Yeast Infection Treatment: Pill vs Cream

Vaginal yeast infections are very common, especially in women of childbearing age. According to the American Academy of Family Physicians, an estimated 75% of women will have at least one vaginal yeast infection in their lifetime. Extreme itchiness in and around the vagina is the most common symptom of a vaginal yeast infection. However, besides vaginal itching, other yeast infection symptoms include burning, redness, swelling, an odorless cottage cheese-like vaginal discharge, pain with sex, and pain with urination.

Both prescription and over-the-counter medications are available to treat vaginal yeast infections and relieve symptoms. These medications come in various forms, such as pills, creams, and suppositories. Please continue reading to find out the pros and cons of using different yeast infection treatments.

What causes vaginal yeast infections?

Vaginal yeast infections occur when there is an overgrowth of a yeast called Candida albicans in the vagina, causing inflammation. Candida (yeast) is a type of fungus that is normally present in the vagina. However, under certain circumstances, such as stress, illness, and the use of certain medications, the balance of microorganisms is altered and affects vaginal health.

The risk of vaginal yeast infections is high during pregnancy and in women with diabetes or an impaired immune system, for example, from an HIV infection. Also at risk are women who take hormonal oral contraceptives and certain medications such as antibiotics (antibiotics reduce the number of harmful bacteria in the vagina, allowing fungi like Candida to thrive). There are several risk factors for yeast infections related to lifestyle as well, such as stress, douching, wearing tight or synthetic clothes that rub against the vaginal opening, and using non-breathable panty liners or sanitary pads, which allow the yeast to grow uncontrolled.

Yeast infections usually clear up after a short course of treatment with antifungal medications. These medications are available as creams and vaginal suppositories. Sometimes, it is necessary to take antifungal medication in the form of oral pills to treat yeast infections.

What is the treatment for a vaginal yeast infection?

One course of treatment with an antifungal drug is usually effective in treating a yeast infection. The infection treatment can be in the form of a cream applied locally using an applicator or a suppository, a medication that melts once placed inside the vagina. Antifungal drugs are also available in pill form.

The duration of treatment for vaginal yeast infections depends on the specific product used and is usually 1-7 days. Side effects of topical yeast infection treatments include burning and itching.

Sometimes, it is necessary to take an oral tablet to treat vaginal yeast infections. This is usually a single-dose treatment. However, infection treatment with a pill can lead to drug interactions with other medications and cause side effects such as headache, nausea, and diarrhea. Also, oral yeast infection treatments may not be safe for use during pregnancy.

Note: Bacterial vaginosis is a vaginal infection caused by bacteria. These vaginal infections do not respond to yeast infection treatment. A healthcare provider can make a correct diagnosis and offer appropriate treatment.

Should I see my doctor for a yeast infection?

If you get recurrent yeast infections or are at risk of complications from a vaginal yeast infection, for example, due to a weakened immune system, you should seek medical advice at the first sign of yeast infection symptoms. Do not continue treating yeast infections with OTC medications without talking to your provider. You may need more intensive treatment with prescription antifungal pills for several months if you have repeated infections.

Is vaginal candidiasis a sexually transmitted infection?

Vaginal candidiasis is not considered a sexually transmitted infection because you can get it without having sex. However, you can get a yeast infection from a sexual partner. Partners of women with vaginal yeast infections do not usually need to be treated. However, treatment may be necessary if your partner has a genital yeast infection as well.

Does the pill or cream work better for yeast infections?

Clinical evidence suggests that both the pill and the cream work equally well for vaginal yeast infections. Yeast infection treatments work by decreasing the synthesis of ergosterol, an essential component of the fungal cell wall. This allows essential nutrients to leak from the fungus, preventing the fungus from thriving and helping to control yeast overgrowth. Both prescription and OTC treatments are available for vaginal treatment in various forms.

Monistat (miconazole) is an OTC treatment that comes in the form of a vaginal cream to be applied using an applicator, vaginal ovule^Ⓡ, an egg-shaped medication to be inserted into the vagina, and a suppository, a medication that melts once placed inside the vagina. The treatment course is for 1, 3, or 7 days depending on the strength of the antifungal medication. Other OTC medications for a vaginal yeast infection include clotrimazole and tioconazole.

Diflucan (fluconazole) is an oral treatment for vaginal yeast infections. This is a prescription medication taken by mouth. Oral medications work in a similar way by decreasing ergosterol formation in fungal cell walls. Diflucan is available as a prescription pill in 50 mg, 100 mg, 150 mg, and 200 mg strengths as well as an oral suspension and injection solution. You need to be evaluated by a physician before starting Diflucan prescription treatment. However, specifically for vaginal yeast infection, Diflucan (fluconazole) is available as a 150 mg one-time dose that usually relieves yeast infection symptoms. More severe infections of vaginal candidiasis may require two or three doses taken 3 days apart.

Is Monistat cream or pill better?

Some women prefer yeast infection pills because they are less messy and need to be taken only once as a single dose for uncomplicated cases. However, the pill is a prescription medication and requires evaluation by a healthcare provider.

Creams and suppositories, on the other hand, can be messy to apply and require yeast infection treatment for more than one day. However, these OTC treatments can be purchased without a doctor’s prescription to treat symptomatic yeast infections.

Medications such as Monistat (miconazole) and Diflucan (fluconazole) are only effective against fungal infections. They will not cure a bacterial infection; therefore, antifungal medications like Monistat and Diflucan will not be effective against bacterial vaginosis (BV). Your healthcare provider may prescribe an antibiotic for you. Yeast infection medication only works against fungal infection.

Vulvovaginal candidiasis is the medical term for vaginal yeast infection. If you have recurrent vulvovaginal candidiasis, meaning you have at least 4 vaginal yeast infections in a year, you should make an appointment to see your healthcare provider instead of continuing to self-treat with OTC products. Your healthcare provider will make a proper diagnosis and give you the appropriate medication.

Which is better: Monistat cream or ovule?

Topical yeast infection medicines are available as creams, suppositories, and ovules^Ⓡ. Yeast infection creams and yeast infection suppositories are both equally effective. Keep in mind that the cream can be applied externally or into the vagina using an applicator.

These different forms of Monistat can be confusing to some people. However, just remember that the same tube of Monistat cream can be applied outside of the vagina using clean fingertips to relieve itchiness and irritation outside of the vagina. Applicators are included with Monistat cream; you can screw the applicator nozzle to the tube, then gently squeeze the tube to push the medicated cream into the applicator. Finally, you can insert the applicator vaginally and then press the plunger down to administer the cream.

Unlike the vaginal cream, the suppository is ready to be used. Suppositories are designed to be melted once placed inside the vagina to deliver the medication.

The ovule is an egg-shaped product that is inserted into the vagina. It is available as a 1-day or 3-day treatment that provides fast symptom relief. The ovule^Ⓡ sticks to the vaginal wall and is a particularly good option for women who lead active lifestyles and do not want to wait until bedtime to start yeast infection treatment. The Monistat ovule comes with a contoured disposable applicator.

Ultimately, it comes down to personal preference when taking yeast infection medication. When choosing between the different topical forms, you can choose vaginal creams, a vaginal suppository, or a vaginal ovule based on what you find the most comfortable to use. The treatment duration (1 day, 3 days, or 7 days) may also be a deciding factor. The 1- and 3-day regimens are recommended for mild symptoms, and the 7-day regimen for more severe symptoms. Again, it is important to seek a medical opinion if you have recurring yeast infections. Your provider may recommend taking oral medication instead of an antifungal cream, suppository, or ovule.

Is Monistat as effective as Diflucan?

Both Monistat (miconazole) and Diflucan (fluconazole) are effective treatment options for a vaginal yeast infection. Women who have recurring yeast infections often find the yeast infection pills to be the most convenient as they only require a single-dose treatment for most non-complicated cases. In addition, Diflucan (oral medication) has slightly higher cure rates compared to an antifungal cream.

Can you treat yeast infections with home remedies?

Treating yeast infections with capsules or suppositories that contain preventive probiotics, garlic cloves, tampons soaked in tea tree oil, etc., to try and restore the natural balance of flora in the vagina is not recommended. These home remedies are not proven to be safe or effective. Also, these treatment options can cause allergic reactions and irritated skin.

Boric acid may be a safe alternative for women with recurrent vulvovaginal candidiasis due to a resistant strain when conventional treatments fail. It is available OTC and by prescription in the form of vaginal capsules and suppositories to be inserted into the vagina. The treatment course is usually 14 days. The boric acid capsule should never be taken by mouth because it can be very toxic. There are reported deaths in adults and children due to accidental boric acid ingestion.

It is best to use antifungal medications that are approved by the U.S. Food and Drug Administration (FDA) for symptom relief from vulvovaginal candidiasis (vaginal yeast infection). Take the medication as soon as symptoms begin, and consult your doctor if you have recurring yeast infections or if you are pregnant.

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