthen time between infections. One brand which offers this is Probaclac Vaginal. Fem-dophilus contains lactobacillus rhamnosus and Lactobacillus reuteri. HLC Candaclear, a popular over the counter remedy was classified as a drug by the FDA in 2011 and is no longer available online or OTC.
Male partners generally do not need to be treated.
Trichomoniasis is a STD (parasite) which affects both men and women, although it is more common in women. For this reason, if an infection occurs, both partners will need to be treated, even if only one shows symptoms. Even if symptoms stop, re-infection of a partner is still possible, so treatment should be sought regardless. Treatment is with antibiotics: metronidazole (Flagyl) or tinidazole (Tindamax). Metronidazole has a 90 to 95 percent cure rate and tinidazole has an 86 to 100 percent cure rate. Only one single dosage is necessary and it is taken orally. Until both partners are completely clear of symptoms they should refrain from intercourse.
Nearly 90 percent of yeast infections (technically known as vulvovaginal candidiasis) are caused by Candida albicans, and the remaining 10 percent are caused by other types including Candida tropicalis, Candida glabrata or Candida parapsilosis. A yeast infection is classified as uncomplicated (mild to moderate cases which occur occasionally) or complicated (recurrent infections, severe cases, or women who are pregnant or who have diabetes).
Uncomplicated/Mild Yeast Infections
Uncomplicated yeast infections respond well to antifungal creams & suppositories. Some creams are applied to the outside of the vagina and can relieve itching, while others are for internal use. Suppositories (in cream and tablet form) are inserted with a plunger type applicator. Medications which are available over the counter and inserted intra-vaginally include: Butoconazole, clotrimazole (brand names Lotrimin or Canesten), miconazole (Micatin, Monistat, Femizol), nystatin and tioconazole (Monistat, Vagistat). Fluconazole (Diflucan) is an antifungal drug which is taken orally, and only requires one single dose. Over the counter products usually resolve Candida symptoms in 85 percent of cases. Suppositories can be used during a menstrual period. See douching, as another option.
A persistent case of vaginitis is normally defined as 4 or more recurrences a year. Doctors usually recommend Fluconazole (Diflucan) every third day for a total of 3 doses. If the infection still persists a doctor may prescribe Terazol, a stronger anti-fungal drug.
Yeast Infections NOT Caused by Candida Albicans
As we mentioned above, in about 10 percent of cases, a yeast infection may be caused by types of yeast other than candida albicans. The exact treatment for non-albicans versions of Candida is not known, so it is usually recommended to apply fluconazole topically for a longer period (7 to 14 days). A study published in the European Journal of Clinical Microbiology & Infectious Diseases concluded that Fluconazole (Diflucan) is effective against non-albican candida but may need to be taken in higher dosages for candida glabrata. Boric acid in gelatin capsule inserted vaginally once a day for 14 days is recommended for recurrences.
As yeast infections are not contracted through intercourse, treatment of both partners is not recommended. However, where a woman has recurrent infections, it may be considered. A small percentage of men may have balanitis which can cause a rash or redness of the penis. They will benefit from an antifungal treatment being applied topically.
|Related Articles on Treatments for Vaginitis
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