Call the OWH HELPLINE: Metronidazole is usually given for up to 10 days in a row. Use this medicine at bedtime.

Yeast infections and BV can cause complications if they aren’t successfully treated. The applicator has a plastic tube called a barrel that is open at one end and has a plunger (another piece of plastic that can move inside the barrel) at the other end. Recent studies have shown a relationship between BV and HIV, so health officials now consider BV a risk factor for HIV acquisition, particularly in developing countries where BV is often untreated. Once your infection is cured and you have returned to normal, you may wish to maintain your vaginal health by ensuring you have an optimal balance of beneficial bacteria and by maintaining healthy vaginal pH. To help clear up your infection completely and to help make sure it does not return, good health habits are also required. Do you have a yeast infection? This study will help uncover key factors related to candida and other fungal infections so they can be better understood and prevented in the future. Ask your doctor about your risk.

RepHresh Vaginal Gel is clinically shown to maintain healthy vaginal pH.

Serious but unlikely side effects of Flagyl include: Wet the vaginal tablet with water for a few seconds. Gently insert the applicator into your vagina (it may help to lie on your back with your knees bent to do this). One of the more disturbing aspects of bacterial vaginosis (BV) is that the infection frequently returns after treatment. Vaginal metronidazole gel is also used to treat bacterial infections of the vagina.

However, pediatric-specific problems that would limit the usefulness of this medication in teenagers are not expected. Bacterial vaginosis is caused by overgrowth of these bacteria. Lactobacilli produce hydrogen peroxide, which inhibits the growth of bacteria and, by the way, can destroy HIV in cell cultures. Stopping the treatment early may cause symptoms to return. Vaginal yeast infection (Candida infection)—Use with caution. There are also reports on breastfed babies who did not have clinical effects while their mothers were taking metronidazole. 7 View/Print Table TABLE 4 Classification of Vulvovaginal Candidiasis Uncomplicated Complicated Sporadic or infrequent infection Recurrent infection Mild-to-moderate infection Severe infection Candida albicans as likely cause Infection with Candida species other than C.

1 Although vaginitis can have a variety of causes (Table 1), it most often is associated with infection or atrophic changes. Consider using birth control pills that don’t contain estrogen, such as progesterone-only pills or an IUD. Physiologically, the normal vaginal flora (mainly lactobacilli) keeps pH levels of the vaginal fluids low, thus preventing the overgrowth of pathogenic and opportunistic organisms. It is caused by an overgrowth of one type of bacteria in the vagina.

This will reduce the risk of bacteria like candida from growing into an infection.

What Is It?

One 150-mg tablet orally once per week Culture and sensitivity results should be used to guide therapy, because non–C. Tea tree oil can make some women’s skin sensitive. OTC and prescription medication can usually clear up a yeast infection within a week. It happens when the different kinds of healthy bacteria in your vagina get out of balance and grow too much. What drugs interact with monistat? The most common symptoms of a yeast infection are itching and burning of the area outside the vagina called the vulva. According to guidelines from the Centers for Disease Control and Prevention (CDC),10 treatment of bacterial vaginosis is indicated to reduce symptoms and prevent infectious complications associated with pregnancy termination and hysterectomy.

Think you may have a yeast infection or BV? However, it is gaining more attention as more research shows that untreated BV can lead to significant health complications, including premature delivery, postpartum infections, clinically apparent and subclinical pelvic inflammatory disease (PID), postsurgical complications (after abortion, hysterectomy, cesarean section and other reproductive procedures), increased vulnerability to HIV infection and, possibly, infertility. Common side effects include nausea, a metallic taste, loss of appetite, and headaches.

It's especially important for pregnant women with symptoms to be treated to help decrease the risk of premature delivery or low birth weight. As many as 30 percent of women who have been treated for BV experience recurrences within 90 days of treatment. Some women with BV also notice painful intercourse or discomfort with urination. Recurrence is usually caused by reinfection with the same organism from a vaginal reservoir. Are going to have a hysterectomy or surgical abortion.

Common infectious forms of vaginitis include bacterial vaginosis, vulvovaginal candidiasis, and trichomoniasis.

When To See A Doctor Or Other Healthcare Provider

Metronidazole may be taken orally with or without food. People can also find over-the-counter antifungal vaginal creams at drugstores, or choose between brands online. Do not take more of it, do not take it more often, and do not take it for a longer time than your doctor ordered. About 1 in 5 people get infected again within 3 months after treatment.

  • While a yeast infection can be treated with over the counter products or may go away on its own, bacterial vaginosis may need to be treated with prescription medication.
  • Follow all directions on your prescription label and read all medication guides or instruction sheets.
  • Do not double doses.
  • Do not get it into your eyes, nose, mouth, or skin.
  • Studies show there is no need to treat male sexual partners for BV, and clinical studies have shown that treating male partners with antibiotics doesn't affect a woman's risk of recurrence or her response to treatment.
  • A recent study looked at over 900 women who had taken metronidazole sometime during their pregnancy and there was no increased risk for preterm birth (birth before 37 weeks), low birth weight, or congenital anomalies.
  • These extravaginal bacteria often are found again in the vagina, suggesting that bacterial vaginosis can be acquired from extravaginal bacterial reservoirs.

How do I know if I have BV or a yeast infection?

If the infections keep recurring, though, you and your doctor need to look for an underlying cause. Take all of the medication that was prescribed unless instructed to stop taking it by a healthcare professional. You may need to use a sanitary napkin during treatment, but do not use a tampon. The most common and minor side effects include:

Tell any doctor who treats you that you are using this medicine.

He may prescribe extended-use metronidazole. Safety and efficacy have not been established. Typically, beneficial vaginal bacteria like Lactobacillus help keep other organisms (like the yeast) under control. It is found in small numbers in the normal vagina.

Check with your doctor immediately if any of the following side effects occur: Reliance on any information provided by LifeScript is solely at your own risk. Take this medicine only as directed by your doctor. Pet care essentials, ● There was recent nipple trauma, which may predispose to thrush. Pelvic examinations are usually recommended to determine the kind of infection you may have and the proper treatment for it.


You experience irritation that leads to cracked or bleeding skin at the site of your infection. Your doctor may decide not to treat you with this medication or change some of the other medicines you take. Given that the disease is sexually transmitted, it is preferable for both partners to receive treatment to eliminate the parasite. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.

A less common form of yeast called Candida glabrata, found in up to 15 percent of women with recurring infections. If you are treating a vaginal infection, your sexual partner may also need to take metronidazole (even if no symptoms are present) or you could become reinfected. It’s common for this infection to come back within a year. Clindamycin (Cleocin, Clindesse, others).

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These include nausea, vomiting, and darkening of urine. Secnidazole , available as a single pill you take once. Vaginal clindamycin does not reduce the risk of preterm birth or peripartum infection. What can I do if I experience this? If dry mouth becomes bothersome, try chewing gum, or sucking on hard candy or ice chips.

The CDC10 advises treatment of symptomatic pregnant women with a single 2-g oral dose of metronidazole but does not recommend treatment of asymptomatic pregnant women.

Medication Summary

So, before I explain what yeast does (other than help dough rise) and how a diagnosis of abnormal vaginal yeast infection is made, I want to say a few words about bacterial causes of vaginal pain and discharge. Also, if you're using intravaginal forms of clindamycin, the oil-based medication may weaken latex condoms or diaphragms. The 200 mg suppositories (Monistat 3) are inserted once nightly for 3 nights. When estrogen levels are lower, vaginal pH levels tend to be higher. 44 The decision to treat trichomoniasis during pregnancy is further complicated by the fact that physicians are reluctant to use metronidazole in pregnant women.

BV is treated with antibiotics. If you are having your period, ask your doctor when you should start the treatment. Infection in males may be asymptomatic. People with an allergy or sensitivity to metronidazole should also not take Flagyl. Two studies comprising 202 women used 2 g versus 1 g secnidazole for assessing the microbiological effect [16, 17]. They can be taken by mouth or inserted into the vagina as a cream or gel. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Metronidazole (Flagyl, Metrogel-Vaginal, others).

Well, no worries ladies. If you have HIV, BV can also make it more likely for you to transmit HIV to any sexual partner who has a penis. 10 Unfortunately, treatment of asymptomatic trichomoniasis has not been shown to prevent these outcomes. Do not douche with yogurt or any other product. This infection is characterized by1: The applicator should be washed with warm soap and water after each use. The 100 mg suppositories (Monistat-7) and intravaginal cream are inserted once nightly for 7 nights.

Understanding Vaginal Yeast Infection Medications Related Articles

It is spread through sex. If your mouth continues to feel dry for more than 2 weeks, check with your medical doctor or dentist. Studies have shown that women with untreated BV are at higher risk of delivering prematurely or giving birth to a low-weight baby. Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances. Tinidazole (Tindamax).

If left untreated, a yeast infection in a man may go away on its own. Insert the medicine directly into your vagina using the applicator provided. Diagnosis should rely on microscopic examination of a sample from the lateral vaginal wall (10 to 20 percent potassium hydroxide preparation).

Drug Basics & Safety

Your doctor will do a vaginal examination and take a swab sample of your vaginal discharge to test for pH factor levels. This medicine may increase your risk of having serious liver problems, which may be life-threatening. Other alcohol-containing preparations (eg, elixirs, cough syrups, tonics) may also cause problems. When pH becomes elevated, the environment shifts in favor of the pathogenic bacteria. As many as one-third of women in the United States have BV.

Once this has been documented, there are various therapies you can try. Can vaginal yeast infections be prevented? With that being said, the development of the yeast infections was more closely to poor immune status than any other factor. RECURRENT BACTERIAL VAGINOSIS Recurrent bacterial vaginosis is common and requires longer treatment (10 to 14 days) with any of the recommended or alternative therapies9 (Table 2). For vaginal tablet dosage form:

Diet, Food & Fitness

Check with your doctor right away if you have burning, numbness, tingling, or painful sensations in the arms, hands, legs, or feet. Nuvessa™ is available inside a prefilled applicator. Do not breast-feed within 48 hours after using this medicine. The discharge may be white, dull gray, greenish, and/or foamy.

But, if the woman has repeated infections, treatment of the partner may be helpful.

Other Uses For This Medicine

Tell your doctor if you are pregnant or if you become pregnant while using this medicine. 29 The characteristic vaginal discharge, when present, is usually thick and white. Healthy vaginas come with bacteria in them. Each type of infection requires a specific treatment, and some infections have more than one cause. For these reasons, before you start using metronidazole vaginal gel it is important that your doctor knows: If your vagina is a tropical paradise whose ecosystem gets hit by a rainstorm, is the storm your fault? Unfortunately, our website is currently unavailable in most European countries.

10,38 Consequently, patients with vaginal trichomoniasis should be offered HIV and other STD screening. Trending on medicinenet, he or she will perform a pelvic exam and may do some testing to determine if it’s yeast that’s causing your symptoms. Adults—750 milligrams (mg) once a day for 7 days. For some women, a case of BV will go away on its own in a few days to a week. In this case, a doctor may recommend additional doses of fluconazole or creams that contain boric acid, nystatin, or flucytosine. Also, it may be desirable to use a condom (rubber) during sexual intercourse. The first thing to do is make sure that your infections are indeed due to yeast. An alternative regimen to treat C glabrata is flucytosine vaginal cream one applicator nightly for 14 days.

Women who have a new sex partner or multiple sex partners are at an increased risk for getting BV, although it is occasionally diagnosed in women who have never had sex. Also, pregnant women may have an increased risk of. The normal vaginal is 3. Do not give this medicine to a child without medical advice. If the medicine upsets your stomach, it is best to take it with a meal or snack. Consider choosing alternative foods that are high in fiber and green vegetables, eggs, beans, lean proteins, fish, nuts, and drinking herbal tea. At the first sign of any abnormal discharge or symptoms of vaginitis, such as burning or itching, contact your doctor. The OWH helpline is a resource line.

Trichomonas Vaginalis

For amebiasis infections: Vaginal creams and suppositories for treatment of "yeast" (Candida) infections do not treat BV. You can pass a yeast infection to any sexual partner. Call your doctor right away if you have confusion, drowsiness, fever, a general feeling of illness, a headache, loss of appetite, nausea, a stiff neck or back, or vomiting.

What Are Possible Side Effects of Flagyl?

Trichomoniasis can be cured with a single dose of prescription antibiotic medication (either metronidazole or tinidazole), pills which can be taken by mouth. A usual course of treatment lasts for five consecutive days. A National Institutes of Health study found that pregnant women with BV were more likely to deliver a baby with low birthweight than those without the infection. If you need help planning the best times to take your medicine, check with your doctor. Also, pregnant women may have an increased risk of miscarriage. If you stop using this medicine too soon, your infection may return. (75 percent) for seven to 10 days followed by an application twice a week for four to six months. The discharge usually is thin and dark or dull gray, but may have a greenish color.

Flagyl is a useful antibiotic and is generally well tolerated with appropriate use. After a breastfeeding mother has taken metronidazole, the infant may experience loose stools, especially when the drug is given directly into a vein (intravenously). If that happens, talk you your doctor about treatments. For vaginal dosage form (gel):

Treatment will depend on the cause of the vaginitis. Adults—One applicatorful (500 milligrams [mg]), inserted into the vagina. In retrospect, you realize that the morning office session schedule is going to be fine. She pulls them aside to make sure they understand that it’s a problem caused by bacteria and that their doctor can treat it. If you think you have thrush, speak with your doctor or pharmacist for advice.


Men usually have no symptoms, but can still spread the infection. If bacterial vaginosis was a simple infection, treatment with metronidazole or clindamycin should be very effective. This overproduction of anaerobic bacteria upsets the natural balance of microorganisms and causes the uncomfortable symptoms associated with this condition. You're in good company, since 75 percent of all women have a diagnosis of vaginal yeast infections (vaginal candidiasis) at some point in their lives.

Can I treat BV with over-the-counter yeast infection medications? Use it at bedtime, unless your doctor tells you otherwise. Antibiotic medicines can cause diarrhea, which may be a sign of a new infection.

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Flagyl is also used to treat some protozoal infections. Compared to pregnant women who don't have it, women who have bacterial vaginosis during pregnancy have a higher risk of early (preterm) delivery or of uterine infection after pregnancy. A moderate infection with increasingly uncomfortable symptoms may require treatment and last for a longer period of time. How is BV treated?

Metronidazole comes as a gel to be used in the vagina. Trichomoniasis usually is treated with a single dose of metronidazole by mouth. Symptoms may include a greenish-yellow discharge accompanied by an unpleasant odor and sometimes itching. Pregnant women in their first trimester should avoid Flagyl. Store in a cool, dry place, away from direct heat and light. It is one of the most common types of vaginal infection. When metronidazole is taken by mouth, it can cause side effects in some patients. Then remove the applicator and throw it away (it can be wrapped in toilet paper and disposed of in a waste bin).

What is bacterial vaginosis? Check with your doctor right away if you have dizziness, problems with muscle control or coordination, shakiness or an unsteady walk, slurred speech, or trouble with speaking. Wash your hands afterwards.

Programs and Activities

Learn to tell the difference here. Avoid douching. Wear cotton panties (or panties or pantyhose with cotton crotches) instead of synthetic (eg, nylon or rayon) panties. But, when the beneficial bacteria cannot keep up and bad bacteria overgrow, you can get a bacterial infection, or Bacterial Vaginosis (BV). Gently push on the plunger of the applicator to empty the gel into your vagina. This medicine may be taken as a pill by mouth (orally). Screening and treatment is appropriate for pregnant women with symptomatic BV. 35 Selected long-term regimens are listed in Table 5.