How to Treat a Yeast Infection

A yeast infection (vulvovaginal candidiasis) occurs when the fungus Candida overgrows in the vagina. It’s very common—up to 75% of people with vaginas will experience one in their lifetime. While usually harmless, symptoms like itching, burning and unusual discharge can be uncomfortable and affect daily life. Here’s a clear, evidence-based guide to treating yeast infections and preventing future episodes.

Recognizing a Yeast Infection

Common symptoms include:

• Intense vaginal itching or soreness
• Thick, white “cottage cheese”-like discharge
• Burning during urination or sex
• Redness and swelling of the vulva

If you’re unsure whether it’s a yeast infection, consider doing a free, online symptom check for to help identify your symptoms.

Getting a Diagnosis

Proper diagnosis helps you choose the right treatment:

1. Self-assessment
   – Note your symptoms and how long they’ve lasted.
   – Avoid self-treating recurrent or unusual cases without professional input.

2. Clinical exam
   – A healthcare provider will inspect the vulva and vagina.
   – A sample of discharge may be examined under a microscope or cultured.

3. When to see your doctor

   • It’s your first time with these symptoms.
   • Symptoms are severe or worsening (e.g., fever, chills).
   • You have more than four yeast infections in a year.
   • You have diabetes, HIV or are pregnant.

Over-the-Counter (OTC) Treatments

Most uncomplicated yeast infections respond well to OTC antifungal medications, which come as creams, ointments or suppositories:

• Clotrimazole (1%, 2%, 3%, or 10% strength)
• Miconazole (2%, 4%, or 6% strength)
• Tioconazole (6.5% ointment)

Duration of therapy

• Single-dose: 1 application of 5 g (e.g., terconazole 0.8% cream)
• Short-course: 3 days of nightly treatment
• Standard: 7–14 days of daily treatment

Choose the shortest course you can comfortably complete. Follow package instructions exactly.

Prescription Treatments

If OTC treatments fail, your doctor may prescribe:

• Fluconazole (Diflucan)
  – Single oral dose (150 mg) often resolves symptoms within 1–3 days.
  – A second dose 72 hours later may be needed for persistent symptoms.

• Boric acid capsules (600 mg vaginally for 14 days)
  – Used for infections resistant to azoles.
  – Not safe in pregnancy.

• Nystatin (vaginal tablets or creams)
  – Alternative for those who can’t tolerate azoles.

Managing Recurrent Yeast Infections

Recurrent vulvovaginal candidiasis (four or more episodes per year) requires a different approach:

1. Extended induction
   – Fluconazole weekly for 6 months (150 mg each dose).
   – Alternatively, a topical antifungal twice weekly.

2. Maintenance therapy
   – After induction, some need longer suppressive therapy.
   – Monitor for breakthrough symptoms; adjust dosing under medical supervision.

3. Address underlying factors

   • Tight or non-breathable underwear
   • High-sugar diet or uncontrolled diabetes
   • Recent antibiotic use

Special Populations

• Pregnant people
  – Topical azoles (e.g., clotrimazole, miconazole) for 7 days are safe.
  – Oral fluconazole is generally avoided in pregnancy.

• People with diabetes
  – Keep blood sugar under control.
  – More prone to recurrent episodes.

• Immunocompromised individuals (HIV, chemotherapy)
  – May need longer treatment courses.
  – Seek specialist care if infections recur or are severe.

Supportive Self-Care Measures

Lifestyle changes and home remedies can ease symptoms and reduce recurrence:

• Wear 100% cotton underwear and loose-fitting pants.
• Avoid douching, scented soaps or feminine hygiene sprays.
• Change out of wet swimsuits or sweaty workout clothes promptly.
• Apply cool compresses to the vulva for temporary itch relief.
• Eat a balanced diet; consider reducing added sugars.

When to Seek Immediate Medical Attention

Though most yeast infections are straightforward to treat, contact your doctor or go to the emergency department if you experience:

• High fever or chills
• Severe pelvic or abdominal pain
• Vomiting or inability to keep fluids down
• Symptoms that rapidly worsen or do not improve after treatment

Preventing Future Yeast Infections

• Complete the full course of any prescribed treatment, even if symptoms improve early.
• Practice good genital hygiene: wash daily with mild, fragrance-free soap and water.
• Rotate antibiotics sparingly and only under medical advice.
• Maintain healthy blood sugar levels if diabetic.
• Consider probiotics (e.g., Lactobacillus) after antibiotic use—though evidence is mixed, it may help restore healthy vaginal flora.

Final Thoughts

Yeast infections are common and usually easy to treat with OTC or prescription antifungals. However, persistent or severe cases warrant medical evaluation. Always complete your treatment course and adjust lifestyle factors that may contribute to recurrence.

Before starting any treatment, consider doing a free, online symptom check for to clarify your symptoms. And remember: if you experience severe symptoms, frequent recurrences or anything that feels life-threatening, speak to a doctor right away. Your health and comfort are worth prompt, professional attention.