What are the key differences between bacterial vaginosis and yeast infections. How can you identify the symptoms of each condition. What causes BV and yeast infections. How are these vaginal infections diagnosed and treated.

Understanding Vaginitis: The Common Culprit Behind Vaginal Discomfort

Vaginitis, the medical term for inflammation of the vagina, is a common condition that affects many women at some point in their lives. It can cause a range of uncomfortable symptoms, including itching, pain, burning sensations, changes in vaginal discharge, and unpleasant odors. Two of the most frequent causes of vaginitis are bacterial vaginosis (BV) and yeast infections.

How prevalent are these conditions? Studies show that:

• BV accounts for 40-50% of vaginitis cases
• Yeast infections are responsible for 20-25% of cases
• Trichomoniasis causes 15-20% of cases
• The remaining 5-10% are not infection-related

Given their prevalence, it’s crucial to understand the differences between BV and yeast infections to ensure proper treatment and relief.

Bacterial Vaginosis vs. Yeast Infections: Spotting the Differences

While BV and yeast infections can cause similar discomfort, they have distinct characteristics that can help in differentiation:

Bacterial Vaginosis Symptoms:

• Thin, gray or white vaginal discharge, often more noticeable after sexual activity
• A foul-smelling, “fishy” odor
• Discomfort and a burning sensation during urination or intercourse
• Vaginal itching
• No visible redness or inflammation of the vulva

Yeast Infection Symptoms:

• Thick, white discharge resembling cottage cheese in consistency
• No noticeable vaginal odor
• Pain or discomfort, especially during intercourse or urination
• Vaginal itching
• Redness and inflammation of the vulva

Can you have both BV and a yeast infection simultaneously? While uncommon, it is possible to experience both conditions at the same time, which may complicate diagnosis and treatment.

The Root Causes: Understanding BV and Yeast Infection Triggers

To effectively prevent and treat these conditions, it’s essential to understand their underlying causes:

Bacterial Vaginosis Causes:

BV occurs when there’s a disruption in the natural balance of vaginal flora. Normally, beneficial Lactobacillus bacteria outnumber harmful bacteria. However, certain factors can upset this balance, leading to BV:

• Vaginal douching
• Smoking
• New or multiple sexual partners
• Unprotected sex
• Natural deficiency of Lactobacillus bacteria

Yeast Infection Causes:

Unlike BV, yeast infections are caused by an overgrowth of Candida, a type of fungus naturally present in the vagina. Factors that can lead to this overgrowth include:

• Use of hormonal contraceptives
• Pregnancy
• Recent antibiotic use
• Weakened immune system

Is stress a contributing factor to vaginal infections? While stress itself doesn’t directly cause these infections, it can weaken the immune system, potentially making one more susceptible to both BV and yeast infections.

Diagnosing Vaginal Infections: The Doctor’s Approach

Accurate diagnosis is crucial for effective treatment. Here’s how healthcare professionals typically approach diagnosing BV and yeast infections:

1. Medical history review: The doctor will inquire about previous vaginal infections, including sexually transmitted infections.
2. Physical examination: This involves looking for signs of infection and examining vaginal discharge.
3. Sample analysis: A sample of the discharge is taken to check for overgrowth of harmful bacteria or fungi.
4. pH testing: A vaginal pH above 4.5 can indicate BV.

Why might a positive fungal culture not always indicate a yeast infection? Approximately 20% of healthy women naturally have Candida in their vaginas without experiencing symptoms. Therefore, a positive culture alone isn’t always conclusive.

Treatment Strategies: Tackling BV and Yeast Infections

Once diagnosed, BV and yeast infections require different treatment approaches:

Bacterial Vaginosis Treatment:

Doctors typically prescribe antibiotic medications for BV, such as:

• Metronidazole (Flagyl): Available as a pill or vaginal gel
• Clindamycin (Cleocin): A vaginal cream
• Tinidazole (Tindamax): Oral medication

Yeast Infection Treatment:

For mild to moderate yeast infections, antifungal medications are recommended:

• Miconazole (Monistat) or terconazole (Terazol): Available as pills, creams, ointments, or suppositories
• Fluconazole (Diflucan): A single-dose oral medication

For severe cases, a longer course of antifungal medication may be necessary. In cases of resistant Candida strains, special antifungal treatments might be required.

How long does it typically take for symptoms to improve after starting treatment? Most women experience relief within a few days of starting treatment, but it’s important to complete the full course of medication as prescribed.

Prevention Strategies: Keeping Vaginal Infections at Bay

While not all cases of BV and yeast infections can be prevented, certain practices can help reduce the risk:

• Avoid douching
• Wear breathable, cotton underwear
• Practice safe sex
• Maintain good hygiene, but avoid over-washing
• Wipe from front to back after using the toilet
• Consider probiotic supplements or foods
• Limit antibiotic use when possible
• Manage stress levels

Are there any dietary changes that can help prevent vaginal infections? While research is ongoing, some studies suggest that a diet low in sugar and high in probiotic-rich foods may help maintain vaginal health.

When to Seek Medical Attention: Red Flags and Complications

While many cases of BV and yeast infections can be managed with over-the-counter treatments, certain situations warrant immediate medical attention:

• Symptoms persist or worsen after treatment
• Recurrent infections (more than four yeast infections in a year)
• Unusual or foul-smelling discharge
• Fever or severe pelvic pain
• Pregnancy or suspected pregnancy
• History of sexually transmitted infections

Can untreated vaginal infections lead to more serious health issues? Yes, if left untreated, BV and yeast infections can potentially lead to more serious complications, including increased risk of sexually transmitted infections, pelvic inflammatory disease, and pregnancy complications.

Debunking Myths: Common Misconceptions About Vaginal Infections

There are several myths surrounding BV and yeast infections that can lead to confusion and improper self-treatment:

Myth 1: All vaginal infections are sexually transmitted.

Fact: While sexual activity can increase the risk of BV, neither BV nor yeast infections are classified as sexually transmitted infections.

Myth 2: You can get a yeast infection from a toilet seat.

Fact: Yeast infections are not transmitted through contact with toilet seats. The fungus responsible for yeast infections requires a warm, moist environment to thrive.

Myth 3: Eating yogurt can cure a yeast infection.

Fact: While probiotics in yogurt may help prevent yeast infections, they are not a substitute for proper medical treatment once an infection has developed.

Myth 4: Douching helps prevent vaginal infections.

Fact: Douching can actually increase the risk of vaginal infections by disrupting the natural balance of bacteria in the vagina.

Why do these myths persist, and how can they be harmful? Misinformation often spreads through word-of-mouth and unreliable online sources. These myths can be harmful by leading to delayed treatment, improper self-diagnosis, or unnecessary anxiety about vaginal health.

The Impact of Hormones: Understanding the Connection to Vaginal Health

Hormonal fluctuations can significantly influence vaginal health and susceptibility to infections:

Menstrual Cycle:

The risk of both BV and yeast infections can increase during certain phases of the menstrual cycle due to hormonal changes.

Pregnancy:

Pregnant women are more susceptible to both BV and yeast infections due to increased estrogen levels and changes in vaginal pH.

Menopause:

Decreasing estrogen levels during menopause can lead to vaginal dryness and increased risk of infections.

Hormonal Contraceptives:

Some hormonal birth control methods may increase the risk of yeast infections in certain women.

How can women manage these hormonal influences on vaginal health? Maintaining good hygiene, using appropriate lubrication when necessary, and discussing concerns with a healthcare provider can help mitigate the impact of hormonal changes on vaginal health.

The Role of the Immune System in Vaginal Health

A strong immune system plays a crucial role in maintaining vaginal health and preventing infections:

• Balanced immune response helps maintain the proper balance of vaginal flora
• Immune cells in the vaginal mucosa help fight off potential pathogens
• Chronic stress, poor nutrition, and certain medical conditions can weaken the immune system, increasing infection risk

What steps can women take to support their immune system for better vaginal health? A balanced diet rich in vitamins and minerals, regular exercise, adequate sleep, and stress management can all contribute to a stronger immune system and better overall vaginal health.

The Psychological Impact of Recurrent Vaginal Infections

Chronic or recurrent vaginal infections can have a significant psychological impact on women:

• Anxiety and stress about potential recurrence
• Negative impact on self-esteem and body image
• Strain on intimate relationships
• Frustration with ongoing symptoms and treatments

How can women cope with the psychological effects of recurrent vaginal infections? Seeking support from healthcare providers, considering counseling or support groups, and practicing self-care can help manage the emotional toll of chronic vaginal health issues.

Future Directions: Emerging Research and Treatments

The field of vaginal health is constantly evolving, with new research offering hope for improved prevention and treatment strategies:

Microbiome Research:

Studies on the vaginal microbiome are providing new insights into the complex ecosystem of the vagina and how it influences health and disease.

Personalized Treatments:

Advances in genetic testing and microbiome analysis may lead to more personalized approaches to preventing and treating vaginal infections.

Novel Probiotics:

Research into new probiotic strains specifically tailored for vaginal health is ongoing.

Immunotherapies:

Future treatments may focus on boosting the body’s natural immune defenses against vaginal infections.

What potential breakthroughs in vaginal health can we expect in the coming years? While it’s difficult to predict specific breakthroughs, the increasing focus on personalized medicine and microbiome research suggests that more targeted and effective treatments for vaginal infections may be on the horizon.

Understanding the differences between bacterial vaginosis and yeast infections is crucial for proper diagnosis and treatment. By recognizing the unique symptoms, causes, and risk factors associated with each condition, women can take proactive steps to maintain their vaginal health and seek appropriate medical care when needed. As research in this field continues to advance, we can look forward to even more effective strategies for preventing and managing these common vaginal health issues.

Bacterial vaginosis vs. yeast infection: How to tell

Bacterial vaginosis (BV) and vaginal yeast infections can both cause pain and discomfort, difficulty urinating, and itching. Other symptoms, such as vaginal discharge, may differ. Treatment will depend on which infection a person has.

A yeast infection and BV are both infections that cause vaginitis.

Vaginitis is the medical term for inflammation of the vagina. It can lead to uncomfortable symptoms, including:

• itching
• pain
• burning
• changes in vaginal discharge
• a foul-smelling odor

Most females have at least one episode of vaginitis in their lifetimes; it is the most common gynecologic diagnosis in a doctor’s practice.

Below, we describe the differences between BV and a yeast infection. In particular, we explore the symptoms of both issues and the steps a person can take to prevent them.

Share on PinterestInflammation of the vagina is an effect of both BV and yeast infections.
Image credit: Joe Raedle/Getty Images

BV and yeast infections have different causes and risk factors, but both cause inflammation of the vagina — vaginitis. In fact, these infections are two of the most common causes of vaginitis.

When a doctor diagnoses a cause of vaginitis, the cause is:

• BV in around 40–50% of cases
• a yeast infection in 20–25% of cases
• trichomoniasis in 15–20% of cases
• not an infection in the remaining 5–10% of cases

It can sometimes be hard to tell whether a person has BV or a yeast infection, but there are some characteristic signs.

Below, find similarities and differences in the symptoms of BV and a yeast infection:

BV causes

“Vaginal flora” collectively refers to the bacteria that live in the vagina.

Usually, among the vaginal flora, there is more of a type of helpful bacteria, called Lactobacillus, than harmful bacteria.

Certain activities can disrupt the natural balance of the microorganisms in the vagina, and this disruption leads to BV.

Risk factors for BV include:

• vaginal douching
• smoking
• having new or multiple sexual partners
• having sex without a condom
• a natural lack of Lactobacillus bacteria

Yeast infection causes

Bacteria do not cause vaginal yeast infections. Instead, the cause is usually a type of fungus, or yeast, called Candida.

Candida can be naturally present in the vaginal area, but Lactobacillus bacteria usually restrict the growth of Candida.

However, in some situations, Candida multiplies unchecked, leading to a yeast infection.

Risk factors for a yeast infection include:

• using hormonal contraceptives, such as birth control pills
• being pregnant
• having recently taken antibiotics
• having a weakened immune system

To determine whether a vaginal infection is BV or a yeast infection, a doctor may:

• Ask about the person’s medical history, including previous vaginal infections, which may have been sexually transmitted.
• Perform an examinationto look for signs of infection and vaginal discharge.
• Take a sample of the discharge for analysis, to see whether an overgrowth of harmful bacteria or fungi is present.
• Test the pH of the vagina, as a pH of 4.5 or above can indicate BV.

Around 20% of healthy females tend to have Candida in their vaginas, so a positive fungal culture does not necessarily indicate that the fungus is responsible for any symptoms.

The treatments for BV and a yeast infection are different. Also, the right course of treatment can depend on the severity of the infection.

BV treatment

To treat BV, a doctor may prescribe antibiotic medications, such as:

• Metronidazole (Flagyl). This is available as a pill or a vaginal gel.
• Clindamycin (Cleocin). This is a cream that a person inserts into their vagina.
• Tinidazole (Tindamax). This comes in pill form.

Yeast infection treatment

If a person experiences mild to moderate symptoms of a yeast infection, a doctor may recommend one of the following antifungal medications:

• Miconazole (Monistat) or terconazole (Terazol). Both can be pills, creams, ointments, or suppositories — available over the counter or by prescription.
• Fluconazole (Diflucan). This is a prescription, single-dose oral medication.

If a person has a severe yeast infection, a doctor may recommend taking a long course of antifungal medication, involving multiple doses.

Some strains of Candida are resistant to conventional medications. When one of these strains is causing the infection, the doctor will recommend special antifungal treatments.

It is not always possible to prevent BV or a yeast infection. However, doing the following can reduce the risk:

• Not douching. Douching can upset the natural balance of organisms in the vagina, increasing the risk of infection.
• Wiping from front to back. Wiping from front to back after using the bathroom helps prevent harmful bacteria from entering the vagina.
• Wearing cotton underwear. Cotton allows air to flow to the vagina and keeps moisture from collecting and creating an environment in which yeast thrives.
• Avoiding hot baths and hot tubs. Instead, a person could soak in a warm bath or take a shower.
• Drying thoroughly after washing. Rubbing the genitals can cause or worsen irritation, so a person should gently pat the area dry instead.
• Staying away from irritants. Avoiding harsh or scented soap products can help prevent or ease irritation.

BV and a yeast infection can cause similar symptoms, though there are telltale differences.

Different issues cause the two infections, so they require different treatments.

BV results from an overgrowth of harmful bacteria in the vagina, while an overgrowth of Candida fungus causes a yeast infection.

Both infections cause changes in vaginal discharge. BV causes thin discharge with a fishy odor, while a yeast infection causes discharge that is thick and odorless.

Doctors typically recommend antibiotic medications to treat BV and antifungal medications to treat yeast infections. Also, over-the-counter tablets, creams, ointments, and suppositories are available to treat mild to moderate yeast infections.

What does a yeast infection look like? Examples and treatments

The appearance of a yeast infection, or candidiasis, depends on its location. It can cause white patches in the mouth, flaking or crusting of the skin, and changes in genital discharge, which may look like cottage cheese.

In this article, we describe how a yeast infection visibly affects the body. We also look at other symptoms, treatments, and more.

A yeast infection occurs when fungi grow excessively in the body. This is particularly common in moist areas with less exposure, such as the mouth, vagina, or feet.

Often, yeast infections are caused by fungi from the Candida species — and according to the Centers for Disease Control and Prevention (CDC), Candida albicans is the type most likely to overgrow and cause an infection.

A vaginal yeast infection, or thrush, typically causes white discharge that is the texture of cottage cheese.

Other symptoms of a vaginal yeast infection include:

• painful urination
• soreness around the vagina
• inflammation and itchiness of the vagina and vulva
• pain during sex

These infections are common, with up to 75% of females having at least one diagnosed in their lifetimes.

Yeast infections can affect the penis, but this is less common. The symptoms tend to develop on the underside of the penis and include:

• scaling
• inflamed patches of skin
• a painful rash

A yeast infection can also cause inflammation near the head of the penis. This issue is called balanitis.

A person with balanitis may experience burning or itching and yellow or white discharge. In some people, the inflammation spreads to the shaft and the area under the foreskin.

Yeast infections are not considered sexually transmitted infections (STIs). However, it is possible for a person to develop a yeast infection after having oral, anal, or vaginal sex with someone who has the condition, especially if they are especially susceptible.

Around 15% of males who have unprotected sex with females experiencing yeast infections develop the infection themselves.

Oral thrush occurs when yeast grows excessively in the mouth or throat. Typically, a person develops white patches on the tongue, cheeks, back of the throat, or roof of the mouth.

Other symptoms of oral thrush include:

• soreness
• pain while eating or drinking
• a cotton-like feeling in the mouth
• cracked skin at the corners of the mouth
• a loss of taste

Most healthy adults do not develop oral thrush, but yeast infections in the mouth or esophagus are common in people with weakened immune systems.

Wearing dentures, smoking, and having dry mouth also elevate the risk of developing oral thrush.

The appearance of a yeast infection on the skin depends on the location, but this type of infection often causes patches of inflammation. These can vary in shape and size.

Sometimes, these patches itch, flake, or develop crusts, and pustules may appear around the edges.

A yeast infection can occur anywhere on the skin, but is most likely to develop in folds, such as:

• under the breasts
• under the arms
• in the groin
• under or in the buttocks
• in the navel
• on the scalp
• between the fingers and toes

If a yeast infection occurs on the scalp, it can cause crusty lesions that can lead to hair loss. Yeast infections can also cause diaper rash in babies.

Yeast infections can develop beneath the nails. An infected nail may turn white or yellow and start to separate from the nail bed.

When a yeast infection occurs under the nails, a person may experience:

• painful swelling
• pus
• nail loss

In small amounts, Candida fungi are not harmful. Many people have yeast on their skin and in their body. Other types of microbe, such as bacteria, help keep Candida from growing excessively.

However, certain factors can disrupt the body’s ability to keep Candida under control, such as:

• Antibiotics: Because antibiotics kill bacteria, the result may be that Candida fungi grow unchecked.
• Hormonal contraceptives: People who take hormonal birth control that contains estrogen are more likely to develop yeast infections.
• Pregnancy: Similarly, the hormonal changes during pregnancy increase the chances of developing yeast infections.
• A weak immune system: Young babies and people with immune disorders or conditions such as HIV may be more susceptible to yeast infections.
• Medications: Some medications and treatments, including steroids, immunosuppressants, and chemotherapy also weaken the immune system.
• Diabetes: Sugar helps yeast grow, so if a person frequently has high blood sugar levels, they are more likely to develop candidiasis.

Vaginal douches and sprays may also increase the risk of developing a vaginal yeast infection.

The treatment for a yeast infection varies, depending on the infection’s location and severity.

For mild, occasional infections, a person can try over-the-counter options, such as topical creams, nail treatments, or vaginal suppositories.

However, it is important to speak with a pharmacist or doctor first, because the symptoms of a vaginal yeast infection are similar to those of bacterial vaginosis and some STIs.

These issues do not respond to yeast infection treatments. They require different approaches and can cause serious health complications if a person does not receive the necessary care.

Also, frequently using antifungal medicine unnecessarily may reduce how effective it is in the future.

For more severe or reoccurring infections, a person may need prescription antifungal medication.

Pregnant women should not take the antifungal medicine fluconazole (Diflucan), as it may cause birth defects, the Office on Women’s Health report.

Some home care strategies may help reduce yeast infection symptoms or prevent the issue from coming back.

Probiotic yogurt may help reduce the amount of yeast in the body. A 2013 pilot study involving 24 women showed that eating 8 ounces of probiotic yogurt per day reduced the presence of Candida in some cases.

However, this was a small study with mixed results. Also, the women had HIV, so their health responses may not reflect those of the general population.

Addressing the cause of the infection is important, especially if the infection keeps coming back. A person may benefit from:

• using a condom during sex
• avoiding the overuse of antibiotics
• switching to a different method of birth control
• better managing underlying conditions, such as diabetes

A person should talk to a doctor if they notice symptoms of a yeast infection.

It is important to receive the right treatment for any infection, and correctly identifying the type of infection is the first step.

Yeast infections often cause changes to genital discharge and patches to form in the mouth or in skin folds.

A doctor can confirm the infection and recommend the best treatment, depending on the severity and the part of the body involved.

what are there and how to choose

The human body is inhabited by many microorganisms that are in a state of necessary balance and coexistence with the host. This balance helps them mutually survive. Any shift in one direction or another, arising from an increase in the number of individual representatives of microorganisms, leads to a violation of the overall composition of the vaginal microflora, and as a result, the emergence of diseases ¹ . So, with excessive reproduction of yeast-like fungi of the genus Candida, candidiasis (“thrush”) develops – an infectious disease of the mucous membranes and mycosis when the skin is damaged by this pathogen.

Fungal infection of the vulva and vagina is called vulvovaginal candidiasis.

In Russia, vaginal candidiasis ranks second among all infectious lesions of the vagina ² . In the USA and European countries, up to 13 million cases of this disease are registered annually ³ .

Symptoms of vaginal candidiasis (thrush)

As a rule, active reproduction of yeast-like fungi Candida manifests itself:

• itching and burning in the perineum
• swelling and intense redness
• cottage cheese-like discharge from the vagina
• pain during urination and during intercourse
• increased symptoms after showering, before menstruation and during pregnancy

In a complicated form of vulvovaginal candidiasis, small bubbles with a cloudy liquid, which are called “vesicles”, may appear. They can burst and form damage to the surface layer of the skin – the epithelium ⁴ .

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Causes that provoke the appearance of thrush

Active reproduction of Candida fungi begins due to the influence of the following adverse factors, such as:

• Taking medications acceptives, corticosteroids, chemotherapy
• Chronic diseases accompanied by a decrease in immunity: oncology, chronic inflammation of the uterus
• Endocrine diseases : diabetes mellitus, hypothyroidism synthetic tissues, use of an intrauterine device, damage to the tissues of the vagina
• Physiological : pregnancy, menopause
• Psychological : stress, chronic fatigue
• Other : dysbacteriosis, metabolic disorders, climate change, non-compliance with the rules of intimate hygiene

The presence of these factors is not a prerequisite for the occurrence of “ thrush “, but the likelihood of its occurrence and a more severe course of the disease significantly increases. Effective treatment should be complex, that is, not only suppress fungi Candida , but also eliminate the causes that provoked their growth.

Diagnosis of vaginal candidiasis

Diagnosis is carried out by a gynecologist based on visual examination, patient complaints and laboratory test results that identify the type of fungi, their number and response to various antifungal drugs. The combination of these methods allows you to choose the most effective treatment.

Vaginal candidiasis can be acute or chronic. The acute form of candidiasis is characterized by pronounced manifestations of the disease, and the duration does not exceed two months. If the treatment is chosen incorrectly, the disease may last longer or constantly return. Then the disease has a chronic course. Therefore, it is very important to choose the right drug for treatment, which will not cause fungi to become addicted to it.

How to treat vaginal candidiasis (thrush)?

For the treatment of thrush, both systemic agents (tablets for oral administration) and local agents are used, which are injected directly into the site of infection – vaginal suppositories and tablets, irrigation solutions, ointments.

The most commonly used in gynecological practice are vaginal suppositories, the main advantages of which are:0022

What are the suppositories for thrush

The main difference between vaginal suppositories is a different active substance, due to which there are different therapeutic effects.

Conventionally, drugs that are part of suppositories for thrush can be divided into the following groups:0022

Consider the mechanisms of action and properties of suppositories based on the above drugs.

Candles against thrush based on antiseptics

Povidone-iodine (Betadine®)

Povidone-iodine is an antiseptic. It is a complex of iodine and povidone. Thanks to this formula, upon contact with the skin and mucous membranes, active iodine is gradually released from povidone, which ensures a long-term effect of the drug ⁵ .

The mechanism of action of the drug is based on the inactivation and destruction of the main proteins and enzymes that make up the cells of harmful microorganisms. As a result, a fungicidal effect occurs – the death of the fungus. Most pathogens can die within 1 minute ⁶ . Biofilms are combinations of microorganisms that create a protective “dome” that prevents the penetration of drugs. Candles Betadine ^® based on povidone-iodine demonstrate efficacy against such microorganisms that are capable of forming biofilms.

Often, the ineffectiveness of the treatment of thrush is associated with the “addiction” of fungi to a particular drug. According to the results of studies, povidone-iodine does not cause the development of resistance – the insensitivity of microorganisms to the effects of drugs ⁷ .

It happens that candidiasis (thrush) is combined with other infections, such as bacterial vaginosis. The wide spectrum of action of suppositories Betadine ^® allows you to treat even such concomitant diseases.

For the treatment of vaginal candidiasis, 1 suppository is inserted into the vagina at night for 7 days. Before treatment, it is necessary to consult a doctor, as the drug has contraindications.

Thus, suppositories based on povidone-iodine (Betadine ^® ) meet the modern requirements of medicines. The drug in many patients demonstrates good tolerance ⁹ , and also supports the ability to restore the vaginal microflora ⁸ .

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Vaginal tablets based on dequalinium chloride

Dequalinium chloride is an antiseptic preparation, the mechanism of action of which is based on the disruption of the fungal cell enzymes, which subsequently leads to the death of the fungal cell.

The drug is active against gram-positive and gram-negative bacteria , fungi and viruses. Has an anti-inflammatory effect.

For the treatment of thrush 1 vaginal tablet is administered intravaginally for 6 days ¹³ . You must complete the full course.

Disadvantages of the drug: in case of excessive dryness of the vagina, there is a possibility that the tablet will remain undissolved, local reactions of irritation, itching, burning or redness of the vaginal mucosa may be observed.

It should be noted that today there is a decrease in the effectiveness of a number of antiseptics that have a chlorine-containing molecule ¹⁰ .

Suppositories for thrush based on drugs of the azole group

Suppositories based on sertaconazole

Sertaconazole is a derivative of imidazole and benzothiophene. The drug is active against yeast-like fungi of the genus Candida , streptococci and staphylococci ¹⁴ .

Sertaconazole has a triple action : inhibits the growth and reproduction of fungi (fungistatic action), causes the death of fungi (fungicidal action) and does not suppress the viability of the main representatives of the normal vaginal microflora – beneficial lactobacilli.

When administered topically, sertaconazole has a direct effect on fungi in the lesion. At the same time, it is not absorbed into the bloodstream, which means a high safety profile of the drug.

Mechanism of action of sertaconazole is to inhibit the synthesis of ergosterol and increase the permeability of the fungal cell membrane, which leads to its death.

For the treatment of thrush, suppositories with sertaconazole are used 1 time by inserting 1 suppository into the vagina. If symptoms persist, it is possible to re-introduce 1 suppository after another 7 days.

Suppositories based on ketoconazole

Ketoconazole is an antimycotic (antifungal) drug of the azole group.

Mechanism of action has a fungistatic and fungicidal effect.

However, fungal resistance to ketoconazole may develop and the disease may become chronic with exacerbations.

For the treatment of thrush, 1 suppository is inserted into the vagina for 3-5 days ¹⁵ .

It is important to follow the treatment regimen prescribed by the doctor, since incomplete therapy can contribute to the development of a chronic form of the disease.

Anti-thrush suppositories based on polyene antibiotics

Natamycin suppositories

Natamycin is an antifungal polyene antibiotic. It has a wide spectrum of antifungal activity, causes the death of fungi.

The mechanism of action of natamycin is based on disruption of the integrity and functioning of fungal cell membranes. The drug is active against most yeast fungi of the genus Candida. Dermatophytes – mold fungi are less sensitive to natamycin .

Apply the drug by inserting one suppository into the vagina 1 time / day at night for 3-6 days ¹⁶ .

The duration of the course is determined by the attending physician. It is not recommended to interrupt treatment immediately after the disappearance of symptoms.

Suppositories for thrush based on combined preparations

Suppositories based on the combination of nystatin + nifuratel

Suppositories based on nystatin and nifuratel are antimicrobial agents. This combination allows you to increase the spectrum of antibacterial action and enhance the antifungal effect. Also, the drug has antimicrobial and antiprotozoal activity.

The agent does not disturb the vaginal microflora, but helps to restore it. This allows you to avoid the occurrence of dysbacteriosis and cure diseases caused by a violation of the vaginal flora.

In the treatment of thrush, 1 suppository at bedtime is inserted into the upper part of the vagina for 8 days. During menstruation, the use of suppositories is suspended and resumed after the completion of critical days.

Suppositories based on the combination of metronidazole + miconazole

Combination preparation for vaginal use with antifungal, antibacterial and antiprotozoal activity.

The combination of these drugs allows you to actively influence the membrane of fungal cells, causing their death, as well as treat infections caused by several microorganisms.

The agent is injected into the vagina 1 suppository in the morning and evening for 7 days. There may be a local reaction in the form of itching, burning, irritation of the vaginal mucosa.

Conclusion

Before using any suppositories, you should consult with your doctor, since each drug has contraindications and its own dosage regimen, depending on the individual characteristics of the course of the disease.

Of course, it is worth giving preference to preparations with a broad spectrum of action, active against fungal biofilms, which remain effective against even drug-resistant microorganisms (for example, suppositories Betadine ^® based on povidone-iodine, suppositories based on sertaconazole).

Molchanov Oleg Leonidovich

Gynecologist, reproductive specialist, doctor of medical sciences.

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References

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2. Kokoeva D. N., Medzhidova M. K., Domova N. A., Kan N. E., Tyutyunnik V. L. Prevention of preterm birth in pregnant women with vaginal candidiasis// Medical Council. 2019;(7):52-56.
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19. Instructions for medical use Neo-penotran, suppositories, radar.

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