Recurrent vaginal yeast infections (Candida vulvovaginitis) is a common problem for many women, leading to frequent visits to their health care providers. By definition, four or more occurrences of this vulvovaginitis within 12 months indicate a recurrent infection, which can lead to much frustration for the suffering patient.
Candida is a microorganism that is normally found in the vagina along with bacteria. There is usually a natural balanced mix of yeast and bacteria in the vagina. When the balance is disrupted, there can be an overgrowth of yeast, which is the infection. Vaginal cultures can be obtained in these patients to check for certain species of yeast that can be resistant to standard treatments.
Fluconazole (brand name Diflucan) is used in one of the advised treatment regimens. This is an antifungal agent that is generally well tolerated but can be associated with headaches, nausea, and abdominal discomfort.
Using this medication, there have been rare cases of serious liver reactions and low blood sugars. This may happen in patients using medications to lower their blood sugar. For the recurrent infections, one treatment plan is fluconazole 150 mg orally every 72 hours for 3 doses, followed by the medication once a week for 6 months.
If the cause of the recurrence is thought to be one of the more resistant species of Candida, intravaginal boric acid capsules taken once a day nightly for 14 days may be a consideration.
As always, this information should only be the start of your journey to treat this common problem. You must have a good discussion with your health care provider concerning any medication and treatment regime that is being considered.