Treatment Overview
You have a number of treatment options for a
vaginal yeast infection, including non-prescription
vaginal medication, prescription oral or vaginal medication, or
non-prescription vaginal boric acid capsules.
Only use non-prescription 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 infection (STI), 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 infection, that
requires different treatment. If you may have been exposed to an STI, it is
best to discuss your symptoms with your health professional before using a
non-prescription medication. Your health professional may recommend testing for
STIs if you have risk factors for these diseases.
For more information about self-treatment, see:
Should I use a non-prescription 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 non-prescription
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
non-prescription vaginal medication (such as Canesten
and 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 non-prescription 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),
non-prescription 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 infection (STI). 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 non-prescription 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.