Treatments for Vaginal Infections

Vaginal infections are more common after menopause. That's because lower estrogen levels typically mean higher vaginal pH levels. The pH scale measures how acidic or basic a substance is. This scale ranges from zero to 14. Seven is considered neutral, so anything lower than seven is more acidic and anything higher than 7 is less acidic and more basic. When the vagina is less acidic, it’s less able to keep bacteria under control, which increases your risk of infection and inflammation.

The most common infections that might affect someone after menopause include vaginal yeast infections, bacterial vaginosis, and urinary tract infections (UTIs). 

If you think you have a vaginal infection, see your doctor so you can figure out the exact cause. Self-diagnosis is never a good idea. Not only is trying to diagnose yourself not accurate, but it can also lead to more stress and delays in care. Your doctor can diagnose which type of vaginal infection you have so you can get the most effective treatment.

A vaginal yeast infection is a fungal infection that causes burning, itching, and redness in and around the vagina. A vaginal yeast infection can also change the consistency of your vaginal discharge, generally causing it to become thicker and whiter.

The vagina has a balanced amount of yeast, including candida, and bacteria. Certain bacteria keep yeast from growing too quickly. When the balance is disrupted and healthy yeast grows out of control, it can lead to a vaginal yeast infection.

Your doctor can diagnose a vaginal yeast infection based on your symptoms and by taking a sample of vaginal discharge for testing. This test can not only confirm a yeast infection but also identify the type of fungus causing the infection so your doctor can prescribe a more effective treatment.

Yeast infections usually respond well to anti-fungal medicines, which can be in the form of pills, creams, or vaginal suppositories. These creams and suppositories are applied directly into the vagina and typically need to be used for a few days to a week. Examples include Monistat and Terazol. Another option is a single or double dose of an oral medicine called Diflucan (chemical name: fluconazole).

Bacterial vaginosis is a bacterial infection caused by an overgrowth of normal bacteria in your vagina. It can also cause other symptoms, like itching, pain with sex, and pain with urination, which might make you think you have a vaginal yeast infection.

The vagina has bacteria called flora that help keep it healthy. When there are more good bacteria (called lactobacilli) than bad bacteria (called anaerobes) it means your vaginal flora is balanced. When there are more bad bacteria, it means the vaginal flora is out of balance, which can lead to bacterial vaginosis.

A pelvic exam lets your doctor check for signs of infection. Your doctor can diagnose bacterial vaginosis based on your symptoms and/or by taking a sample of vaginal discharge for testing to see if the vaginal cells have an overgrowth of bacteria. The doctor may also test the pH of your vaginal fluid, as a more basic pH (>4.5) is associated with bacterial vaginosis.

Bacterial vaginosis can be treated with antibiotics taken by mouth, with cream or suppositories inserted into the vagina. All of these bacterial vaginosis treatments require a prescription. Common choices include Flagyl (chemical name: metronidazole) and Cleocin (chemical name: clindamycin).

If you have pain, discomfort, or vaginal discharge, see your doctor immediately so you can figure out the exact cause. Your doctor can confirm whether you have a vaginal infection or whether your symptoms are from something else, like vaginal dryness, genitourinary syndrome of menopause (formerly known as vaginal atrophy), or a sexually transmitted infection. If you’re getting vaginal infections frequently, you may find it helpful to use a vaginal moisturizer. You can apply vaginal moisturizers directly to your vagina daily or several times a week to help lower pH levels.