Dr. Jen Gunter

Anyway, how politics gets involved with women's health, we don't see that with men's health.

So I think that's actually the biggest issue is that the politicking of women's health.

Yeah, so if somebody's coming in and they give you a history for, you know, they have, so first of all,

a white discharge and an unreliable sign of a yeast infection.

So somebody's got itching, they've got burning, pain with sex, something like that.

If it keeps recurring, you need a culture because you need to know that's really what it is because there are other things that can absolutely present like that.

So you need to get a culture.

If the culture is positive, then you need to know if it's sensitive or resistant.

And you can ask the lab to run sensitivity testing.

And if it's sensitive, then you put them on the standard regimen that Jack Sobel initially published in the New England Journal of Medicine, where you would take a dose of fluconazole today, one in three days.

You can still do your third one three days later, and then once a week.

And whether you should do that for six months or a year, we don't have good data to say otherwise.

I usually ask people kind of how they feel about it.

It's a really safe medication.

If you have a resistance strain, so the MIC for fluconazole is, you know, generally over four or comes back and says, you know, that it's resistant, then obviously you need to come up with a different agent.

And usually we default to boric acid for that.

We used to use Brexifem, but it's not available anymore.

whichever drug company is making that, please get on that because this has really been a problem.

And if the culture is negative, then, you know, what you want to do is, well, did I catch the patient at the right time?

You know, maybe she had symptoms that are gone away, but also make sure they don't have any redness or anything on their vulva that would go.