A vaginal yeast infection, medically known as vaginal candidiasis, is a common fungal infection affecting most people assigned female at birth. It arises from an overgrowth of Candida yeast, most often Candida albicans, which naturally exists in the vagina but can multiply excessively. Symptoms typically include intense itching, irritation, and soreness in the vagina and vulva, a burning sensation during urination or intercourse, and a thick, white discharge resembling cottage cheese. This article focuses on oral medication options.
Understanding Oral Treatments
Fluconazole is the primary oral medication used to treat vaginal yeast infections. This antifungal medicine targets the Candida fungus responsible for the infection. For uncomplicated vaginal yeast infections, a single oral dose of 150 milligrams (mg) of fluconazole is typically prescribed.
Fluconazole is available as capsules or a liquid that patients swallow. While some pharmacies may sell fluconazole for vaginal thrush without a prescription, it is primarily a prescription-only medication. A healthcare provider often prefers this treatment due to its ease of use and effectiveness.
How Oral Medications Work
Fluconazole inhibits an enzyme within the fungal cells called lanosterol 14-α-demethylase. This enzyme is necessary for the conversion of lanosterol to ergosterol, a vital component of the fungal cell membrane. By disrupting ergosterol production, fluconazole interferes with the formation of a stable fungal cell membrane.
Without a proper cell membrane, yeast cells cannot survive or multiply. This mechanism allows fluconazole to effectively kill the Candida fungus, clearing the infection and alleviating symptoms. Symptom relief often begins within 24 hours, with significant improvement within three days, though complete resolution can take up to seven days.
Important Considerations for Oral Treatment
Patients taking fluconazole may experience side effects, including headache, nausea, abdominal pain, and diarrhea. These gastrointestinal side effects are generally mild. More serious, but less common, side effects include liver problems or heart rhythm issues, particularly in individuals with pre-existing conditions.
Fluconazole can interact with other medications, potentially altering their effectiveness or increasing adverse effects. For instance, it can interact with blood thinners like warfarin, certain diabetes medications, and some heartburn medications. Inform a healthcare provider about all current medications, including over-the-counter drugs and herbal supplements, before starting fluconazole.
Precautions are necessary regarding pregnancy and breastfeeding. Fluconazole should generally be avoided during pregnancy, particularly in the first trimester and at high doses, due to potential risks to the unborn baby. While a single low dose may sometimes be prescribed during breastfeeding if other treatments are ineffective, the medication passes into breast milk. Consultation with a doctor is advised to weigh benefits against potential risks.
When to Consult a Healthcare Provider
Seeking medical advice is important for accurate diagnosis and treatment of a yeast infection. If it’s a first-time experience with yeast infection symptoms, consult a healthcare provider to confirm the diagnosis, as symptoms can mimic other conditions. Diagnosis often involves examining vaginal discharge for yeast.
Consult a doctor if symptoms persist or worsen after over-the-counter treatments. Individuals with recurrent infections (four or more within a year) should see a doctor, as this may indicate an underlying health issue or a resistant yeast strain. Severe symptoms like extensive redness, swelling, fissures, or atypical discharge color or odor require immediate medical attention. Pregnant individuals should always consult their doctor before any self-treatment.