Yeast Infection of the Vagina: Treating It Yourself and When to Get Checked

Is it really a yeast infection?

Studies have found that many women who buy over-the-counter yeast treatment do not actually have a yeast infection. Other conditions cause very similar itching, burning and discharge, and using antifungals for them delays the right treatment. More detail on symptoms and causes is on our main vaginal yeast infection page.

A clinician can confirm yeast in minutes by looking at a swab under the microscope and checking vaginal pH (yeast infections leave the pH normal, under 4.5; BV and trich raise it). Home vaginal pH test kits can help tell yeast from BV but cannot rule out STIs.

Choosing an over-the-counter treatment

All the common OTC azole antifungals clear about 80 to 90% of uncomplicated infections.

Combination packs include an external cream for vulvar itching. A prescription alternative is a single oral fluconazole tablet, which is less messy but works no faster.

Using it correctly

• Insert the cream or suppository at bedtime, lying down, so it stays in place
• Finish the full course even if symptoms improve
• Use a panty liner, since cream will leak
• Avoid sex until treatment is finished. Some creams weaken latex condoms and diaphragms for several days
• Do not use tampons during treatment
• Expect itching to ease in 1 to 3 days and to be gone within a week

Why a yeast infection may not go away

If symptoms have not improved after 3 days or are not gone after 7 days, see a clinician. Common reasons include:

1. It is not yeast: BV, trichomoniasis, irritation, or a skin condition.
2. A resistant species: Candida glabrata and other non-albicans yeasts respond poorly to standard treatment and may need boric acid vaginal capsules (never taken by mouth) or other prescription antifungals.
3. A complicated infection: severe swelling and cracking needs a longer course, such as 7 to 14 days of cream or repeated fluconazole doses.
4. Ongoing triggers: uncontrolled diabetes, recent antibiotics, high-estrogen states, or a weakened immune system.
5. Irritation from the treatment itself, or from scented products, douches or tight synthetic underwear.
6. Mixed infection, such as yeast and BV together.

A vaginal culture identifies the species and is recommended before treating persistent or recurrent infections.

Recurrent yeast infections

Having 3 or more symptomatic infections in a year is called recurrent vulvovaginal candidiasis. It affects a small minority of women. Management:

• Confirm with a culture during an episode
• A longer initial treatment to clear the infection
• Then maintenance therapy, typically a weekly oral fluconazole dose for 6 months, prescribed by a clinician
• Newer options such as oteseconazole for some people
• Check for diabetes and review contraception, antibiotics and hormone use

About half of people have recurrences after stopping maintenance treatment, and repeat courses are common.

Special situations

• Pregnancy: yeast infections are more common. Use a 7-day vaginal azole after confirming the diagnosis. Oral fluconazole is generally avoided.
• Diabetes: high blood sugar fuels yeast. Better glucose control reduces infections. Some diabetes medicines (SGLT2 inhibitors) also increase the risk.
• Weakened immunity, including HIV and chemotherapy: longer treatment may be needed.
• Girls before puberty: yeast infections are uncommon. Vulvar itching more often has another cause and should be checked by a doctor.

Lowering your risk

• Avoid douches, scented soaps, sprays and bubble baths
• Wear breathable cotton underwear and change out of wet swimwear and sweaty clothes promptly
• Take antibiotics only when needed. If you always get a yeast infection after antibiotics, ask about preventive treatment
• Keep blood sugar in range if you have diabetes
• Evidence for probiotics, yogurt and garlic is weak. They are unlikely to harm but should not replace proven treatment

Frequently asked questions

Can I treat a vaginal yeast infection myself?

Yes, if you have had a yeast infection diagnosed by a clinician before, your symptoms are the same, and you are not pregnant. Use an over-the-counter antifungal cream or suppository as directed. For a first infection, unusual symptoms, or repeat infections, get tested first.

Which is better, 1-day, 3-day or 7-day yeast infection treatment?

They cure infections at similar rates. The 1-day option is most convenient, while the 7-day cream is gentlest and preferred in pregnancy or when the skin is very inflamed. Symptoms take a few days to settle whichever you choose.

Why won't my yeast infection go away?

The most common reasons are that it is not a yeast infection (often bacterial vaginosis or an irritant reaction), a resistant yeast species, an infection needing a longer course, or an ongoing trigger such as diabetes or antibiotics. See a clinician for testing if symptoms persist after a week.

How do I know if it's a yeast infection or BV?

Yeast infections usually cause intense itching and thick, white, odorless discharge. BV usually causes thin, gray discharge with a fishy smell and little itching. A clinic swab and pH test can tell them apart quickly. BV needs antibiotics, which antifungals will not replace.

How long does a yeast infection last without treatment?

Mild yeast infections sometimes clear on their own within a few days to a week or two, but many persist or worsen. Treatment usually brings relief within 1 to 3 days. Untreated yeast infections are uncomfortable but rarely cause serious complications in healthy people.

Can a man get a yeast infection from his partner?

It is possible but uncommon. Yeast infections are not considered sexually transmitted, and partners do not routinely need treatment. A male partner with an itchy red rash on the penis may have balanitis, which responds to an antifungal cream.