As soon as the itching starts, so does the yeast infection panic. Some women worry that all vaginal itching and irritation are signs of a yeast infection. Other are so afraid of yeast infections they use special soaps and cleansers hoping to stop them, not realizing that might actually make it worse.
The problem is, most women can't reliably and accurately diagnose their own yeast infections, said gynecologist Dr. Jen Gunter.
“If you don’t know what the symptom is you could be getting misdiagnosed,” said Gunter, the author of the new book, The Vagina Bible — The Vulva and the Vagina: Separating the Myth from the Medicine, told TODAY. “Maybe your vagina is irritated because you have trichomoniasis, a sexually transmitted infection. Maybe you’re irritated because you’re going through menopause and you could be treated with estrogen.”
It's a legitimate concern. About 70 percent of women have at least one yeast infection during their lives, Gunter writes in her book. About five to eight percent cope with recurrent infections.
By far, the most common type of yeast infection is Candida albicans.
A yeast infection can cause a red, itchy rash in the vaginal area, soreness and a burning sensation during sex or urinating. When the first symptoms strike, some women turn to holistic remedies or do what their mom or friends do. Gunter says women shouldn’t rely on “ancient technologies or old-time medicine.”
“Women deserve better than old wives’ tales,” she said. “Women aren’t stupid. They go online and they go to trusted sources and they are told to do that.”
Gunter explains why most natural remedies for common yeast infections don't relieve itching and irritation — and how some can actually be harmful.
1. Boric acid
Many natural treatments promising to regulate vaginal Ph — which is actually not a medical thing, Gunter said — or treat yeast infections contain boric acid.
Doctors sometimes use boric acid for yeast infections that are treatment resistant, but they consider it a last option. That’s because boric acid is so caustic that it causes injuries and kills everything in the vagina, including the good bacteria.
“Boric acid kills the yeast because it nukes everything,” she said. “We actually see quite a significant amount of vaginal trauma from it. You are putting a caustic substance in the vagina and you can irritate the epithelium, it can damage the mucous and I think, paradoxically, make you more vulnerable to getting infections.”
Bottom line: avoid any product with boric acid, unless prescribed by a medical doctor.
Lactobacilli — a type of bacteria commonly found in the body that aids in normal functioning — populate the vagina. Another type of lactobacilli is found in yogurt.
Some women believe that if they slather yogurt on when they’re suffering from a yeast infection, the yogurt’s lactobacilli will change the vagina’s microbiome and good bacteria will flourish. As recently as last year, Gunter found this as a suggested treatment in the book, “Our Bodies, Ourselves” and other online sources.
It sounds like a good idea — in theory.
But, there’s no evidence this works and it could be harmful.
“We don’t know what the risk of exposing your vagina to this not-needed lactobacilli is,” she said. “Yogurt has live cultures. What other bacteria could be growing in there?”
Many argue that yogurt feels soothing, which shows it works. But that’s not because of the yogurt's cultures, Gunter said.
“Yeast creams are soothing when you first apply them because they’re a cream. You’re not feeling better because it is killing the yeast immediately,” she said. “A lot of women mistake the fact that they’re getting soothing from a yogurt as a medicinal effect.”
“You have this raw inflamed vagina from a yeast infection and now you’re going to put cut up garlic in there. Oh my god, that stings.”
Garlic contains an anti-inflammatory component, called allicin, which some think has anti-fungal properties. That’s why some women think if they put garlic in their vagina during a yeast infection, they’ll feel relief.
While this sounds like it could work, the science behind it is iffy.
“Studies aren’t so good," Gunter said. "To release allicin, just like you get the flavor of garlic, you have to cut and crush it. If you have a whole clove of garlic you don’t have the allicin,” Gunter explained.
And, putting crushed, cut up garlic in one’s vagina is as physically unpleasant as it sounds.
“You have this raw inflamed vagina from a yeast infection and now you’re going to put cut up garlic in there,” she said. “Oh my god, that stings.”
Then, it needs to be removed.
“I have fished out cut up pieces of garlic. It is not easy to get out,” she said.
The bottom line: Natural doesn’t mean better.
“We have great potential pharmaceutical options so there's no need to experiment with all these,” Gunter said. “There’s nothing that tells us it’s safe.”
What helps a yeast infection
There are over-the-counter medications from a class of drugs called azoles that are available in either cream or ovule form that provide relief to many women, Gunter said.
If symptoms drive you to the doctor, there are effective prescription treatments available:
- Oral medication called fluconazole effectively treats yeast infections. One 150 gram dose cures mild to moderate infections while two doses taken 72 hours apart tackle severe infections.
- Taking oral antihistamines, such as cetirizine or loratadine, minimizes the itching and helps women feel relief sooner.
- Topical steroids on the vulva can also lessen irritation and swelling.