There are plenty of reasons why having a vagina can be great. It can lead to some pretty pleasurable experiences (hey, hey, G-spot orgasms, if that’s a thing your body can do). And, obviously, it often comes with that whole miracle-of-life potential. But there are downsides, too. Enter the dreaded yeast infection: You’re going about your business and suddenly your underwear is covered in a sticky, white residue, or you’re having sex and realize it’s not so much hot as it is burning.
It’s no wonder why you might not want to head to the doctor to treat a yeast infection. Waiting to see the doctor can extend your itchy-vagina experience, and actually following through with the appointment can be time-consuming. Plus, isn’t that the entire point of all those at-home yeast infection treatments at the drugstore? We spoke with ob/gyns to find out: When the going gets cottage cheesy, is it OK to just treat a yeast infection at home?
Why do yeast infections even happen in the first place, and what does treatment typically involve?
This kind of infection results from an overgrowth of Candida, a type of yeast in moist (sorry) areas like the vagina, according to the American College of Obstetrics and Gynecologists (ACOG).
Candida is a fungus that occurs naturally in the vagina at low levels without issue, but in large numbers, it can lead to the uncomfortable symptoms of a yeast infection, like irritation of the vulva and vaginal opening, a burning sensation during sex or while peeing, a vulvar or vaginal rash, and a thick, lumpy discharge that resembles cottage cheese. (Keep in mind that you may not always have all of these symptoms.)
This fungal overgrowth can happen for many reasons. Things that increase your estrogen, such as pregnancy, combined hormonal contraceptives, and hormone therapy, can raise the glycogen (a type of sugar) in the vagina. Wouldn’t you know it: Yeast happen to love sugar. Uncontrolled diabetes can also contribute, due to the excess sugar circulating in your blood. Antibiotics that disrupt the balance of Lactobacillus bacteria, which can prevent yeast overgrowth, are another factor, according to the Mayo Clinic. There are also lifestyle-related reasons, like spending too much time in damp workout clothing or swimwear, or wearing non-cotton underwear that doesn’t allow for much airflow.
The most common treatment for yeast infections is a one-, three-, or seven-day course of antifungal medicines called azoles, which are in medications such as Monistat. “The over-the-counter treatments work well for the most common yeast [that causes infections], Candida albicans,” Linda Eckert, M.D., professor in the Women's Health Division of the department of obstetrics and gynecology at the University of Washington, tells SELF. However, she notes that other strains of yeast can also cause yeast infections, and Candida albicans has developed some resistance to azoles. As such, sometimes longer treatment is necessary, like a course of treatment that lasts 14 days.
If this is your first yeast infection, you should definitely hold off on at-home treatments and see a doctor for a diagnosis.
Whenever your vagina is suddenly crying out for attention with symptoms you’ve never experienced before, you should see a doctor so you know for sure what you’re dealing with, ACOG explains. But what if this isn’t your first yeast infection rodeo?
“If you've been clinically diagnosed by a physician with a yeast infection on … prior occasions, and the symptoms that you have are consistent with the symptoms that you had before, I do think that it's reasonable to try some of these over-the-counter remedies,” Chantel Cross, M.D., assistant professor of gynecology and obstetrics at Johns Hopkins Medicine, tells SELF.
That said, you can still see a doctor for confirmation of your yeast infection even if you’ve had one diagnosed in the past. In general, people don’t seem to be particularly good at self-diagnosing their vaginal health issues. A 2010 study of 546 people published in Nursing Research found that study participants with yeast infections misdiagnosed themselves around 30 percent of the time, and those with bacterial vaginosis or the sexually transmitted infection trichomoniasis misdiagnosed themselves around 44 percent of the time. A lot of these conditions can share the same symptoms, so it’s not your fault if you can’t always tell them apart. So, if you’re at all unsure, see a doctor.
Is it OK to self-treat with one of those “natural” yeast infection treatments people talk about, like yogurt or garlic?
Some people worry that using actual yeast infection medications will further upset the microbial balance in the vagina, leading to more discomfort. But Leena Nathan, M.D., an ob/gyn at UCLA Health, says this concern isn’t necessary because these drugs are only affecting your yeast overgrowth. “It's OK to go ahead and treat it and not worry about trading one [infection] for another,” she tells SELF. You might experience side effects such as a bit of burning or irritation, and if you choose vaginal suppositories they could weaken the latex in condoms (so use a different form of contraception if necessary)—but antifungals aren’t going to somehow create a different vaginal infection.
Still, that hasn’t stopped people from turning to alternative remedies, like putting yogurt in the vagina. This hasn’t been found effective in large, controlled studies, and Dr. Eckert says she’s had to pull blueberries out of people’s vaginas thanks to this less-than-established treatment.
Garlic is another buzzed about remedy, but again, the science hasn’t proven itself, and there are significant problems with people sticking whole cloves into their vaginal cavities. “Raw garlic is actually quite caustic,” Dr. Nathan says. On the other hand, no vampires? (Seriously, though, don’t do this. The Mayo Clinic recommends always seeing a doctor before you try any kind of alternative yeast infection treatment, because you don’t want to make things worse.)
If you treat your yeast infection at home and it either doesn’t go away or comes back with a vengeance, you need to see a doctor.
Let’s say you’ve had a diagnosed yeast infection in the past, you self-treated a recent one in the last month or two, and it seems like the infection didn’t go away—or it went away but now it’s back. That might mean the treatment simply masked the symptoms rather than eradicating the overgrowth completely. “If your symptoms aren't better and they don't stay better, then you really have to go in and get checked,” Dr. Eckert says.
It could also mean you’re experiencing recurrent yeast infections (more than four yeast infections a year), according to the Mayo Clinic. Your doctor can work with you on identifying your triggers and provide more effective treatments to help manage the yeast overgrowth, such as a longer course of drugs or a preventive antifungal regimen to use even when you don’t have any symptoms.
Another possibility: Your “yeast infection” is persisting because it’s actually a different condition, such as bacterial vaginosis or trichomoniasis. This is why it’s especially important to prioritize heading to the doctor ASAP if you’re pregnant and your self-treated yeast infection comes back. Some issues that can masquerade as yeast infections can be dangerous during pregnancy. For example, bacterial vaginosis can increase the risk of preterm labor, according to the Centers for Disease Control and Prevention.
Ultimately, you shouldn’t hesitate to see your doctor when you’re concerned that things have gone south…down south.
If you’ve had a yeast infection before and you’re totally certain you’ve got one again, trying an over-the-counter medicine before checking with your doctor could be an acceptable treatment option. At best, you’ll be back in optimal vaginal health in a few days. At worst, if symptoms return, you’ll need to set up an appointment and pursue better treatment. The choice is yours—may the Lactobacilli be with you.