Most yeast infections can be treated at home with antifungal creams or suppositories available without a prescription. These over-the-counter products come in one-day, three-day, and seven-day options, and symptoms typically clear up within a few days to a week. If this is your first infection, your symptoms are severe, or infections keep coming back, a prescription oral antifungal may be the better route.
Over-the-Counter Antifungal Treatments
The most common OTC options are miconazole (sold as Monistat) and clotrimazole (sold as Trivagizole). Both come as vaginal creams or suppositories with an applicator. Miconazole is available as a single-dose insert, a three-night regimen, or a seven-night regimen. Clotrimazole comes in three-day and seven-day versions. A third option, tioconazole (Vagistat), is an ointment applied once.
All three work the same way: they kill the fungus causing the infection directly at the site. Short-course treatments (one to three days) are effective for straightforward yeast infections. The seven-day versions aren’t necessarily better for a simple infection, but they may be preferred if you’ve had irritation with stronger, shorter-course products. You’ll usually notice itching and burning start to ease within two to three days, though full resolution can take up to a week.
Prescription Options
A single oral dose of fluconazole is the main prescription alternative. It’s convenient because you take one pill and you’re done. For infections that are more severe, with significant redness, swelling, or sores, a longer course is recommended: typically three doses spread over a week, followed by topical treatment for 7 to 14 days total.
There are also prescription vaginal creams and suppositories (terconazole, butoconazole) that a provider might recommend if OTC products haven’t worked or if the infection involves a less common strain of yeast.
Make Sure It’s Actually a Yeast Infection
Before you treat, it helps to know what you’re dealing with. Yeast infections, bacterial vaginosis, and trichomoniasis can all cause vaginal irritation, but they require different treatments. Here’s how to tell them apart:
- Yeast infection: Thick, white, odorless discharge, often described as cottage cheese-like. Intense itching and sometimes a white coating in and around the vagina.
- Bacterial vaginosis: Grayish, foamy discharge with a noticeable fishy smell.
- Trichomoniasis: Frothy, yellow-green discharge that smells bad and may have spots of blood.
If your discharge has a strong odor, looks discolored, or your symptoms don’t match the typical yeast infection pattern, OTC antifungals won’t help and could delay the right treatment.
What to Do About Recurring Infections
If you get four or more yeast infections in a year, that qualifies as recurrent vulvovaginal candidiasis, and the approach changes. A single dose of antifungal won’t keep the infection from bouncing back. CDC guidelines recommend starting with a longer initial treatment to fully clear the fungus, then moving to a maintenance phase: a weekly oral antifungal for six months. If pills aren’t an option, intermittent topical treatments can serve as an alternative.
This maintenance strategy works well for most people, but it does require a prescription and monitoring from a healthcare provider. Recurrent infections sometimes involve yeast strains that are resistant to standard antifungals, so getting a culture done can help guide treatment.
Probiotics as a Supplement to Treatment
Probiotics containing Lactobacillus strains have shown some promise for reducing yeast infection recurrence when used alongside standard antifungal therapy. In one controlled trial of women with recurrent infections, those who took an oral probiotic containing L. acidophilus and L. rhamnosus alongside their antifungal had significantly lower recurrence rates: about 33% experienced a recurrence at three months compared to 92% in the group that used antifungals alone. At six months, the gap widened further (29% vs. 100%).
That said, the evidence is mixed. A broader review of five trials found inconsistent results, and at least one study using a different Lactobacillus strain showed no improvement in symptoms at all. Probiotics are not a replacement for antifungal treatment, but they may offer an added layer of protection if you’re prone to repeat infections. Look for products specifically containing L. acidophilus or L. rhamnosus.
Treatment During Pregnancy
Yeast infections are common during pregnancy, and the good news is that OTC vaginal creams and suppositories like miconazole and clotrimazole are safe to use at any point during pregnancy. They don’t cause birth defects or pregnancy complications.
Oral antifungals are a different story. Fluconazole, the standard prescription pill, has a possible link to miscarriage and birth defects, particularly when taken during the first trimester. Stick with topical treatments during pregnancy and avoid oral antifungals unless specifically directed otherwise by your provider.
Habits That Help Prevent Yeast Infections
The CDC specifically recommends wearing cotton underwear to reduce yeast infection risk. Cotton breathes better than synthetic fabrics, keeping the vaginal area drier and less hospitable to yeast overgrowth. Beyond underwear choice, a few other habits make a difference:
- Change out of wet clothing quickly. Sitting in a damp swimsuit or sweaty workout clothes creates the warm, moist environment yeast thrives in.
- Skip scented products. Douches, scented tampons, and fragranced sprays disrupt the natural balance of bacteria and yeast in the vagina.
- Avoid unnecessary antibiotics. Antibiotics kill the beneficial bacteria that keep yeast in check, which is why yeast infections often follow a course of antibiotics.
- Wear loose-fitting clothing. Tight pants and pantyhose trap heat and moisture against the skin.
None of these strategies guarantee you’ll never get another yeast infection, but together they meaningfully lower the odds, especially if you’re someone who gets them frequently.