introduction

About 75% of all women suffer from vaginal yeast at least once in their life. About 10% of symptomatic women even have a chronic, relapsing course in which vaginal yeast infections can occur up to 4 times a year. Excruciating itching, pain and an unpleasant smell are the result of the annoying fungus. Understandably, there is great interest in medication and treatment options for vaginal thrush.

Read more on the topic: Eczema in the genital area - causes, treatment & more, itching in the vagina

The vaginal fungus, which is also known as Candidal vulvovaginitis can be treated with various drugs. A distinction is made between locally effective and systemically effective drugs. There are also different groups of active ingredients that can be used depending on the severity of the symptoms. The following article answers important questions about the topic of "drugs against vaginal thrush". The most important drugs are presented and explained in more detail with regard to interesting aspects.

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What groups of active ingredients are there?

The vaginal fungus is one of the so-called Mycoses or fungal infection. Medicines that are directed against fungal infections are known as Antifungal drugs. Within the antimycotics there are different groups of active substances, some of which differ in terms of their effect and chemical structure.

The so-called imidazole derivatives are an important group. These are so-called broad-spectrum antimycotics, which are intended for local use, e.g. in the form of a cream. The term "broad spectrum" means that the drug is effective against many different types of fungi.

In the case of vaginal thrush, the active ingredients clotrimazole (Canesten®) and miconazole are used from this group of active ingredients. In the case of vaginal thrush, these drugs are used as a cream or vaginal suppository.

Another important group of active ingredients are the polyenes. A representative from this group, which is used in vaginal thrush, is nystatin.

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The last important group of active ingredients are the triazole derivatives. From this group, the active ingredients itraconazole and fluconazole are used to combat vaginal fungus. However, this group of active substances is only suitable for systemic therapy. This means that the medication is taken in the form of tablets and not applied locally, for example in the form of creams or suppositories.

cream

Various creams are available to treat vaginal thrush. These contain antifungal agents such as clotrimazole, econazole or nifuratel. The duration of the application of vaginal creams varies from a few days to a week. They are often combined with vaginal suppositories or vaginal tablets. There are both non-prescription and prescription-only (see above) products that differ in the dosage or the type of active ingredient.

When using creams in the genital area, it is important to apply them thoroughly. Both the outer and inner labia, the perineum and, in some cases, the entrance to the vagina should be covered with plenty of cream in order to completely catch the fungus.

Read more on the topic: Anti-inflammatory cream

Suppositories

The treatment of vaginal thrush often includes the use of vaginal suppositories. These are inserted deep into the vagina, where they release their active ingredient. Vaginal suppositories exist with various active ingredients such as clotrimazole, econazole, nifuratel or fenticonazole. Vaginal suppositories are usually used over a period of 3 to 6 days.

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A combined treatment with a cream for external use in the intimate area with the same active ingredient is often carried out.

Some suppositories exist as depot preparations that only have to be introduced once. They release the active ingredient in such a way that a sufficient concentration of the active ingredient is present for 72 hours. Vaginal suppositories are common for both over-the-counter and prescription drugs.

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What over-the-counter medications are there?

There are some over-the-counter medications available from pharmacies for vaginal thrush. This includes, for example, Canesten, which many women are familiar with from advertising or the pharmacy. This product, which exists in different versions (see Canesten section), contains the active ingredient clotrimazole, which is effective against many types of fungus.

Another very well-known product that is available without a prescription is the KadeFungin. This product also exists in different versions, which mostly consist of a combination of vaginal suppositories and a cream for external use. Like Canesten, KadeFungin contains the active ingredient clotrimazole.

Another product available without a prescription is "Fenizolan 600 mg Vaginalovulva". This vaginal suppository contains the active ingredient fenticonazole, which attacks the vaginal fungus. A single application is sufficient for this preparation.

The product "Vagisan Myko Kombi" is a combination of a vaginal suppository and a cream, both of which contain the same active ingredient - clotrimazole. As with “Fenizolan”, with “Vagisan Myko Kombi” a single application is sufficient

Canesten

The "Canesten" product line from the manufacturer "BAYER" is geared towards the treatment of various fungal diseases, including vaginal thrush. The so-called "Canesten GYN" products are available for treating vaginal thrush. These all contain the active ingredient clotrimazole, which intervenes in the metabolism of the fungus and disrupts the formation of the cell membrane. This damages the fungus and combats the infection.

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Canesten products are available in pharmacies without a prescription and must therefore be paid for privately. There are various products that should usually be used for 3 days. They are either vaginal suppositories, creams or a combination of both. Experience has shown that Canesten products are very well tolerated due to the mild dosage of the active ingredient.

There is also a depot suppository that only needs to be used once. This is available under the trade name "Canesten Gyn Once Kombi". The suppository only needs to be inserted once and maintains a sufficient level of active ingredient for 72 hours.

Even after treatment with Canesten, the success of the treatment should be checked again by a gynecologist. In some cases, treatment with over-the-counter medications is inadequate and cure is not achieved. If this is the case, the gynecologist will prescribe additional medication.

Vagisan

The Vagisan product range consists of various over-the-counter medicines and care products for the intimate area, which can be used, among other things, for vaginal thrush. The product "Vagisan Myko Kombi" contains a vaginal suppository and cream with the active ingredient clotrimazole. This product is effective directly against vaginal thrush. The suppository only needs to be inserted once. The combination pack also contains a cream that can be applied to the genital area for a week.

Apart from this directly effective preparation, there are various care products and lactic acid products that have a positive effect on the vaginal flora and can be used to prevent vaginal yeast infections or for aftercare. One example of such a product is “Vagisan Lactic Acid”. Consisting of 7 or 14 capsules, it is usually used over a period of about a week to maintain or restore the natural pH of the vagina. It is also suitable for preventing vaginal infections from recurring.

What prescription drugs are there?

There are a number of different prescription drugs that are used to treat vaginal thrush. This differentiates from over-the-counter drugs either a higher dose of the active ingredient or the type of active ingredient itself. In the following section, important prescription drugs that are used to treat vaginal thrush are presented. For a better overview, the drugs are sorted by active ingredient.

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  • Clotrimazole: Important prescription drugs that contain the active ingredient clotrimazole include "Canesten Gyn 6-Tage", "Clotrimazol AL 100", "Fungizid Ratiopharm Vaginal Cream 1%" or "Antifungol HEXAL". What these drugs have in common is that they are used either as a cream or as a vaginal tablet. They differ from over-the-counter drugs in that they are used for a longer period of time or that the dosage of the active ingredient clotrimazole is higher.
  • Fluconazole: The active ingredient fluconazole is only contained in prescription drugs. Examples are “Fluconazol STADA 50 mg / 100 mg / 150 mg hard capsules”, “Fungata” or “Fluconazol Ratiopharm”. Fluconazole is only taken as a tablet and does not exist as a cream or vaginal suppository.
  • Miconazole: There is a product called "Gyno Daktar", which is available either only as a vaginal cream or as a cream in combination with vaginal suppositories. The active ingredient is miconazole.
  • Econazole: With the active ingredient Econazole various products with the name "Gyno-Prevaryl" are available. This drug also exists either individually as a vaginal suppository or in combination with a topical cream. The application periods also differ.
  • Nifuratel: The prescription drug "Inimur" contains the active ingredient Nifuratel. Creams, coated tablets as well as vaginal suppositories and combination packs are available.
  • Itraconazole: If the external application of medication does not help against a vaginal thrush, there is the possibility of therapy with "SIROS capsules". These contain the active ingredient itraconazole and are taken orally.

What medication can I take during pregnancy?

Pregnancy represents a state of emergency for women and requires special care when using medication. There are well-tolerated drugs that can be used during pregnancy without hesitation, but also drugs that must not be used. In principle, you should also keep your hands off over-the-counter medications during pregnancy, unless the use has been expressly discussed with your doctor or pharmacist with regard to the pregnancy.

Read more on the topic: Vaginal fungus in pregnancy, drugs during pregnancy

Vaginal yeast infections should also be treated during pregnancy. Preparations with the active ingredients nystatin or clotrimazole are permitted. Other active ingredients are usually contraindicated and must not be used. When using clotrimazole (e.g. KadeFungin®) 200 mg vaginally, as a suppository, are recommended for a period of 3 days. These should be inserted vaginally in the evening before going to bed. Alternatively, 100 mg vaginally in the evening for a period of 5–7 days or 500 mg vaginally as a single dose are possible. In addition, a cream with clotrimazole should be used. This usually has to be applied thinly 2 to 3 times a day for a period of 2 to 3 weeks. The active ingredient nystatin is also applied as a cream 2 to 3 times a day over a period of 2 to 3 weeks. Vaginal thrush should always be treated by a gynecologist during pregnancy.

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Read more on the topic: Skin diseases during pregnancy

Home remedies

There are many myths that persist when it comes to “home remedies for vaginal thrush”. Many of them are not only ineffective, but even potentially harmful. You should definitely refrain from bathing in hip baths with “medicinal herbs” such as chamomile, horsetail or myrrh. Allergic reactions and worsening of the condition due to an impairment of the vaginal flora can result. The fungus is unimpressed by such home remedies and ultimately only therapy is missed. The same applies to rinsing with vinegar or lemon, which are also often touted.

Only treatment with natural yoghurt can be useful in some cases. With the help of its natural lactic acid bacteria, this should help restore the vaginal flora. However, yogurt is only helpful in combination with drug therapy. Before use, the gynecologist should be asked whether he considers yogurt therapy to be useful. Usually, natural yoghurt only helps to restore the vaginal flora after successful drug therapy of the fungus. In this case, it is applied thinly to the vagina for a few days in the evening and washed off with lukewarm water in the morning.

yogurt

Many gynecologists recommend natural yoghurt as a natural means of restoring the pH value of the vagina in the case of vaginal fungus.This contains lactic acid bacteria, which are very important for the vaginal flora and the acidic pH value of the vagina. If the vagina is infected, this natural environment is disturbed and must be restored. This is why the recommendation often follows, apart from drug therapy, to cream the vagina with natural yoghurt.

It is important to use natural milk yoghurt and not soy yoghurt. The yogurt is usually applied in the evening over a period of about a week. The next morning, the remains can be removed with lukewarm water. However, aggressive shower gels or soaps should not be used as they alter the pH level and promote infection.


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