Being a woman is so much fun. Sarcasm aside, I wouldn’t trade it for anything. But there are aspects of the architecture/engineering of our bodies that I take issue with, that have only been compounded by the centuries of gaslighting we’ve been shown regarding the often painful treatment courses we get, all while being told it “shouldn’t be anything more than we can handle.” Our standard of healthcare shouldn’t be excruciating to begin with. I’m encouraged by the news of the self-administered pap smears coming our way in the fall, and I really enjoyed everyone’s comments on that story. So let’s keep talking healthy vaginas! The Mayo Clinic says three out of four women will be affected by yeast infections at some point (or many) in their lives. Monistat is the common over-the-counter treatment, and it comes in seven, three, or one-day courses. Some doctors are advising against the one-day, though, because it has 12 times the active ingredient (miconazole) as the seven-day. This can result in unpleasant symptoms, even after the infection is gone.

The one-day treatment can cure the infection, but still leave you with discomfort: Dr. Brandye Wilson-Manigat says she’s seen this a lot. She’s an OB-GYN in the Los Angeles area. She says patients come in thinking the one-day treatment they’d tried didn’t work. An exam would show the medication had cleared the yeast infection but then caused its own problems. “I would just explain that it was kind of like a contact dermatitis, where the treatment led to this kind of inflammatory response.”

The over-the-counter options: When you’re at the pharmacy with a yeast infection, looking for relief, there are usually three options — a seven-day version, a three-day version and a one-day version. All use miconazole, an antifungal medication. The most common brand name in Monistat. The one-day version of the medicine has 12 times the active ingredient as the seven-day cream. Guidelines from the CDC say any of these work equally well to clear yeast infections, although, “local burning or irritation might occur.” Many patients don’t report any side effects, but those who do describe them in colorful language. Product reviews and forum posts use words like agony and hot lava. One poster wrote that it burns, “like the fire of a thousand suns.”

Other causes, factors, & treatments: Prestige Brands, which distributes Monistat, declined to comment for this story. Dr. Jen Gunter, a San Francisco Bay area OB-GYN and author, notes it could be that women who pick a one-day treatment are more inflamed to begin with, or maybe they didn’t have a yeast infection in the first place. That’s quite common. There is an oral medication to treat yeast infections called fluconazole, or Diflucan. That requires a prescription, which can be a barrier. Dr. Libby Wetterer, a professor of family medicine at the University of Pennsylvania, says the rationale for why the pill needs a prescription is that overuse could lead to drug-resistant microbes. She tries to make getting the oral pill as easy as possible. “For patients irritated and they’ve had a history of yeast infection, I would trust the person and their body and send them that prescription, often without seeing them.”

[From NPR]

Bless you Dr. Libby Wetterer for trusting women’s accounts of their own bodies. What a novel idea! So, my reading of this is that there’s no way to know ahead of time if you’ll be one of the lucky few who experience the side effects of agony, lava, or the burning of “a thousand suns.” But the one-day option likely increases the chances of a reaction, given the higher concentration of the medicine? As always, check in with your own doctor to discuss the best course of treatment for you. These could include over-the-counter miconazole or clotrimazole or prescription fluconazole. The original NPR story also noted that doctors suggested keeping the medicine cream in the refrigerator for more relief. I tell you, it feels like we’ve been getting a lot of women’s health news updates lately. And they’re great, but also a little overwhelming! I’m thinking it may be time for me to crack open my hefty copy of Our Bodies, Ourselves, instead of just using it to prop up my laptop for Zoom calls…

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