Vaginal Cream and How to Apply It

Vaginal creams are medications that are inserted into the vagina using a provided application device. Some types of vaginal cream are prescribed to treat an infection. Hormonal vaginal cream may be prescribed after menopause or during breastfeeding when low estrogen levels cause vaginal dryness and itching.

How you apply a vaginal cream matters. If the correct steps are not taken, you may not get all of the therapeutic effects the medication has to offer.

This article describes the various types of vaginal creams and their uses. It also walks you through everything you need to know to properly use vaginal cream.

Types of Vaginal Cream and Their Uses

Vaginal creams are available over-the-counter and by prescription for different purposes, including the treatment of:

• Vaginal yeast infection
• Vaginal itching, burning, dryness, inflammation, and painful intercourse due to menopause-related vaginal atrophy
  
• Bacterial vaginosis (BV)—a bacterial infection in the vagina caused by an overgrowth of certain bacteria

Vaginal creams come in cream form, but vaginal ointments and gels are typically lumped into this category too. (Other vaginal medications are available as a suppository—a solid medication that becomes liquid after it is inserted into the vagina.)

Antifungal Vaginal Cream

A yeast infection is an overgrowth of the fungus Candida in the vagina. Most cases can be treated with an over-the-counter (OTC) antifungal vaginal cream or suppository.

Vaginal yeast infection treatments typically come in 1-day, 3-day, and 7-day strengths.

OTC vaginal creams or suppositories that treat vaginal yeast infection include:

• Gyne-Lotrimin (clotrimazole)
• Gynazole (butoconazole)
• Monistat (miconazole nitrate)
• Vagistat (tioconazole)
  

Estrogen Vaginal Cream

When levels of the hormone estrogen dip—as is the case with menopause—vaginal atrophy can occur. Vaginal wall tissue thins, dries, and can become inflamed, which can cause vaginal itchiness, burning, dryness, inflammation, and pain during sex.

An estrogen vaginal cream may be recommended in this case. One such example is Estrace, which contains estradiol—the main estrogen hormone involved in maintaining the reproductive system.

Antibiotic Vaginal Cream

Bacterial vaginosis (BV) is a bacterial infection of the vagina. Your healthcare provider may prescribe a course of antibiotic vaginal cream or gel, such as:

• Cleocin (clindamycin)
• MetroGel-Vaginal (metronidazole)

BV can become a recurring infection, in which case your healthcare provider may prescribe an extended-use metronidazole vaginal gel. The medication is typically used twice daily for 10 to 14 days, followed by twice weekly for three to six months.

When to Apply Vaginal Cream

Using vaginal cream is easiest if it's done before going to bed. This will help the medicine stay in place and prevent daytime discharges. If you need to apply it more than once a day, check the instructions for the timing of your applications.

You may want to wear a panty liner if you are not going to be going to bed immediately after applying the cream. Do not use a tampon when you are using vaginal cream because it can absorb the drug.

Consider setting reminders for yourself so you don't forget to apply your vaginal cream. If you missed a dose, check the instructions to see what to do in case of a missed dose, and if this information isn't provided with your prescription, call your pharmacist to ask.

How to Apply Vaginal Cream

To use a vaginal cream, find a comfortable place where you can lie down while applying the cream. Your bed can be an ideal option, though you may want to place a towel underneath you to prevent any cream from spilling on your linens.

Wash your hands with soap and water and then follow these steps:

1. Open the tube and screw the applicator nozzle onto it. It should be secure, but not overly tight.
2. Gently squeeze the tube from the bottom to push a sufficient amount of cream into the applicator barrel. Make sure it is enough to reach the prescribed dose. (Most applicators provide markings to indicate where you should stop.)
3. Unscrew the applicator from the tube.
4. Lie on your back with your knees drawn toward you.
5. Gently insert the applicator deep into your vagina. (If you are pregnant, do this gently and don't insert the applicator past the point where you feel resistance.)
6. Press the plunger down until it reaches its original position.
7. Wash your hands with soap and water again after applying the cream.

Cleaning the Applicator

Reusable applicators should be cleaned by pulling the plunger to remove it from the barrel and washing it with mild soap and warm water. Wipe it dry and allow it to air dry while disassembled. You can assemble it to store away once it is dry, such as in the morning if you are using it before bedtime.

Never boil your reusable applicator or use extremely hot water, as this can cause the plastic to melt or deteriorate.

If you are using vaginal cream to treat an infection, you should discard the applicator once you have finished your course of treatment. The used applicator could transfer yeast, bacteria, and other microorganisms if you were to reuse it in the future.

Storage and Expiration

Most vaginal creams should be stored at room temperature. Check with your pharmacist if you have questions about storing your vaginal cream.

Many prescription creams are intended for one use only and are not meant to be saved. Check with your healthcare provider if unsure.

If using a vaginal cream saved from before, check the expiration date. Dispose of it if it has expired.