A vaginal yeast infection is a common and uncomfortable problem that most women will experience at least once. It needs to be diagnosed by your doctor to rule out other causes of the symptoms, but it can usually be effectively treated with an over-the-counter product. For severe or frequent yeast infections, your doctor may prescribe a single-dose medication instead. There are many lifestyle changes you can make to help speed the clearing of an infection and prevent a recurrence.
The OTC products available for vaginal yeast infections typically have one of four active ingredients: butoconazole nitrate, clotrimazole, miconazole, and tioconazole. These drugs are in the same anti-fungal family and work in similar ways to break down the cell wall of the Candida organism until it dissolves. These products are safe to use if you are pregnant.
When you visit your doctor the first time you have a yeast infection, ask which product may be best for you and discuss the advantages and disadvantages of the different forms the products come in: vaginal suppositories (inserts), vaginal tablets, or creams with special applicators.
Once you start using an OTC anti-fungal medication, your yeast infection symptoms will probably begin to disappear within a few days. As with antibiotics, though, it’s extremely important to continue to use your medication for the entire number of days recommended. Even if your symptoms have gone away, the fungus may still be active enough to cause a relapse.
When using one of these products, you may want to talk to your doctor about alternatives to prevent sexually transmitted infections and pregnancy. Some of these OTC options can weaken condom material and spermicide, so be sure to read the directions. In addition, vaginal intercourse during treatment could displace medication from the vagina, lessening effectiveness, and cause irritation.
These OTC products should never be used by men, nor should they be used for other types of infections, such as fungal infections under the fingernails or inside the mouth (known as thrush).
Over-the-counter fungal treatments are highly effective, but if any of these apply to you while using one, contact your doctor:
- Abdominal pain, fever, or a foul-smelling discharge
- Increased irritation of the vagina or nearby skin
- No improvement within three days
Symptoms that recur within two months are also worth bringing to your doctor’s attention. Any of the above could indicate that you need a stronger approach to fighting off the fungus once and for all.
You can ask your physician for a prescription for Diflucan (fluconazole) if you’d prefer taking a single oral dose of medication over using a vaginal cream or suppository. The drug is appropriate for uncomplicated cases and had only mild to moderate side effects—including headache, dizziness, diarrhea, heartburn, and stomach pain—in clinical trials. However, oral fluconazole should not be taken if you are pregnant, as it can cause birth defects.
For severe or frequent Candida vaginal yeast infections, a doctor may prescribe two to three doses of Diflucan given 72 hours apart. Another oral medication that can be used in these cases is Nizoral (ketoconazole), which is taken for seven to 14 days, either once or twice daily, depending on your physician’s recommendations. Women with diabetes may need this longer course of treatment to clear the infection.
Sometimes the yeast infection is due to the species Candida glabrata, which doesn’t respond to the usual oral medications. The alternatives include 14 days of intravaginal treatment with a boric acid gelatin capsule, nystatin suppository, 17 percent flucytosine cream, or a cream with 17 percent flucytosine and 3 percent amphotericin B.
If you have recurring yeast infections, your doctor may recommend 10 to 14 days of treatment with a clotrimazole vaginal suppository or oral Diflucan pill, then weekly doses of Diflucan for six months.
It is important to take the full amount of medication recommended and not stop when you feel better or the symptoms are gone. Stopping early can mean that the most resistant yeast will multiply. This is especially true if you have diabetes because you are more at risk of the yeast infection spreading.
Home Remedies and Lifestyle
There are many ways you can reduce your risk of a yeast infection (or a recurrence) and speed healing if you have one. These generally involve eliminating sources of vaginal irritation and yeast transmission and discouraging a vaginal environment that leads to the overgrowth of yeast.
To relieve symptoms, you can sit in a warm (not hot) bath or take a shower. You may want to avoid soap and just rinse with water. Perfumed bath additives, feminine hygiene sprays, and body powders can be irritating to the genital area and should be avoided during treatment (as well as afterward to lessen the risk of recurrence).
Condom or oral dam use can prevent the passing of yeast to and from your sexual partner. It is possible for a male partner to get a yeast skin infection on his penis or have irritation from a vaginal treatment product. If you’re using one, remember to read medication instructions to ensure that it doesn’t influence condom effectiveness.
If you’re advised to avoid vaginal sex during the treatment, be sure you know when you can resume safely. Post-menopausal women and women who use oral contraceptives may find using a vaginal lubricant during sexual intercourse helpful in preventing vaginal discomfort and irritation that can lead to future yeast infections.
Keeping your vaginal area cool and dry is important both during treatment and to prevent a recurrence. Wear underwear with a cotton crotch and avoid too-tight pants and pantyhose. You may want to switch to wearing skirts or loose pants at least until the infection is cleared.
Exercise is fine during treatment, including swimming. However, be sure to change out of wet swimwear or sweaty exercise clothes as soon as possible. Also, be sure to launder these items between each wearing.
If you are using a vaginal cream or suppository for treatment, refrain from using tampons, as they can block or remove the medication. Opt for a deodorant-free pad or liner if menstruating or just to protect your clothes from leakage, and change it often to prevent additional moisture build-up. Douching is never advised and it is especially to be avoided while you clearing a yeast infection.
Finally, be sure to wipe from front to back after a bowel movement to prevent transferring yeast that naturally occurs in the bowel and rectum to the vaginal area. This also helps prevent urinary tract infections.
Complementary Medicine (CAM)
You will see suggestions to use a variety of non-pharmacologic remedies. There are a couple that are supported by research.
Boric Acid Suppository
Use of a boric acid suppository is accepted as a treatment for Candida species other than the most common one, Candida albicans, which responds well to the usual treatments. The boric acid is contained in a gelatin capsule, and you can get instructions on how to make your own using over-the-counter boric acid and a fillable size 0 or 00 gelatin capsule. You should be sure that you get medical advice on using this; 600 milligrams, once or twice daily for seven to 14 days is usually recommended. You should never take boric acid by mouth or use it on open wounds. It is not safe to use while pregnant. Even when used as recommended, you may have some skin irritation.
Probiotics and Active-Culture Yogurt
The health of the vagina relies on beneficial probiotic bacteria (lactobacilli, including L. acidophilus) to maintain a slightly acidic pH and keep yeast from overgrowing. Some suggest that women consume probiotics naturally found in yogurt or kefir, take probiotic supplements, or apply probiotic products vaginally (as appropriate), either to help relieve yeast infection symptoms or prevent recurrent yeast infections.
Some study reviews have found no benefit of this approach, while others say there may be some. Studies are ongoing in the use of a slow-release vaginal product that has specific lactobacilli. However, it should be noted that people with a suppressed immune system or recent abdominal surgery should avoid probiotic supplements. Supplements aren’t regulated by the FDA. However, enjoying yogurt or kefir as part of a balanced diet poses little risk.
More Research Needed
You may see suggestions for using coconut oil; oregano oil, tea tree oil, other essential oils; or garlic supplements for yeast infections. Clinical studies are needed to show that they are safe and effective in humans, especially pregnant women. These either haven’t been done or have shown that these options are not effective (in the case of garlic). A wide variety of plant oils and extracts have antifungal effects in the test tube, but many can be irritating or toxic to the body.
While the appeal of an alternative treatment is strong for some when feeling the itching and burning of a yeast infection, most women want to turn to something they can be assured will give relief quickly.