THIS MEDICATION IS UNLIKELY TO CAUSE HARM TO YOUR BABY:
Available studies have found no association between topical or intra-vaginal miconazole use during pregnancy and birth defects. Topical miconazole is not expected to pose a risk of harm to your baby, and it is considered compatible with breastfeeding. As with any medication used during pregnancy or while breastfeeding, it is important to consider the potential benefits to the mother and risks to the baby before using the medication.
What is Monistat?
Monistat is a topical antifungal medication that is currently available as both generic and brand name medications. Monistat is available as a intra-vaginal/topical cream or suppository and is applied once at bedtime for 3 to 7 days. The active ingredient in Monistat is miconazole. Miconazole is also available as an oral tablet, powder, spray, and solution for oral fungal infections and Athlete’s foot, jock itch, and ringworm. Miconazole is also found in combination products. It is available over-the-counter and by prescription from your doctor.
What is Monistat used to treat?
Monistat is used to treat vaginal yeast infections in children over 12 years old, adolescents, and adults. Vaginal yeast infections can occur during pregnancy due to changes in hormones and other chemicals in the body. Symptoms of a vaginal yeast infection can include redness, soreness, painful intercourse, discomfort during urination, and vaginal discharge. Seven days of topical miconazole is recommended in pregnant women with vaginal yeast infections. You can read more about vaginal discharge and vaginal yeast infections during pregnancy here.
How does Monistat work?
Miconazole works by damaging the fungal cell membrane, leading to fungal death.
If I am using Monistat, can it harm my baby?
Small studies have found no association between topical miconazole use during pregnancy and birth defects. Absorption of topical miconazole into the body is expected to be minimal. Because further study is required, it is recommended to avoid first trimester use of vaginal miconazole and the widespread use of topical miconazole on the skin during pregnancy. However, intra-vaginal miconazole is recommended as a first-line treatment for vaginal yeast infection in pregnant women. Oral miconazole is not recommended during pregnancy unless the potential benefit outweighs possible risks.
Evidence from animal studies with miconazole:
Oral miconazole exposure in pregnant rats and rabbits caused toxicity in the offspring, longer gestation time, and abnormal size and position of the babies. The combination of miconazole with metronidazole increased the risk of adverse effects in the offspring.
Evidence for the risks of miconazole in human babies:
Available information on topical miconazole focuses on different formulations used to treat vaginal fungal infections in women. These studies have found no evidence to support an association between vaginal miconazole exposure during pregnancy and birth defects; however, one study in pregnant Michigan women between 1980 and 1983 suggested a link between miconazole use during the first trimester and miscarriage. Data collected from 1985 to 1992 in over 7,000 infants exposed to vaginal miconazole during the first trimester found a 4.2% risk of major birth defects, similar to the risk in the general population. A 2005 study in Hungarian women exposed to a vaginal combination medication including miconazole during the second or third month of pregnancy found an increased risk of foot and hand deformities in infants compared women not exposed to the miconazole-containing medication. A study including 633 pregnancies in Israel found no increase in miscarriages with exposure to vaginal miconazole through 20 weeks gestation. Because of the lack of consistent evidence around miconazole and miscarriage risk, miconazole should be avoided during the first trimester of pregnancy and widespread use on the body should be avoided throughout pregnancy.
Bottom line: Limited evidence suggests topical miconazole does not increase the risk of birth defects in babies. It is recommended to only use this medication during pregnancy after weighing the risks versus benefits.
If I am using Monistat and become pregnant, what should I do?
If you are using topical miconazole and become pregnant, you should contact your doctor immediately. Your doctor will determine if your medication is medically necessary, or if it should be discontinued until after the birth of your baby.
If I am using Monistat, can I safely breastfeed my baby?
Little information is available on the presence of miconazole in breast milk or the overall safety of breastfeeding while using vaginal miconazole. The World Health Organization classifies topical miconazole as compatible with breastfeeding. The risks versus benefits of miconazole exposure should be weighed before breastfeeding an infant.
Bottom line: Although there are no reports describing the use of topical miconazole while breastfeeding a baby, the risk of infant harm from exposure to this medication while breastfeeding is expected to be minimal.
If I am using Monistat, will it be more difficult to get pregnant?
Vaginal miconazole can decrease the effectiveness of condoms and diaphragms, increasing the risk of pregnancy. Animal and laboratory studies suggest miconazole can negatively affect testosterone production in males.
If I am using Monistat, what should I know?
Limited evidence has found no association between vaginal miconazole and fetal birth defects. Topical miconazole is not expected to pose a risk of harm to your baby. The World Health Organization considers topical miconazole as compatible with breastfeeding. As with any medication used during pregnancy or while breastfeeding, it is important to consider the potential benefits to the mother and risks to the baby before using the medication.
If I am using any medication, what should I know?
This report provides a summary of the available information about the use of Monistat during pregnancy and breastfeeding. Content is from the product label unless otherwise indicated.
You may find Pregistry's expert reports about infections here, about Candida (yeast) infections here, and reports about the individual medications used to treat infections here. Additional information can also be found in the resources below.
For more information about Monistat during and after pregnancy, contact http://www.womenshealth.gov/ (800-994-9662 [TDD: 888-220-5446]) or check the following link:
Drugs.com: Monistat Drug Information
Monistat: Vaginal yeast infections during pregnancy
Centers for Disease Control and Prevention: Vulvovaginal Candidiasis
General information
It is very common for women to worry about having a miscarriage or giving birth to a child with a birth defect while they are pregnant. Many decisions that women make about their health during pregnancy are made with these concerns in mind.
For many women these concerns are very real. As many as 1 in 5 pregnancies end in a miscarriage, and 1 in 33 babies are born with a birth defect. These rates are considered the background population risk, which means they do not take into consideration anything about the health of the mom, the medications she is taking, or the family history of the mom or the baby’s dad. A number of different things can increase these risks, including taking certain medications during pregnancy.
It is known that most medications, including over-the-counter medications, taken during pregnancy do get passed on to the baby. Fortunately, most medicines are not harmful to the baby and can be safely taken during pregnancy. But there are some that are known to be harmful to a baby’s normal development and growth, especially when they are taken during certain times of the pregnancy. Because of this, it is important to talk with your doctor or midwife about any medications you are taking, ideally before you even try to get pregnant.
If a doctor other than the one caring for your pregnancy recommends that you start a new medicine while you are pregnant, it is important that you let them know you are pregnant.
If you do need to take a new medication while pregnant, it is important to discuss the possible risks the medicine may pose on your pregnancy with your doctor or midwife. They can help you understand the benefits and the risks of taking the medicine.
Ultimately, the decision to start, stop, or change medications during pregnancy is up to you to make, along with input from your doctor or midwife. If you do take medications during pregnancy, be sure to keep track of all the medications you are taking.