Recurrent vaginal yeast infections are a stressful challenge for many people.

Occasional yeast infections are common for women and people assigned female at birth, especially during their menstrual years.

But recurrent yeast infections are characterized by four or more yeast infections in a year, which can significantly impact one’s quality of life and prompt a quest for effective (and cost-effective) remedies to treat and prevent repeat episodes.

Hopefully, this article can shed some light on practical strategies that can be used to treat recurrent yeast infections while warding off any future recurrences.

Diagnosing Chronic Yeast Infections

Most people recognize the symptoms of a yeast infection. Common symptoms of yeast infections include:

• Itching and irritation on the vulva and around the vagina
• Pain with urination and intercourse
• Red or swollen vulvar and vaginal tissues
• Abnormal discharge that can be watery or white and clumpy

Most people are comfortable self-treating with over-the-counter topical medications. However many vagina owners don’t realize how important it is to get an accurate diagnosis when experiencing recurrent yeast infections.

Clinical evaluation of recurrent yeast infections is a must-do. Self-diagnosing can lead to missing important contributors like contraceptive use, weakened immune system, and high blood sugar. It's best to consult a medical professional for accurate diagnosis and treatment.

Examining the vagina and collecting a sample can identify the specific type of Candida fungus causing the infection. This includes strains of Candida albicans that are resistant to treatment.

Treating Chronic Yeast Infections

For episodic yeast infections, topical over-the-counter anti-fungal medications or a single oral dose of fluconazole are still the most commone forms of treatment. When used correctly, these first-line treatment choices resolve symptoms quickly and produce a negative culture in up to 90% of women who complete treatment.

For repeat yeast infections, it's best to use the prescribed or over-the-counter treatment for an extended period. Doctors often recommend a maintenance regimen, too.

Chronic infections often need more than one dose of fluconazole or up to two weeks of topical treatment. For reference, standard treatment can last for one, three, or seven days.

For example, the CDC recommends using oral fluconazole weekly for six months as an initial treatment for recurrent yeast infections.

The long story short: After the acute infection has been treated, followed preventive therapy is important even if optimal treatment. Consequently, treatment must be individualized based on efficacy, convenience, side effects profile, and cost.

Most experts agree on a strategy that includes treating the initial yeast infection then starting maintenance therapy at one to three times per week using a topical medication of choice. Twice a week dosing is most often utilized. Boric acid is also an option for either Candida albicans or non-albicans fungi. Most studies also suggest prophylaxis for six months before re-evaluating and re-adjusting the medication, dosage, and frequency based on symptoms and recurrence rates.

Alternative Therapies, Lifestyle Adjustments, and Personal Triggers

Some people, especially those who don’t respond to conventional treatments, explore alternative therapies for treating and preventing recurrent yeast infections, including tea tree oil, garlic supplements, essential oil of oregano, boric acid, and probiotics. Many of these “at-home” remedies fall into the “won’t hurt/might help” category, but it’s critical to consult with a healthcare provider before trying any of these methods to make sure they’re safe and, at least, potentially effective.

Certain lifestyle and diet changes may help prevent the recurrence of yeast infections. Many people also find it helpful to be made aware of behaviors, practices, and situations that can lead to recurrent yeast infections.

• Genital Hygiene: Avoid over-washing or using harsh, scented products that can disrupt healthy vaginal flora.
• Clothing: Breathable, loose-fitting clothes and underwear made from natural fibers reduce moisture and heat, which promotes yeast growth.
• Diet: Yeast feeds on sugar, so reducing sugar consumption and refined carbohydrates is advisable.
• Antibiotics: Antibiotics kill healthy, protective vaginal bacteria. Ask your provider for strategies, like eating yogurt with lactobacillus, to prevent yeast overgrowth if you are prescribed antibiotics.
• Diabetes: High blood sugar (hyperglycemia) is considered a risk factor for recurrent yeast infections.
• Contraceptive Methods: Vaginal sponges, diaphragms, spermicidal gels, birth control pills, and hormonal IUDs may increase the risk of yeast infections.
• Weakened Immune System: Yeast infections are more common in people with weak immune systems due to HIV, other illnesses, or certain medications like steroids and chemotherapy.
• Sexual Activity: Yeast infections are not STIs, but some studies have found a positive correlation between frequency of sex and frequency of yeast infections.
• Pregnancy: Pregnant women (and anyone experiencing hormonal shifts) are more prone to yeast infections because hormone changes can alter the pH balance of the vagina.

Win the Fight Against Chronic Yeast Infections

Recurrent yeast infections require a multifaceted approach to treatment and prevention. Beyond the immediate relief provided by antifungal medications, finding the right strategy for preventing recurrent yeast infections can take a trial of time and error. It’s important to work with your healthcare provider to develop a personalized plan that considers the unique aspects of your health and lifestyle.

Besides that, considering alternative therapies, addressing lifestyle factors, making dietary changes, and recognizing triggers are other ways to significantly reduce the odds of experiencing recurrent yeast infections going forward.

If you’re suffering from chronic yeast infections, it’s important to know that what you’re feeling is valid and you don’t have to “just deal with it.” Meeting with a healthcare provider can help you figure out what’s going on and get the relief you deserve. At Tia, our team of women’s health experts use a comprehensive approach to connect the dots on your symptoms, find the root cause, and create a treatment plan that’s personalized to you. (And yes, we even take insurance!)