Vaginal Yeast Infections - Treatment Overview

Treatment Overview

You have a number of treatment options for a vaginal yeast infection, including nonprescription vaginal medication, prescription oral or vaginal medication, or nonprescription vaginal boric acid capsules.

Only use nonprescription vaginal yeast infection treatment without a doctor's diagnosis and advice if you:

• Are not pregnant.
• Are sure your symptoms are caused by a vaginal yeast infection. (In one study, only 1 out of 3 women who had self-diagnosed a simple vaginal yeast infection actually had one.²) If you have never been diagnosed with a vaginal yeast infection, see your health professional.
• Have not been exposed to a sexually transmitted disease (STD), which would require a medical examination.
• Are not having multiple, recurrent infections.

The risk of self-treatment is that your symptoms may be caused by another vaginal infection, such as a sexually transmitted disease, that requires different treatment. If you may have been exposed to an STD, it is best to discuss your symptoms with your health professional before using a nonprescription medication. Your health professional may recommend testing for STDs if you have risk factors for these diseases.

For more information about self-treatment, see:

Should I use a nonprescription medication for a vaginal yeast infection?

Yeast infection during pregnancy

Vaginal yeast infections are common during pregnancy, likely caused by elevated estrogen levels. If you are pregnant, don't assume you have a yeast infection until it is diagnosed, and don't use nonprescription medications without discussing your symptoms with your health professional.

Vaginal medication is used to treat a vaginal yeast infection during pregnancy. If you are pregnant, do not use antifungal medication pills that you take by mouth. Also, do not use vaginal boric acid treatment.

Acute vaginal yeast infection

For the occasional yeast infection, you can use a nonprescription vaginal medication (such as Gyne-Lotrimin, Vagistat, or Monistat) without seeing your doctor first. Only use these medicines if you are certain that your symptoms are caused by a yeast infection. If you prefer, you can use a single-dose prescription oral tablet, a prescription vaginal tablet, or boric acid capsules (600 mg boric acid in a size 00 gelatin capsule inserted in the vagina once daily for 2 weeks). Vaginal treatments are applied at bedtime. Medications are used for 1 to 7 days, depending on the type. All treatments cure vaginal yeast infection 80% to 90% of the time.^{3, 4, 5}

If you have HIV infection, your vaginal yeast infection treatment options are the same as those for women without HIV.⁶ But your treatment may take longer or need to be repeated.

Recurrent yeast infection

For a vaginal yeast infection that recurs within 2 months of treatment, or four times in 1 year (recurrent vaginal yeast infection), see your health professional. Further testing or a different treatment may be needed. If you have been using a nonprescription medication for your vaginal symptoms, be sure to tell your health professional. This information could affect what treatment is recommended.

Recurrent vaginal yeast infection can be treated with prescription oral medication (one or two doses), nonprescription vaginal medication (7 to 14 days), or vaginal boric acid capsules (14 days), followed by less frequent suppressive or maintenance therapy over 6 months to 1 year to prevent reinfection.^{7, 5} About 30% to 40% of women develop another yeast infection after discontinuing maintenance therapy.⁷

Although both men and women can get yeast infections, most doctors do not treat sex partners. A vaginal yeast infection is not a sexually transmitted disease (STD). After having unprotected sex with a man who has a yeast infection, you may have more than the normal amount of yeast in your vagina. But if after having sex you develop a yeast infection that causes symptoms, it is most likely because other factors are also involved.

What To Think About

It is important to complete the entire recommended treatment to cure a yeast infection.

Studies have shown that vaginal infections caused by types of yeast other than Candida albicans may be more difficult to cure with standard antifungal medication. For treatment-resistant infections, a culture of vaginal discharge is done to identify the type of yeast causing the infection.

Boric acid is usually effective for treating Candida albicans (C. albicans) infection, as well as non–C. albicans yeast infections that don't respond to antifungal medication.^{7, 5}

Women who take the anticoagulant medication warfarin (such as Coumadin) and use a nonprescription vaginal yeast-fighting medication, such as Monistat, may have increased bruising and abnormal bleeding. If you take warfarin, talk with your health professional before using a yeast-fighting medication.