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Vaginal Clotrimazole

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Vaginal clotrimazole is used to treat vaginal yeast infections in adults and children 12 years of age and older. Clotrimazole is in a class of anti fungal medications called imidazoles. It works by stopping the growth of fungi that cause infection.

How should this medicine be used?

Vaginal clotrimazole comes as a tablets to be inserted into the vagina. It also may be applied to the skin around the outside of the vagina. The cream is inserted into the vagina once a day at bedtime for 3 or 7 days in a row, depending on the product instructions.

The cream is used twice a day for up to 7 days around the outside of the vagina. Follow the directions on the package or your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Use clotrimazole exactly as directed. Do not use more or less of it or use it more often than directed on the package or prescribed by your doctor.

Vaginal clotrimazole is available without a prescription (over the counter). If this is the first time you have had vaginal itching and discomfort, talk to a doctor before using clotrimazole. If a doctor has told you before that you had a yeast infection and you have the same symptoms again, use the vaginal cream as directed on the package.

Do not have vaginal intercourse or use other vaginal products (such as tampons, douches, or spermicides) during your treatment.

You should begin to feel better during the first three days of treatment with clotrimazole. If your symptoms do not improve or get worse, call your doctor.

To apply the clotrimazole cream to the outside area around the vagina, use your finger to apply a small amount of cream to the affected area of skin.

To insert the clotrimazole tabs vaginally , read the instructions provided with the medication and follow these steps:

Fill the special applicator that comes with the cream/tablet to the level indicated.

Lie on your back with your knees drawn upward and spread apart or standing with your feet far apart and knees bent.

Gently insert the applicator into the vagina, and push the plunger to release the medication.

Withdraw the applicator.

Discard the applicator if it is disposable. If the applicator is reusable, pull it apart and clean it with soap and warm water after each use.

Wash your hands promptly to avoid spreading the infection.

The dose should be applied when you lie down to go to bed. It works best if you do not get up again after applying it except to wash your hands. You may wish to wear a sanitary napkin while using the vaginal cream to protect your clothing against stains. Continue using clotrimazole vaginal cream even if you get your period during treatment.

What special precautions should I follow?

Before using vaginal clotrimazole,

tell your doctor and pharmacist if you are allergic to clotrimazole, any other medications, or any of the ingredients in clotrimazole vaginal cream. Ask your pharmacist for a list of the ingredients.

tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Your doctor may need to change the doses of your medications or monitor you carefully for side effects.

tell your doctor if you have lower stomach, back, or shoulder pain. fever, chills, nausea, vomiting, or foul-smelling vaginal discharge; been exposed to or have human immunodeficiency virus (HIV) or acquired immunodeficiency syndrome (AIDS); or have had frequent vaginal yeast infections (once a month or 3 or more infections in 6 months).

tell your doctor if you are pregnant, plan to become pregnant, or are breastfeeding. If you become pregnant while using clotrimazole, call your doctor.

you should know that condoms and diaphragms may be weakened if they are used during your treatment with vaginal clotrimazole. Because of this, these devices may not be effective at preventing pregnancy or sexually transmitted diseases if you use them during your treatment.

What side effects can this medication cause?

Clotrimazole may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

increased burning, itching, or irritation of the vagina

Some side effects can be serious. If you experience any of the following symptoms, stop using clotrimazole and call your doctor immediately:

rash

hives

stomach pain

fever

chills

nausea

vomiting

foul-smelling vaginal discharge

What other information should I know?

Keep all appointments with your doctor.

Ask your pharmacist any questions you have about clotrimazole.

If you still have symptoms of infection 7 days after starting treatment with clotrimazole, call your doctor.

It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a

hospital. It is also important information to carry with you in case of emergencies.

Pelvic Inflammatory Disease

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This is an infection of the female reproductive organs. It usually occurs when sexually transmitted bacteria spread from your vagina to your uterus, fallopian tubes or ovaries. Many women who develop pelvic inflammatory disease either experience no signs or symptoms or don’t seek treatment. Pelvic inflammatory disease may be detected only later when you have trouble getting pregnant or if you develop chronic pelvic pain.

Symptoms

Signs and symptoms of pelvic inflammatory disease may include:

Pain in your lower abdomen and pelvis
Heavy vaginal discharge with an unpleasant odor
Irregular menstrual bleeding
Pain during intercourse
Fever
Painful or difficult urination
PID may cause only minor signs and symptoms or none at all. PID with mild or no symptoms is especially common when the infection is due to chlamydia.

When to see a doctor

Go to the emergency room if you experience the following severe signs and symptoms of PID:

Severe pain low in your abdomen
Vomiting
Signs of shock, such as fainting
Fever, with a temperature higher than 101 F (38.3 C)

If your signs and symptoms aren’t severe, but they’re persistent, see your doctor as soon as possible. Vaginal discharge with an odor, painful urination or bleeding between menstrual cycles can be associated with a sexually transmitted infection (STI). If these signs and symptoms appear, stop having sex and see your doctor soon. Prompt treatment of an STI can help prevent PID.

Causes

Pelvic inflammatory disease can be caused by a number of bacteria but are most often caused by gonorrhea or chlamydia infections. These bacteria are usually acquired during unprotected sex.

Less commonly, bacteria may enter your reproductive tract anytime the normal barrier created by the cervix is disturbed. This can happen after intrauterine device (IUD) insertion, childbirth, miscarriage or abortion.

Risk Factors of Pelvic inflammatory disease

A number of factors may increase your risk of pelvic inflammatory disease, including:

Being a sexually active woman younger than 25 years old
Having multiple sexual partners
Being in a sexual relationship with a person who has more than one sex partner
Having sex without a condom
Having had an IUD inserted recently
Douching regularly, which upsets the balance of good versus harmful bacteria in the vagina and may mask symptoms that might otherwise cause you to seek early treatment
Having a history of pelvic inflammatory disease or a sexually transmitted infection

Complications

Untreated pelvic inflammatory disease may cause scar tissue and collections of infected fluid (abscesses) to develop in your fallopian tubes and damage your reproductive organs. Complications may include:

Ectopic pregnancy. PID is a major cause of tubal (ectopic) pregnancy. In an ectopic pregnancy, the fertilized egg can’t make its way through the fallopian tube to implant in the uterus. Ectopic pregnancies can cause massive, life-threatening bleeding and require emergency surgery.
Infertility. PID may damage your reproductive organs and cause infertility — the inability to become pregnant. The more times you’ve had PID, the greater your risk of infertility. Delaying treatment for PID also dramatically increases your risk of infertility.
Chronic pelvic pain. Pelvic inflammatory disease can cause pelvic pain that may last for months or years. Scarring in your fallopian tubes and other pelvic organs can cause pain during intercourse and ovulation.

Tests and Diagnosis

Doctors diagnose pelvic inflammatory disease based on signs and symptoms, a pelvic exam, an analysis of vaginal discharge and cervical cultures, or urine tests.

During the pelvic exam, your doctor uses a cotton swab to take samples from your vagina and cervix. The samples are sent to a lab for analysis to determine the organism that’s causing the infection.

To confirm the diagnosis or to determine how widespread the infection is, your doctor may recommend other tests, such as:

Ultrasound. This test uses sound waves to create images of your reproductive organs.
Endometrial biopsy. During this procedure, your doctor removes a small piece of your uterine lining (endometrium) for testing.
Laparoscopy. During this procedure, your doctor inserts a thin, lighted instrument through a small incision in your abdomen to view your pelvic organs.

Treatment and Drugs

Treatment for pelvic inflammatory disease may include:

Antibiotics. Your doctor may prescribe a combination of antibiotics to start taking right away. After receiving your lab test results, your doctor may adjust the medications you’re taking to better match what’s causing the infection.

Usually, your doctor will request a follow-up visit in three days to make sure the treatment is working. Be sure to take all of your medication, even if you start to feel better after a few days. Antibiotic treatment can help prevent serious complications but can’t reverse any damage that’s already been done.

Treatment for your partner. To prevent reinfection with an STI, advise your sexual partner or partners to be examined and treated. Partners can be infected and not have any noticeable symptoms.
Temporary abstinence. Avoid sexual intercourse until treatment is completed and tests indicate that the infection has cleared in all partners.
More-serious cases

Outpatient treatment is adequate for treating most women with pelvic inflammatory disease. However, if you’re seriously ill, pregnant or haven’t responded to oral medications, you may need hospitalization. At the hospital, you may receive intravenous (IV) antibiotics, followed by antibiotics you take by mouth.

Surgery is rarely necessary. However, if an abscess ruptures or threatens to rupture, your doctor may drain it.

In addition, surgery may be performed on women who don’t respond to antibiotic treatment or who have a questionable diagnosis, such as when one or more of the signs or symptoms of PID are absent.

Erectile Dysfunction

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ED is the inability to get and keep an erection firm enough for sex for an averagely normal period of time. Erectile dysfunction remains a reproductive health concern to men.

Having erection trouble from time to time isn’t necessarily a cause for concern. If erectile dysfunction is an ongoing issue, however, it can cause stress, affect your self-confidence and contribute to relationship problems.

Problems getting or keeping an erection can also be a sign of an underlying health condition that needs treatment and a risk factor for heart disease.

If you’re concerned about erectile dysfunction, talk to your doctor — even if you’re embarrassed. Sometimes, treating an underlying condition is enough to reverse erectile dysfunction. In other cases, medications or other direct treatments might be needed.

Symptoms of Erectile Dysfunction

Erectile dysfunction symptoms might include persistent:

Trouble getting an erection

Trouble keeping an erection

Reduced sexual desire

When to see a doctor

A family doctor is a good place to start when you have erectile problems. See your doctor if:

You have concerns about your erections or you’re experiencing other sexual problems such as premature or delayed ejaculation

You have diabetes, heart disease or another known health condition that might be linked to erectile dysfunction

You have other symptoms along with erectile dysfunction

Causes of Erectile dysfunction

Male sexual arousal is a complex process that involves the brain, hormones, emotions, nerves, muscles and blood vessels. Erectile dysfunction can result from a problem with any of these. Likewise, stress and mental health concerns can cause or worsen erectile dysfunction.

Sometimes a combination of physical and psychological issues causes erectile dysfunction. For instance, a minor physical condition that slows your sexual response might cause anxiety about maintaining an erection. The resulting anxiety can lead to or worsen erectile dysfunction.

Physical causes of erectile dysfunction

In many cases, erectile dysfunction is caused by something physical. Common causes include:

Heart disease

Clogged blood vessels (atherosclerosis)

High cholesterol

High blood pressure

Diabetes

Obesity

Metabolic syndrome — a condition involving increased blood pressure, high insulin levels, body fat around the waist and high cholesterol

Parkinson’s disease

Multiple sclerosis

Certain prescription medications

Tobacco use

Peyronie’s disease — development of scar tissue inside the penis

Alcoholism and other forms of substance abuse

Sleep disorders

Treatments for prostate cancer or enlarged prostate

Surgeries or injuries that affect the pelvic area or spinal cord

Low testosterone levels

Psychological causes of erectile dysfunction

The brain plays a key role in triggering the series of physical events that cause an erection, starting with feelings of sexual excitement. A number of things can interfere with sexual feelings and cause or worsen erectile dysfunction. These include:

Depression, anxiety or other mental health conditions

Stress

Relationship problems due to stress, poor communication or other concerns

Risk factors of Erectile Dysfunction

As you get older,

Various risk factors can contribute to erectile dysfunction, including:

Medical conditions, particularly diabetes or heart conditions

Tobacco use, which restricts blood flow to veins and arteries, can — over time — cause chronic health conditions that lead to erectile dysfunction

Being overweight, especially if you’re obese

Certain medical treatments, such as prostate surgery or radiation treatment for cancer

Injuries, particularly if they damage the nerves or arteries that control erections

Medications, including antidepressants, antihistamines and medications to treat high blood pressure, pain or prostate conditions

Psychological conditions, such as stress, anxiety or depression

Drug and alcohol use, especially if you’re a long-term drug user or heavy drinker

Complications

Complications resulting from erectile dysfunction can include:

An unsatisfactory sex life

Stress or anxiety

Embarrassment or low self-esteem

Relationship problems

The inability to get your partner pregnant

Prevention of Erectile dysfunction

The best way to prevent erectile dysfunction is to make healthy lifestyle choices and to manage any existing health conditions. For example:

Work with your doctor to manage diabetes, heart disease or other chronic health conditions.

See your doctor for regular checkups and medical screening tests.

Stop smoking, limit or avoid alcohol, and don’t use illegal drugs.

Exercise regularly.

Take steps to reduce stress.

Get help for anxiety, depression or other mental health concerns.