Recurrent Vaginal Yeast Infection Support

Also called recurrent vulvovaginal candidiasis, RVVC, chronic yeast infection, vaginal candidiasis

Recurrent vaginal yeast infection means three or more infections in a year. When a provider prescribes a specific antifungal form, Mixwell in Chino, CA prepares it to their order.

Reviewed by Linda Pungpravat, Compounding Pharmacist, RPh Mixwell Compounding Pharmacy, Chino, CA

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Signs people notice

Itching around the vagina and vulva
Soreness or burning
Pain or discomfort during sex
Burning when urine touches irritated skin
Unusual discharge, often thick and white
Redness or swelling of the vulva
Symptoms that return after treatment

Clinical Overview

What is recurrent vaginal yeast infection?

Recurrent vaginal yeast infection means having three or more symptomatic yeast infections in less than a year. Most are caused by Candida albicans, a yeast that normally lives in small amounts in the body. Some are caused by other Candida species that respond less well to common treatments [1].

Who is more likely to have it

Yeast infections are common. About 75% of women will have at least one, and 40 to 45% will have two or more. Recurrent infection is less common, affecting fewer than 5% of women [1].

Recurrence can happen without a clear reason, or it can be linked to frequent antibiotic use, diabetes, or other health factors. People with diabetes or a weakened immune system are more likely to have complicated infections [1].

Why standard products do not always fit

Over the counter yeast treatments are short courses meant for an occasional, uncomplicated infection [1]. Recurrent infections usually need a culture to identify the yeast, a longer course, and sometimes a medicine that works differently from the common azole drugs [1][2]. Some of those options, such as vaginal boric acid, nystatin, or flucytosine preparations, are prepared by compounding pharmacies to a provider's prescription.

How Compounding Can Help

When a provider prescribes a treatment that is not sold in the form they need, a compounding pharmacy can prepare it.

Vaginal boric acid in the dose form the prescriber orders, for vaginal use only [1][2]
Nystatin vaginal suppositories [2]
Flucytosine cream, alone or with amphotericin B, as named in guidelines for hard to treat yeast [2]
Amphotericin B vaginal suppositories when other options have not worked [4]
Dye free versions and a choice of suppository base

Your provider decides which option, if any, fits your situation, and for how long.

Common Formulas Prescribers Order for This

Suppository · VaginalBoric Acid Vaginal SuppositoryA compounded boric acid vaginal suppository, prepared in Chino, CA to a prescriber's order for recurrent or azole res...Technical details Cream · VaginalNystatin Vaginal Cream (Ellage®)A compounded nystatin vaginal cream in Ellage base, prepared in Chino, CA to a prescriber's order for yeast infection...Technical details Suppository · VaginalAmphotericin B Vaginal SuppositoryA compounded amphotericin B vaginal suppository, prepared in Chino, CA to a prescriber's order for yeast vaginitis th...Technical details

Each formula is prepared only with a valid prescription. Your prescriber decides what is appropriate.

What to ask your provider

Should we do a culture to find out which yeast I have?
Could something other than yeast be causing my symptoms?
Is a longer course or a maintenance plan right for me?
Are any of these treatments unsafe if I am pregnant or planning to be?
Could my other medicines or health conditions be playing a role?
When should I check back if symptoms return?

Call (909) 378-7301

Common Questions

Why does my yeast infection keep coming back?

Having three or more yeast infections in a year is called recurrent infection. It can happen without a clear cause, or be linked to frequent antibiotic use, diabetes, or a less common type of yeast that resists usual treatment. A provider can take a culture to identify the yeast, which helps guide what to use.

Is boric acid used for yeast infections?

Guidelines name vaginal boric acid as an option for certain hard to treat yeast infections, especially those caused by less common Candida species. It is for vaginal use only and must never be swallowed, and it is avoided during pregnancy. Your provider decides whether it fits your situation.

Should I keep using over the counter yeast treatments?

Over the counter treatments are meant for an occasional, uncomplicated infection. If you have three or more infections in a year, or symptoms don't clear, see a provider. Other conditions can cause similar symptoms, and recurrent infections often need a culture and a different plan.

Do I need a prescription for a compounded medication?

Yes. Every compounded preparation is made for one patient with a valid prescription from a licensed prescriber, such as a physician, nurse practitioner, dentist, or veterinarian. If you do not have one yet, ask your provider whether a compounded preparation fits your situation, and they can send the order to us.

Can I use my HSA or FSA to pay for compounded medications?

You should be able to use a health savings account or flexible spending account for compounded medications prescribed for you. We cannot charge veterinary prescriptions to these accounts. Check your plan's rules if you are unsure, and call the pharmacy for pricing.

References

Centers for Disease Control and Prevention. Vulvovaginal candidiasis. Sexually transmitted infections treatment guidelines, 2021. CDC guidelines
Pappas PG, Kauffman CA, Andes DR, et al. Clinical practice guideline for the management of candidiasis: 2016 update by the Infectious Diseases Society of America. Clin Infect Dis. 2016;62(4):e1 to e50. doi:10.1093/cid/civ933
Phillips NA, Bachmann G, Haefner H, Martens M, Stockdale C. Topical treatment of recurrent vulvovaginal candidiasis: an expert consensus. Womens Health Rep. 2022;3(1):38 to 42. doi:10.1089/whr.2021.0065
Phillips AJ. Treatment of non albicans Candida vaginitis with amphotericin B vaginal suppositories. Am J Obstet Gynecol. 2005;192(6):2009 to 2012. doi:10.1016/j.ajog.2005.03.034

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Compounded in Chino, CA. Delivered across California.

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Mixwell Compounding Pharmacy 13788 Roswell Ave, Ste 158, Chino, CA 91710
(909) 378-7301

Mixwell is a state licensed, non sterile compounding pharmacy and a PCCA member, preparing each formula in a lab built to USP 795 and USP 800 standards. Compounded medications are not reviewed or approved by the FDA and are dispensed only with a valid prescription. We do not prepare sterile products or injectables. Nothing here promises a specific result, and compounded preparations are not presented as superior to commercially available products. Mixwell does not accept insurance. Call for pricing.

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