Best treatment options for yeats infection?

February 21, 2010 6:32 PM

I have my first yeast infection after many years of thinking I was invulnerable. What's the best way of treating it given that my ladyparts are extra-sensitive due to lichen sclerosis?

I can see that Monistat is available over the counter in 1 day, 3 day and 7 day formulations, and given that it can take up to 7 days for the infection to clear even with a 1 day application, I'm inclined to go for the 7 day treatment rather than bomb the area with a higher dose of meds over a shorter period. But is there any reason to believe that a more concentrated dosage might be a more effective way of treating this?

I have a doctor, but she's unavailable until late next week. It's taken me three days to finally realize what was ailing me, so I'd like to start treatment ASAP. I'm making an appointment with her nonetheless in case this is something else besides yeast.

posted by anonymous to health & fitness (14 answers total)

Ask your doctor's office about oral fluconizole (1 tablet treatment). They may prescribe it over the phone so you wouldn't have to wait a week. Or, they may recommend topical treatment now so you don't have to wait. IANAD, IANYD.
posted by tristeza at 6:53 PM on February 21, 2010 [1 favorite]

Diflucan from your doctor would be the ideal treatment since it's a pill with no mess and no discomfort, but I can understand that you don't want to wait. I can't speak to lichen sclerosis issues specifically, but I like the 3 day stuff. The cream is messy and unpleasant, and a lot of people (me among them) find that it can burn the already irritated outer tissues something fierce. Thus, the fewer days you have to deal with it, the better.

However, I often find the 1 day stuff doesn't knock it out completely, so I split the difference and go 3 day. Now that I think about, since your ladyparts are already extra-sensitive, you may want to go with the Monistat 1 Ovule. It's the treatment that I've had the most trouble with getting to actually nip my killer yeasties in the bud, but it's by far the least drippy and irritating. And really, as uncomfortable as you are already, you probably don't want to find out now if you're one of the people who finds the cream externally burning if you can possibly help it.
posted by mostlymartha at 6:55 PM on February 21, 2010 [1 favorite]

Also, a thick smear of hydrocortisone cream can help take the edge off for a few days while whatever treatment you choose starts to work.
posted by mostlymartha at 6:56 PM on February 21, 2010

please do NOT use anything but 7 day monostat!! I have recently had a recurrent yeastie beastie (soooo fun) and I initially treated with one day. that didnt work in this case and ultimately I went to doc. doc and 2 advice nurses independently, very adamantly encouraged that I only ever use 7 day. they said 1 day can just be too harsh on the environment down there.

the sooner you treat the better, and if you can get diflucan rx over the phone that would be best. external app of cortisone cream, as mostlymartha suggests, is great for relief of pain/irritation.

you may also want to take acidophilus or pro-biotics. my allopathic western doctor suggested this to me as a completely legitimate and effective aid. its not just some hippy folk remedy thing. good luck!
posted by supermedusa at 7:10 PM on February 21, 2010 [1 favorite]

One of my doctors told me that the 1 day treatments are a waste of money because they don't actually work. He recommended the 3 day ones. Unfortunately, I have also experienced the burning that mostlymartha referred to, but I don't think it happened every time. Most of the 3 day packs that I've bought have come with a topical cream to help with the itch/pain. I have also used Diflucan, but I've had a dr. tell me that it only works on one type of yeast.
posted by Nolechick11 at 7:10 PM on February 21, 2010

damn! this is a great opportunity to make a weird joke about a poet, but I can't think of one!!!
posted by supermedusa at 7:11 PM on February 21, 2010 [3 favorites]

Get the 7 day treatment. It's more effective than the shorter doses (say three separate docs/nurses I've seen regarding this issue).
posted by pintapicasso at 7:23 PM on February 21, 2010 [1 favorite]

Do yourself a favor and do not try any of the OTC medications. If you're sensitive, it's not worth the misery you might experience if you react negatively. Diflucan will do what you want. OTC meds might work, but also might make everything worse (this happened to me. It was awful). I tried Monistat at the suggestion of my sister, and I figured, hey, we have the same genes, so it's probably going to work for me. It made everything worse, and gave me persistent cramps on top of everything.

I think your best bet is to call your doctor. See if she can call a scrip for Diflucan in for you without seeing you. If not, wait for the Diflucan, and use plain yogurt to relieve your symptoms. Plain yogurt really does work. It won't heal you faster, but it will relieve the discomfort. You can soak a tampon in plain yogurt, a pad in plain yogurt, or just apply it to the area. Eating yogurt (and drinking acidophiles milk) also helps. I'd actually suggest buying two large tubs of yogurt, one for applying, and the other for eating for breakfast.

Also be sure to let the area breathe! Sorry you're not feeling well, and hope it clears up very soon!
posted by pazazygeek at 7:42 PM on February 21, 2010

Going to nth recommending the 7 day, as someone who had them all the time for a while. I got to the point where I could tell if it was going to be OK to use a 3-day or if I needed a 7-day. Get the 7-day suppositories, not the cream; a lot less messier and less irritating. Bonus: it's almost always the cheapest option. Store brand is fine.

Diflucan doesn't work for everyone, or possibly for all strains (can't recall, but I know that was wasted money for me.)
posted by cobaltnine at 7:44 PM on February 21, 2010

follow-up from the OP

Thanks for all the answers. I posted this on Friday afternoon, but some glitch meant it didn't show up until tonight. I wound up phoning my sister on Friday, who recommended 3 day Canestan, and I went out to the store and started treating myself with the cream version. I have experienced no irritation from the med and have used the external cream a couple of times to bring a mild itch down to no itch. I'll be using the hydrocortisone cream prescribed for my lichen sclerosis on Monday morning and evening as usual (one day a week is all I need for that.)

Oddly enough, even before I treated myself that night, my discharge had basically stopped and hasn't been back since. I'm completely asymptomatic now, too, but am finishing the course of meds nonetheless. It's been almost 25 years since my last diagnosed and treated yeast infection, so it's possible that I am semi-invulnerable and/or tend to clear up pretty quickly on my own. Or perhaps I just got a really weak strain this time.

But if it does happen again, I'll be sure to avoid the 1 day treatments and go for 3 days or even 7 days. Thanks again!

posted by jessamyn at 8:04 PM on February 21, 2010

OP, glad you're feeling better.

Anecdotal, but Diflucan gave me a horrible headache and nausea, and didn't clear up the yeast infection. I found the 7-day treatment messy but effective and relatively soothing. From other ladies who talked to me after trying the ovule, the majority of them who even mentioned it found it painful, removed it soon, and rinsed rinsed rinsed with cool water.

I'm glad to have been dodging that bullet for almost a decade now.
posted by lilywing13 at 12:39 AM on February 22, 2010

nthing Diflucan, if you can take it (and if it recurs, take these at the first sign)
posted by bunny hugger at 6:24 AM on February 22, 2010

Plain, plain, PLAIN organic yogurt applied topically to treat the symptoms and Diflucan for the infection itself.

I've had more yeast infections than I care to think about and nothing is more soothing for the actual itchy/burny than yogurt. The creams all made me feel WORSE. Also, acidophilus pills (ingested, not applied) help move the healing along a bit faster.
posted by grapefruitmoon at 6:31 AM on February 22, 2010

For future reference.. any time you feel a yeast infection coming on, start eating yogurt or taking acidophilus pills, you can stop it that way. And when you get your period, everything kind of "resets" itself and the yeast infections go away - so if you're a day or 2 away from getting your period, know that relief is coming soon!

I don't want to say that grapefruitmoon is wrong, but I've heard to never never NEVER actually apply yogurt (even plain!), just eat it.
posted by KateHasQuestions at 6:36 PM on February 22, 2010