Self-medication with vaginal antifungal drugs: Physicians’ experiences and women’s utilization patterns
Abstract
BACKGROUND: In many countries, vaginal antifungal drugs have been released on over-the-counter (OTC) markets, yet little is known about women's management of their symptoms. OBJECTIVES: The aim of this study was to judge the appropriateness of self-medication with vaginal antifungal drugs by examining utilization patterns and physicians' experiences of women's self-medication. METHODS: An anonymous questionnaire survey was carried out in 20 pharmacies in Finland of women buying OTC vaginal antifungal drugs in 1997. Out of the 453 questionnaires distributed, 299 (66%) were returned. A survey of a random sample of gynaecologists (n = 169) and specialists in general practice (n = 288) was carried out in 1996. The response rate was 77%. RESULTS: Nearly all women had used vaginal antifungal drugs previously, 49% during the previous 6 months. Most women did not report any difficulties with treatment, but 44% of women used the drug against recommendations. Half of the women had symptoms that are more likely to be related to infections other than Candida. Physicians had observed several disadvantages of self-treatment, with unnecessary use and use for the wrong indications being the most often reported. In all, 31% of gynaecologists and 16% of GPs reported that these adverse events had been clinically significant, with delay in the treatment of other infections being the most common problem. CONCLUSION: The results raise concerns about inappropriate use and women's ability to self-diagnose correctly. Because vaginal antifungal drugs are likely to remain on OTC markets, two ways to address these concerns are for physicians and pharmacy personnel to provide spontaneous information and to have more informative advertisements on vaginal antifungal drugs.
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Erroneous self-diagnosis and treatment with antifungals delay proper diagnosis and timely treatment of candidosis, as well as other gynecological conditions.
“Erroneous self-diagnosis and treatment with antifungals delay proper diagnosis and timely treatment of candidosis, as well as other gynecological conditions (Sihvo et al., 2000).”
From Management of recurrent vulvovaginal candidosis: Narrative review of the literature and European expert panel opinion (2022) · cites this paper as Sihvo et al., 2000
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Cites
Kushner (2021) · doi:10.12788/jfp · Cited by 3,799 · see citing works
The Journal of Family Practice
Geyman, J. P. (1997) · American Journal of Family Therapy · doi:10.1080/01926189708251066 · Cited by 3,088 · see citing works
The Limited Value of Symptoms and Signs in the Diagnosis of Vaginal Infections
Schaaf, V. M. (1990) · Archives of Internal Medicine · doi:10.1001/archinte.1990.00390200111021 · Cited by 133 · see citing works
Evolving Pathogens in Vulvovaginal Candidiasis: Implications for Patient Care
Horowitz, B. J., Giaquinta, D. B., & Ito, S. (1992) · The Journal of Clinical Pharmacology · doi:10.1002/j.1552-4604.1992.tb03833.x · Cited by 97 · see citing works
Women's use of over-the-counter antifungal medications for gynecologic symptoms.
Ferris, D. G., Dekle, C. L., & Litaker, M. S. (1996) · PubMed · Cited by 82 · see citing works
General practitioners' views on over the counter sales by community pharmacists: Table 1
Erwin, J., Britten, N., & Jones, R. (1996) · BMJ · doi:10.1136/bmj.312.7031.617 · Cited by 52 · see citing works
Fortnightly Review: Management of genital candidiasis
Denning, D. W. (1995) · BMJ · doi:10.1136/bmj.310.6989.1241 · Cited by 37 · see citing works
Women's experiences of general practitioner management of their vaginal symptoms.
O’Dowd, T. C., Parker, S. M., & Kelly, A. (1996) · PubMed · Cited by 31 · see citing works
Management of genital candidiasis
White, D. J., & Drake, S. M. (1995) · BMJ · doi:10.1136/bmj.311.7005.629a · Cited by 25 · see citing works
Physicians' perceptions of the impact of the reclassification of vaginal antifungal agents.
Ca, T., & Lipsky, M. S. (1994) · PubMed · Cited by 18 · see citing works
Physicians' Attitudes Toward Reclassifying Drugs As Over-the-Counter
Sihvo, S., Hemminki, E., & Ahonen, R. S. (1999) · Medical Care · doi:10.1097/00005650-199905000-00011 · Cited by 16 · see citing works
Self-citationThe use of over-the-counter antifungal vaginitis preparations by college students.
Lipsky, M. S., & Taylor, C. (1996) · PubMed · Cited by 14 · see citing works
Infectious vaginitis. Selecting therapy and preventing recurrence.
Goode, M. A., Grauer, K., & Gums, J. G. (1994) · PubMed · Cited by 7 · see citing works
Goode, M. A., Grauer, K., & Gums, J. G. (1994) · Postgraduate Medicine · doi:10.1080/00325481.1994.11945924 · Cited by 6 · see citing works
Developmentally disabled people as a culture.
Chicoine, B. (1993) · PubMed · Cited by 1 · see citing works
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Research works printed but not linked: 2
- Sihvo S, Hemminki E, Ahonen R. Physician's attitudes toward re- classifying drugs as over-the-counter. Med Care 1999; 37: 518-525.
- Kabongo ML. Problems with over-the-counter vaginal preparations. Am Fam Physician 1993; 48: 579.
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Global burden of recurrent vulvovaginal candidiasis: a systematic review
Denning, D. W., Kneale, M., Sobel, J. D., & Rautemaa-Richardson, R. (2018) · The Lancet Infectious Diseases · doi:10.1016/s1473-3099(18)30103-8 · Cited by 639 · see citing works
Donders, G., Sziller, I. O., Paavonen, J., Hay, P., de Seta, F., Bohbot, J. M., Kotarski, J., Vives, J. A., Szabo, B., Cepuliené, R., et al. (2022) · Frontiers in Cellular and Infection Microbiology · doi:10.3389/fcimb.2022.934353 · Cited by 82 · see citing works
Trends in prescribing for vulvovaginal candidiasis in the United States
McCaig, L. F., & McNeil, M. M. (2005) · Pharmacoepidemiology and Drug Safety · doi:10.1002/pds.960 · Cited by 18 · see citing works
- Authors
- Sihvo, S., Ahonen, R., Mikander, H., & Hemminki, E.
- Affiliations
- University of Eastern Finland (FI)
- University of Helsinki (FI)
- Venue
- Family Practice
- Publisher
- Oxford University Press (OUP)
- Published
- 2000-04-01
- Volume
- 17
- Issue
- 2
- Pages
- 145-149
- ISSN
- 0263-2136 (ISSN-L)
- 1460-2229
- OpenAlex
- W2033884841
- Cited by
- 72
- References
- 15
- Citations by year
- 2025: 3 · 2024: 1 · 2023: 2 · 2022: 2 · 2021: 1 · 2020: 1 · 2018: 3 · 2017: 3 · 2016: 2 · 2015: 3 · 2014: 4 · 2013: 1 · 2012: 2
- FWCI
- 3.93
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Family Practice (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Life Sciences › Pharmacology, Toxicology and Pharmaceutics › Pharmacology › Pharmacy and Medical Practices
- Life Sciences › Immunology and Microbiology › Applied Microbiology and Biotechnology › Antibiotic Use and Resistance
- Life Sciences › Immunology and Microbiology › Microbiology › Reproductive tract infections research
- Keywords
- self-medication, over-the-counter drugs, inappropriate medication use, women's health, physician experience, gynecologists, general practitioners, self-diagnosis, candidiasis, drug utilization patterns, pharmaceutical advertising
- MeSH terms
- Adolescent, Adult, Aged, Antifungal Agents, Attitude of Health Personnel, Candidiasis, Vulvovaginal, Drug Utilization, Nonprescription Drugs, Family Practice, Female, Finland, Gynecology, Humans, Middle Aged, Physicians, Surveys and Questionnaires, Self Medication
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