ZocdocAnswersDoes oral anti-fungal medication work?

Question

Does oral anti-fungal medication work?

I have a fairly serious yeast infection, and my doctor just prescribed an oral anti-fungal medication. I'm 32, and I've always treated my yeast infections with topical creams. Do these pills really work? I'm skeptical.

Answer

The diagnosis and management of candida vulvovaginitis (yeast infection) should involve the care of specialists including internists, obstetricians / gynecologists, and others. Candida is a common form of yeast that is populates the lower genital tract of a large percentage of healthy women without symptoms. And the symptoms of vulvovaginitis are equally very common. Risk factors for acquiring yeast infections include diabetes, antibiotics, immunocompromised states, certain contraception devices (such as vaginal sponges, diaphragms, and intrauterine devices), and certain sexual behaviors. The diagnosis can be made in a doctor's office by examination of the vagina and the vaginal discharge. This can be distinguished between other causes for vaginitis. In general, for uncomplicated infections, generally both oral and vaginal medications are similarly effective. Topical formulations can cause local burning or irritation but oral preparations can cause gastrointestinal distress, rash, and potentially some lab abnormalities. Oral medications can take a day or two longer for symptomatic relief but some patients prefer it due to ease. For severe symptoms, a more prolonged course of topical therapy or pills may be indicated. For such severe symptoms, there isn't good data to guide which (topical or oral) is better but given the convenience of therapy, pills are generally recommended. The diagnosis and management plan can not be done without seeing the patient in person. It is the strong recommendation to be evaluated by an internist or obstetrician / gynecologist in person.

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