vaginal infection, irritation and itching. What to do about it?
29-year-old woman
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David Tan · 4 years ago
Hello,
To treat a vaginal yeast infection, the product of choice is clotrimazole (also known under the trade name Canesten) to be applied once a day at bedtime. If you look for it in a pharmacy, you will see that there are several types of Canesten cream, including:
- 1 day cream
- Generally not recommended, as the treatment time is very short
- 3-day cream
- To be used if you have less than 4 yeast infections in less than 12 months
- There is also a CombiPak that includes the cream and vaginal eggs... The ovules are useful if your infection is more internal and deeper in the vagina (although the cream can also be applied to both the outside and inside of the vagina)
- 6-day cream:
- Use if you have more than 4 yeast infections in less than 12 months
- If you are pregnant or taking an antibiotic
- Oral capsule (CanesOral):
- A capsule to be taken by mouth in a single dose... Formerly available with a prescription only, it is now available over the counter but must be requested from the pharmacist. I reserve the oral capsule for more severe and frequent infections or when the cream fails.
As an alternative, you will also find miconazole cream (also known under the commercial name of Monistat) which is just as good as Canesten. I usually suggest Monistat as a 2nd choice if Canesten fails
Other measures to consider:
- Clean the genital area with a mild unscented soap and rinse well;
- Avoid douching, deodorants, bubble baths and bath oils;
- Wipe from front to back after each bowel movement;
- Change your tampon or pad regularly;
- Wear white cotton underwear and avoid synthetic underwear;
- Avoid wearing wet clothing (e.g., bathing suits, sportswear) for several hours;
- Avoid hot tubs and spas;
- Wear loose fitting clothing.
Finally, if you have any of the following symptoms, it would be best to suggest a doctor, as your infection may be bacterial in origin and may require an antibiotic instead:
- Malodorous vaginal secretions ( fishy smell)
- Greyish-white vaginal secretions
The Canesten site below includes a quick questionnaire that will help you determine if your infection is more yeast (fungal) or bacterial: https://www.canesten.ca/fr/female/yeast-infection-symptom-checker/
I hope this answers your question. If there is anything else, please do not hesitate to contact me again and I will be happy to answer you.
Sincerely,
David Tan, pharmacist
29-year-old woman · 4 years ago
Hello,
Thank you for your quick answer. As advised, I had indeed the reflex to buy the product Monistat (vaginal ovules for 3 days). I am currently on the third day. However, I still have discomfort and a little itching at the entrance of the vagina. I am not a doctor but at this point I would say that I have a bacterial infection and not a yeast infection. So what should I do? How can I see a gynecologist without a prescription and as soon as possible?
David Tan · 4 years ago
Hello,
Out of curiosity, have you tried the questionnaire I referred you to? Although it doesn't replace an actual diagnosis by a doctor, it would give me a better indication on how to proceed and if a medical consultation would indeed be required.
I look forward to hearing from you :)
29-year-old woman · 4 years ago
i just tried the question and my answers indicate that I may have the symptoms of a vaginal yeast infection.
As mentioned, I have been using the monistat product and am on my third and final day of using the vaginal ovule. The discomfort is still there
David Tan · 4 years ago
Hello,
Perfect... Thank you for the information. So I don't think you need to see the doctor. There are three options in light of your situation:
- Extend your Monistat treatment to 6 days assuming there was still a slight improvement in your symptoms in the last 3 days;
- Switch from Monistat to Canesten (6 days)... perhaps a change of molecule will give a better result;
- Opt for CanesOral... The capsule is much more effective than the cream, because you swallow it and it is absorbed into the bloodstream. You can also take the capsule AND continue to apply the cream if you wish; there is a CanesOral CombiPak form that includes both (capsule and cream).
I hope this answers your situation. Please keep me informed of your choice and the progress of your symptoms. If your symptoms persist despite the application of one of the above options, let me know and I will continue to support you as needed.
Sincerely,
David Tan, pharmacist
29-year-old woman · 4 years ago
hello again,
I can already tell you that after 3 days of using the Monistat, I do feel an improvement
i'm thinking of opting for option #3 (CanesOral). I will buy the product today
i really want to thank you for your advice and your listening. I will keep you posted on how things are going
Thank you
have a nice day
David Tan · 4 years ago
Excellent! This is a good choice! It will have the merit that if your symptoms persist despite taking the capsule a few days later, the other options will not be more effective and your situation will necessarily require that you see the doctor there.
If you have already had a fluconazole capsule (the generic name for CanesOral) prescribed in the last 4 years (since August 2016), then I suggest you ask your pharmacist if he can prescribe it for you so that the cost can be passed on to insurance (he will then perform a consultation by asking you a few questions). Otherwise, the CanesOral recommendation remains appropriate regardless. :)
I wish you good luck in the future and I remain at your disposal if needed.
Have a nice day,
David Tan, pharmacist
29-year-old woman · 4 years ago
Hello again,
If my memory is good I have indeed had to take fluconazole in the past. It should therefore be in my file
I am going to return it to a jean coutu and see if he would be able to prescribe it to me again. If not, I will take the canesOral as you say
Thank you for everything!
Dorine Pierre
29-year-old woman · 4 years ago
Hello,
I just went to the pharmacy and was able to get the fluconazole. However, I last had my period on July 18, so this prompted me to buy a pregnancy test. It turns out that I am pregnant so I don't know if I should still take the fluconazole
i have to tell you that I don't plan on keeping the child so I may need your advice on how to proceed with an abortion
thank you!
David Tan · 4 years ago
Hello,
According to the references, fluconazole is indeed associated with a possible risk of malformation in the fetus... However, this is most noticeable when used for a long period of time. Otherwise, the references still say that fluconazole can be used if it is used for a short period of time and if the benefits outweigh the risks
In short, this means that if other options (such as creams) can be used, it would be preferable to do so to avoid any possible risks. On the other hand, if creams have already been used and have not provided adequate relief, the use of fluconazole could be considered with minimal risk to the fetus.
I hope this addresses your concerns. Please do not hesitate to contact me again if you have any further questions.
Have a great week!
David Tan, pharmacist
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