Most women will experience a yeast infection at least once in their life. It’s not rare, it’s not shameful, and it’s not something you need to panic about - but it is something you need to treat correctly. Candida vaginitis, also called vulvovaginal candidiasis, is caused by an overgrowth of Candida fungi, mostly Candida albicans, which normally live harmlessly in small amounts in the vagina. When the balance gets thrown off - by antibiotics, hormones, diabetes, or even tight clothing - these fungi multiply and cause uncomfortable, sometimes painful symptoms.
What Does a Yeast Infection Actually Feel Like?
You’ll know it when you feel it. The most common sign is intense itching in and around the vagina. In fact, 97% of women with a yeast infection report this symptom. It’s not just a mild annoyance - it can be constant, burning, and worse at night. Many also feel soreness or a raw, irritated sensation on the vulva. Sexual intercourse becomes painful, and peeing can sting, especially when urine touches inflamed skin.
The discharge is another big clue. It’s usually thick, white, and clumpy - like cottage cheese. It doesn’t smell strong or fishy, which helps distinguish it from bacterial vaginosis. Sometimes it’s more watery or slightly yellowish, but if it’s green, gray, or has a foul odor, it’s probably not yeast. You might also notice redness, swelling, or even small cracks in the skin around the vulva. These signs aren’t subtle. If you’ve had one before, you’ll recognize them quickly.
Why Do Yeast Infections Happen?
It’s not about being "dirty." Yeast infections happen because your body’s natural defenses got disrupted. Antibiotics are the top trigger - they kill off good bacteria that keep Candida in check. About 30-50% of cases happen after a course of antibiotics. Pregnancy is another big one. Rising estrogen levels during pregnancy create a sugar-rich environment that yeast loves. Women with uncontrolled diabetes (HbA1c over 7%) are 2.3 times more likely to get recurrent infections because high blood sugar feeds the fungus.
Wearing damp clothes - like a wet swimsuit or sweaty workout gear - for too long also creates the perfect warm, moist habitat for yeast to grow. Tight synthetic underwear, douching, and even certain soaps can irritate the area and throw off the pH balance. Stress and a weakened immune system (from illness or HIV) make it harder for your body to fight off overgrowth. And yes, it can happen even if you’re not sexually active. Yeast infections aren’t STDs.
Over-the-Counter Treatments That Actually Work
If this is your first time, you’re probably wondering: Can I just buy something at the pharmacy? The answer is yes - but only if your symptoms match the classic picture. For uncomplicated cases (one-time, mild to moderate, no pregnancy, no diabetes), OTC antifungals are effective 80-90% of the time.
There are three main types of OTC treatments:
- Clotrimazole: Available as a 1% cream (apply twice daily for 7-14 days), 2% cream (once daily for 3 days), or vaginal tablets (100mg or 200mg, once daily for 3-7 days).
- Miconazole: Comes as a 2% cream (once daily for 7 days) or vaginal suppositories (100mg, once daily for 7 days).
- Tioconazole: A single-dose 6.5% ointment applied directly inside the vagina.
These products all work by killing the yeast cells. Most women start feeling better within 24 to 72 hours. But here’s the catch: you have to finish the full course. About 35% of treatment failures happen because people stop once the itching fades. That’s like stopping antibiotics early - the yeast comes back, stronger.
What About the Single-Dose Pills?
You’ve probably seen fluconazole (Diflucan) advertised. It’s a one-pill oral treatment that cures yeast infections in 85% of cases. But here’s the problem - it’s not available over the counter in the U.S. You need a prescription. Some women order it online or get it from a telehealth service, but for most, topical treatments are the first step.
Why stick with creams and suppositories? Because they’re targeted. The medicine goes right where it’s needed, with fewer side effects than a pill. Plus, if you’re pregnant, oral fluconazole is unsafe. Only topical treatments are approved during pregnancy.
When OTC Treatments Don’t Work - And Why
Half the women who self-treat for a yeast infection are wrong. That’s not a typo. According to CDC data, 50-70% of women who buy OTC meds for suspected yeast infections are actually dealing with bacterial vaginosis, trichomoniasis, or even a skin condition like eczema. These conditions look similar - itching, discharge, irritation - but they need completely different treatments.
If you try an OTC product and nothing improves after 7 days, or if your symptoms get worse, stop. Don’t keep reapplying. See a doctor. Same goes if you have fever, chills, or pelvic pain - that could mean the infection has spread. Recurrent infections (four or more a year) also need medical evaluation. You might have a non-albicans strain like Candida glabrata, which doesn’t respond well to standard OTC drugs. Resistance is rising - 8% of C. glabrata strains are now resistant to clotrimazole, up from 3% just five years ago.
How to Use OTC Treatments Right
Using the product correctly matters just as much as choosing the right one. Here’s what works:
- Apply at bedtime. You’re less likely to move around and push the medicine out. A Johns Hopkins study found 85% of successful users applied treatment before sleeping.
- Follow the full course. Even if you feel better after day two, finish all 3, 7, or 14 days.
- Avoid sex during treatment. Semen and friction can reduce effectiveness by up to 30%.
- Insert suppositories properly. Push them in as far as your finger can reach. A 2022 analysis found 70% of failures were due to poor placement.
- Don’t use tampons. Use pads instead. Tampons can absorb the medication and reduce its effect.
Many women hate the messiness of creams. That’s why suppositories and tablets are popular - they’re cleaner, even if they cost a bit more. Amazon reviews show users rate Monistat 7 cream at 4.2/5, but suppositories get 3.8/5. Still, 65% prefer suppositories because they’re less sticky.
When to See a Doctor
You don’t need to run to the clinic for every itch. But you should if:
- This is your first time - get a proper diagnosis.
- You’re pregnant - only topical treatments are safe.
- Your symptoms don’t improve after 7 days.
- You have fever, chills, or lower belly pain.
- You’ve had four or more infections in the past year.
- The discharge is green, gray, or smells bad.
Doctors can do a quick swab test to confirm it’s yeast - no need to guess. If it’s resistant or recurrent, they might prescribe a longer course, a different antifungal, or even maintenance therapy.
Preventing Future Infections
Once it’s gone, you want to keep it gone. Here’s what helps:
- Wear cotton underwear - no synthetics.
- Change out of wet clothes right after swimming or sweating.
- Avoid douches, scented sprays, and bubble baths.
- Keep blood sugar under control if you have diabetes.
- Consider probiotics with Lactobacillus strains - some studies show they help maintain balance.
- Don’t take antibiotics unless you really need them.
There’s no magic pill to prevent yeast infections. But small daily habits make a big difference. And if you’re prone to them, talk to your doctor about keeping a backup OTC treatment on hand - but only use it when symptoms match exactly.
What’s Changing in Yeast Infection Treatment?
Things are shifting. The FDA approved a new clotrimazole tablet in June 2023 that sticks to the vaginal wall for 24 hours - it’s showing 92% cure rates, better than older versions. Telehealth apps now use AI symptom checkers to guide women through CDC-approved questions before recommending OTC treatment - cutting misdiagnosis rates in half.
But the biggest concern is resistance. As more people self-treat without confirmation, the fungus is adapting. In the UK, you now need to talk to a pharmacist before buying yeast meds. In the U.S., that’s not required - and that’s part of why misuse is so common.
By 2028, some OTC antifungals might become prescription-only. The goal isn’t to make treatment harder - it’s to make it smarter. You deserve relief. But you also deserve the right treatment.
Can I treat a yeast infection without seeing a doctor?
Yes - but only if you’ve had a yeast infection before and your symptoms match exactly: intense itching, thick white discharge, no odor, and no fever or pelvic pain. If it’s your first time, or if you’re pregnant, diabetic, or have recurrent infections, see a doctor. Self-diagnosis is wrong in up to 70% of cases.
How long does it take for OTC yeast infection treatments to work?
Most women notice relief from itching and burning within 24 to 72 hours. But full healing takes the full course - 3, 7, or 14 days depending on the product. Stopping early increases the chance of recurrence.
Are suppositories better than creams for yeast infections?
Suppositories and tablets are less messy and easier to use, especially at night. Creams can be more effective for external itching because they coat the vulva. Cure rates are similar - around 85% - but 65% of users prefer suppositories for convenience. Choose based on your comfort, not just price.
Can men get yeast infections from their partners?
Yes, though it’s less common. Men can develop balanitis - redness, itching, or a rash on the penis - after unprotected sex with an infected partner. It’s not an STD, but it’s treatable with antifungal cream. Both partners should be treated if symptoms recur, especially if intercourse is involved.
What should I avoid when I have a yeast infection?
Avoid douches, scented tampons, tight synthetic underwear, hot tubs, and prolonged wet clothing. Don’t have sex until symptoms are gone - it can worsen irritation and reduce treatment effectiveness. Also, don’t use leftover medication from past infections - strains can change, and old products may be expired.
Is it normal to have discharge after using a yeast infection treatment?
Yes. It’s common to notice a thick, white, or creamy discharge after using creams or suppositories - that’s the medication working its way out. It’s not a sign the infection is still there. If the discharge becomes foul-smelling, green, or bloody, or if itching returns after treatment ends, see a doctor.