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I have a 50+ year history of chronic vaginal yeast infections. They have increased in frequency. I've done it all....Monistat topical for years, Yeast allergy diet and oral nystatin, then fluconazole came out and I was thrilled. I also had an episode of bacterial vaginosis and was put on boric acid capsules. I did that for several years but then stopped as I seemed to be in a good place. But within the last few years my infections increased in frequency (I would take the usual course of fluconazole) and my insurance company denied coverage for the new drug Vivjoa which is about $2800 out of pocket for 18 tablets. So, as a result I was put on an extended treatment of fluconazole 150mg every other day. That worked until recently when I had a breakthrough infection. I then used a course of Terconazole 0.8% topical for 3 days. It cleared up only to become symptomatic again 3 days later. I went to my gyn today and had a culture done which honestly, no one ever suggested before. I am 71 and sexually active/monogamous. My partner is asymptomatic. I am so tired of thinking about my vagina all the time and for the wrong reasons. I have a strong libido as does my partner and this sure gets in the way. I am kinda at my wits end, I gotta say.

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Yeast infections at age 71 are uncommon, not unheard of, but uncommon, so the very first step is a culture to confirm it is indeed yeast; if the culture is positive for Candida albicans, then it is essential to get sensitivities so your doctor knows what the yeast can be treated with.

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Hi Dr Jen, I suffer from chronic yeast. I’ve done two rounds of long-term therapy (of fluconazole) but they come back once I stop the medication. Is it safe to be on maintenance therapy for longer than 6 months at a time? Also, does it matter if it’s 150 mg fluconazole vs 200 mg? Thank you

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This article really explains the pros and cons of this treatment very clearly. Excellent info.

My impertinent comment: I got a wee laugh at the sentence that began, “ It can only be prescribed to people who can get pregnant by physicians …”

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Ha! I need a comma there

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Thanks so much for this post. I am post menopausal and have been dealing with recurrent yeast for a long time. This gives me some hope.

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The most important thing is getting a culture so you know what yeast and if it is Candida albicans making sure they do sensitivity testing

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