Gynecologic Conditions
Vaginal Yeast Infection: Symptoms, Treatment and Prevention
A vaginal yeast infection is an overgrowth of a fungus called Candida. It causes itching and burning in the vagina and vulva, redness, and thick white discharge that can look like cottage cheese. Most yeast infections clear with over-the-counter antifungal creams or suppositories, or a prescription pill. If it's your first one, you're pregnant, or they keep coming back, see a clinician to confirm what's going on.
Is it actually a yeast infection?
This is the big question, and it's worth asking honestly. Yeast infections are very common, but research has shown many people who are sure they have one actually have something else, most often bacterial vaginosis (BV). Treating the wrong thing means another week of itching.
Quick comparison:
| Yeast infection | Bacterial vaginosis | Other causes | |
|---|---|---|---|
| Discharge | Thick, white, clumpy | Thin, gray or white | Varies |
| Odor | Usually none | Fishy | Varies |
| Itching | Often intense | Mild or none | Varies |
| Treatment | Antifungal | Prescription antibiotics | Depends on cause |
A strong or fishy smell isn't typical of yeast. That points toward BV or another cause. Other look-alikes include trichomoniasis, irritation from soaps or products, skin conditions like lichen sclerosus, and vaginal dryness. Compare with our guide to bacterial vaginosis.
What it feels like
- Itching in the vagina and vulva, often intense enough to wake you up
- Burning, especially when you pee or during sex. The sting is usually on the outside skin as urine passes over it, which is how many people tell it apart from a UTI.
- Redness and swelling of the vulva
- Thick, white, odorless discharge that may look like cottage cheese
- Soreness or small cracks in the vulvar skin
Why it happens
Candida normally lives in small amounts in the vagina, mouth and gut without causing trouble. When the vaginal balance shifts, it can overgrow and cause inflammation. The medical name is vulvovaginal candidiasis. Most infections are from Candida albicans; other species are less common and may not respond as well to standard treatment.
Common triggers:
- Antibiotics, which reduce protective vaginal bacteria
- Pregnancy and other times of higher estrogen
- Uncontrolled diabetes
- A weakened immune system, such as from HIV or medicines like steroids
- Hormonal birth control, in some people
Yeast infections aren't considered sexually transmitted. That's a common worry, especially with a new partner.
How a clinician confirms it
A visit is usually quick. Your clinician may:
- Look at the vulva and vagina
- Check vaginal pH with a test strip
- Look at a swab of discharge under a microscope, sometimes during the same visit
- Send a culture or lab test, especially if infections keep coming back
Getting tested matters most if it's your first infection or if over-the-counter treatment didn't work.
Treatment options
Over the counter
Antifungal creams, ointments and vaginal suppositories, such as miconazole and clotrimazole, come in 1-day, 3-day and 7-day courses. Follow the package directions.
What people don't expect: the one-day versions aren't a one-day fix. Symptoms often take a few days to settle no matter which course you pick, and longer courses can feel gentler on already irritated skin. Insert at bedtime so it doesn't leak all day, and wear a panty liner.
Prescription
- Fluconazole, an oral antifungal pill, is commonly prescribed for uncomplicated infections.
- Prescription-strength vaginal antifungals, such as terconazole.
- Longer or repeated treatment for severe or recurrent infections.
- Other antifungals for less common Candida species.
Your clinician will choose the medicine and schedule that fits you.
During pregnancy
The CDC recommends topical (vaginal) antifungal treatment, usually for seven days, rather than oral fluconazole during pregnancy. Check with your prenatal provider before using anything.
While you're treating it
- Some vaginal creams and suppositories are oil-based and can weaken latex condoms and diaphragms. Check the insert.
- Skip sex until symptoms clear; it usually makes the irritation worse anyway.
- Wear loose, breathable cotton underwear.
When it keeps coming back
Three or more symptomatic yeast infections in a year is called recurrent vulvovaginal candidiasis. That's a reason to see a clinician rather than keep buying OTC kits. They may:
- Confirm the diagnosis with a culture
- Check for less common Candida species
- Look for underlying causes, such as diabetes
- Recommend a longer first treatment followed by a maintenance plan, such as weekly medicine for several months
After antibiotics
Antibiotics lower the protective bacteria that keep yeast in check. Not everyone gets a yeast infection afterward, but if you always do, tell the clinician prescribing the antibiotic. They can tell you what to do if symptoms start.
With diabetes
High blood sugar makes yeast infections more likely and harder to clear. If you have diabetes and keep getting them, tell your clinician; it can be a sign your blood sugar needs attention. Frequent infections in someone without a diabetes diagnosis can also be a reason to check blood sugar.
Myth vs. fact
"Any itching means yeast." Itching can come from BV, trichomoniasis, skin conditions or product irritation.
"Yogurt in the vagina will cure it." There's no good evidence for this, and it isn't recommended.
"My partner needs treatment too." Partners usually don't, unless they have symptoms.
Prevention that's worth doing
- Cotton underwear; skip tight, non-breathable clothes when you can
- Change out of wet swimsuits and sweaty workout clothes promptly (yes, even after a sweaty summer subway ride)
- No douching or scented products: sprays, bubble baths, scented pads
- Keep blood sugar in range if you have diabetes
- Use antibiotics only when you need them
Evidence that probiotics or yogurt prevent yeast infections is limited.
When to see a doctor
See a gynecologist or women's health nurse practitioner if:
- This is your first suspected yeast infection
- You're pregnant
- Symptoms don't improve after over-the-counter treatment
- You have three or more infections in a year
- You have a fishy odor, unusual discharge color, or pelvic pain
- You have sores, blisters or severe swelling
- You have diabetes or a weakened immune system
- You may have been exposed to an STI
Call your provider promptly for fever, chills or lower belly pain along with vaginal symptoms.
Your next step
A gynecologist, OB/GYN or women's health nurse practitioner can usually confirm a yeast infection in one visit. Use our provider search, or browse women's health nurse practitioners in Manhattan and OB/GYNs across New York City, Long Island and the Hudson Valley.
Frequently asked questions
How long does a yeast infection last?
With treatment, symptoms of an uncomplicated yeast infection usually improve within a few days. Some treatments take up to a week to fully clear symptoms. If they do not improve, see a clinician.
Can a yeast infection go away on its own?
Mild yeast infections sometimes clear on their own, but treatment usually relieves symptoms faster. If you are not sure it is a yeast infection, get checked rather than waiting.
Is a yeast infection an STI?
No. Yeast infections are not sexually transmitted infections, although sexual activity can sometimes trigger them.
How many yeast infections a year is too many?
Having three or more yeast infections within a year is considered recurrent and should be evaluated by a clinician.
Sources
- CDC — Vulvovaginal Candidiasis: STI Treatment Guidelines (2021)
- CDC — Vaginal Candidiasis
- ACOG — Vaginitis (Patient FAQ)
- ACOG — Vaginitis in Nonpregnant Patients (Practice Bulletin 215)
- MedlinePlus — Vaginal yeast infection
This article is for general education and is not medical advice. It does not replace an evaluation by a licensed clinician who knows your history. If you think you have a medical emergency, call 911.