You probably already know the telltale symptoms of a vaginal yeast infection, which include intense itching, inflammation, and a thick, white discharge (and if you need a refresher, here's a rundown of yeast infection symptoms). The good news: Once you've gotten your diagnosis, you have a few options for treating the uncomfortable condition—some are even available to you over the counter.
Alyssa Dweck, MD, a gynecologist and assistant clinical professor at Mount Sinai School of Medicine in Westchester County, NY, explains that doctors will usually recommend one of two treatments for a yeast infection: antifungal cream or oral tablets.
"I think both are equally effective," she says, adding that the decision to use one or the other is often personal. "Some people are just not comfortable putting things in the vagina, or want to go with what's on their insurance plan, so they'll choose the pill."
We asked Dr. Dweck to give us the lowdown on each treatment type—and also weigh in on whether or not home remedies are worth trying.
Antifungal creams are the go-to over-the-counter treatment for yeast infections. "They are generally well-tolerated and preferred by some women because they don’t need to call their doctor to get them,” Dr. Dweck explains. "And they work well." Another selling point: Some come with external wipes that are meant to be used in combination with the treatment to calm itch.
These creams—which can be applied by hand or with an applicator that's inserted into the vagina—are sold by a number of brands (you've probably spotted ones like Monistat and Terazol on your pharmacy's shelves). They're also available in a variety of strengths, ranging from one- to seven-day treatments, but they all belong to the same family of medication, called azoles. Not sure which strength you need? Dr. Dweck says the choice is a personal one, but she generally recommends the three-day option to patients: "One-day regimens can cause irritation, and the seven-day ones can be cumbersome, so three days is a reasonable option for most."
Still, they're not for everyone: "I do warn those who have sensitive skin to be cautious when it comes to using the one-day treatments, which are stronger,” says Dr. Dweck. Antifungal creams can also be messy—some of the OTC products are marketed specifically for nighttime use for this reason.
If you'd prefer not to use a cream, you can also take an oral antifungal medication called fluconazole (Diflucan). "This is the main thing that I see women wanting to be treated with now," says Dr. Dweck. "It's less messy than a cream."
It does require a prescription from your doctor, though, so some women may prefer to try an over-the-counter treatment for a faster fix. Depending on your symptoms, your doc may prescribe just one pill, or two pills taken 72 hours apart.
The use of home remedies for yeast infections has long been disputed, and many experts are conflicted about whether or not these DIY treatments really work.
The most popular home treatments are yogurt and probiotics, but their effectiveness "is somewhat controversial," says Dr. Dweck. "It seems that the literature does not support this 100%, although some studies reveal that it can help for women who are very prone to infections to take probiotics." One small study, published in 2003 in the journal FEMS Immunology & Medical Microbiology, found that healthy women who took the probiotic lactobacillus rhamnosusexperienced a decrease in vaginal yeast after 28 days in comparison to a control group. But in a 2006 review, researchers expressed skepticism about the results of earlier clinical trials on probiotic use, arguing that the women studied were often not a relevant sample—for example, they didn't report experiencing recurring vaginal infections, or the studies weren't conducted on at-risk women, such as those taking antibiotics.
In other words, while it isn't proven that yogurt or oral probiotics can cure or prevent a yeast infection, it won't hurt to incorporate them into your diet, especially since they both boast additional health benefits: yogurt is a good source of protein and calcium, while probiotics may help aid digestion.
A lesser-known home remedy is gentian violet, a topical antifungal that's "painted" on the areas that are itchy or affected by yeast. "This can be a messy and inconvenient treatment form, and it does stain," says Dr. Dweck. "Every so often, I will get a patient who is either allergic to the other treatments or not getting relief from them, and will resort to this old-fashioned standby."
Finally, as for those Internet claims that you can treat a yeast infection by inserting yogurt or garlic into your vagina, Dr. Dweck isn't a fan. "There's really no place for it in treatment," she says.