Yeast infections can be painfully distressful. Unfortunately, certain over-the-counter remedies may backfire on you and worsen the situation further.

At first, choosing an overnight solution might seem appealing; but doctors and patients caution that taking such measures for vaginal yeast infections could cause discomfort and burning in as little as one day. On NPR’s show “Vaginal Health Matters: From Vaginitis to PAP Treatment” on January 27, Selena Simmons-Duffin/NPR discusses this.
Dr. Stephanie Arnold received an urgent phone call from one of her patients complaining of discomfort that made them seek an urgent appointment the same day, suggesting a yeast infection was likely. But there was something strange going on: She used over-the-counter treatment that only provided temporary relief; yet still experienced symptoms a week later? Arnold examined the patient, took a swab sample to examine under microscope, found no yeast or bacteria, suggested chemical irritation was likely the problem: she told the patient in return to exam room: she thought medicine used may have cleared infection but made discomfort worsening while medicine meant for treating infections could actually worsened their burning sensation while medicine intended to treat infections made her symptoms worse as they cleared symptoms without actually treating infections; rather, medicine would likely clear infections quickly while making burning sensation worse while simultaneously clearing infections with burning sensation.
Vulvovaginal candidiasis accounts for an estimated annual cost of treatment totalling an estimated $368 Million and results in more than one million outpatient visits annually. Fungus infections are extremely widespread: 70% of women will contract at least one yeast infection during their reproductive years. Patients seeking relief at their pharmacy usually find three types of miconazole topical antifungal medication — 7-day version, 3-day version and 1-day version — available. Each version carries 100 mg of active ingredient while 1-day versions typically provide 1,200 mg. Dr. Brandye Wilson-Manigat, an OB/GYN in Los Angeles area who treats many similar cases to Arnold’s patient, reports seeing many instances where Monistat or generic medications have been effective against similar complaints as Arnold. “Usually what I saw were patients coming in thinking the medication did not work as promised because of continuing symptoms of burning, irritation and swelling,” according to she reveals. She says when she examined these patients after one-day treatments had worked, often finding no longer any yeast infections present. “The treatment led to some kind of an inflammatory response which eventually reversed itself,” says Sutter.
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Patients often describe symptoms like irritation and burning using more colorful language; one Reddit thread was entitled: “Monistat 1 Burning like the Fire of a Thousand Suns”, while a product review described their experience as similar to being inside “scorching Hot Lava.” Wilson-Manigat states there are no formal recommendations regarding which strength of treatment to utilize; she makes an effort, however, to discuss potential risk factors with patients taking antibiotics or at risk for yeast infections. “Typically I warn them and say: ‘Hey if you need over-the-counter medication for acne relief, make sure not to buy just 1-day; use 7 or 3-day’.” Prestige Brands, who distribute Monistat, declined comment for this story. Dr. Jen Gunter of San Francisco Bay Area OB-GYNs and author of The Vagina Bible cautions that any anecdotal accounts are misleading as there have been studies comparing 1-day and 7-day Monistat head to head and their outcomes are similar as far as side effect concerns go; she writes in an email to NPR. She suggests there could be other explanations for more reports of problems related to 1-day therapies: We don’t know, for instance, whether women who opt for 1-day therapies experience more inflammation so any product would likely be more irritating; Gunter notes this possibility and adds that patients often misdiagnose themselves with yeast infections so it could also be possible that “they used inappropriate therapy and experienced irritation as a result. (Consulting with your physician beforehand would ensure you treat what needs treating).) An exam at their office would provide the most definitive proof.)
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Dr. Stephanie Arnold examines fluid samples taken from patients for signs of yeast or bacteria contamination. Eliza Nadworny of NPR provides this image.
Monistat 1 patient information states: Despite their namesake, 1-day versions don’t always solve issues quicker; according to its patient information sheet for Monistat 1, most women experience some improvement within 1 day and full relief by 7 days; thus the “1-Day Versions” designation represents how many applicators or ovules you use versus how quickly relief comes. According to package inserts, relief typically takes around a week no matter which version is taken.
Oral medication available through prescriptionThere’s another oral option for treating yeast infections; fluconazole (Diflucan). While in the U.S. this prescription must be obtained before being purchased or consumed; Canada doesn’t currently impose this restriction. Dr. Libby Wetterer, assistant professor of family medicine at University of Pennsylvania, often recommends oral medications as her preferred choice for her patients. Wetterer believes the main factor preventing it from being sold over-the-counter is similar to why antibiotics don’t – out of concern that its overuse would create drug resistant microbes – thus making getting their pills as easy as possible for her patients. She makes getting their medicine as convenient for her patients. “If someone was feeling uncomfortable and had had previous yeast infection issues and messaged me saying they suspected having one, then I would trust their judgement and send them the prescription,” according to this physician, noting that not all doctors work this way. Dr. Stephanie Arnold of Richmond prescribed steroid cream as topical treatment for one patient suffering from yeast infections; “this should help calm things down”, Arnold told her before suggesting they keep it chilled for added relief.