First Treatments for Yeast Infections That Come Back

Medically Reviewed by Traci C. Johnson, MD on June 10, 2022
4 min read

Yeast infections are caused by a type of yeast (which is a fungus) called candida. It’s normal for candida to be inside our bodies and on our skin. But if too much candida grows in the vagina, it can turn into a yeast infection.

Symptoms include a thick, white-to-yellow discharge from your vagina (that typically doesn’t smell bad). Other symptoms include itching, discomfort, or a burning feeling around the outside of the vagina when you pee or have sex.

Once diagnosed, a yeast infection goes away after you take an antifungal medicine like fluconazole (Diflucan) or miconazole (Monistat) for a few days. But sometimes, a yeast infection comes back.  

It’s defined as having four or more yeast infections within a year that are unrelated to taking antibiotics and which have symptoms. If this happens to you, it’s important to see your doctor because the symptoms may be due to other causes or to additional causes.

Most people who get recurrent yeast infections are healthy. Some people just get more yeast infections that others. That said, recurrent infections can have a number of causes.

  • Your infection may be caused by a type of yeast that resists treatment. If you get a yeast infection within 3 months of your last one, it’s likely that your infection is not caused by candida albicans, which is the most common type.
  • Your last yeast infection may not have totally cleared up, or perhaps you didn’t finish taking all your medicine.
  • You may have some other health issue that is weakening  your immune system, such as HIV or AIDS.

Several things can raise your chances:

Taking antibiotics can destroy your vagina’s flora, the healthy organisms that normally live there. When that happens, yeast can grow beyond the normal amount to become an infection.

Women who take birth control pills have higher rates of yeast infections. Spermicidal jellies and creams can change vaginal flora so it’s easier for yeast to multiply. Women on hormone replacement therapy (HRT) are also more likely to have yeast infections.

Lifestyle factors can also play a role. Wearing tight clothes or underwear while sweating or in the heat, for example, can increase heat and moisture. Irritating or repetitive movements in or near the vaginal area -- caused by tight clothing or sex -- can increase the likelihood of a yeast infection.

Two less common risk factors are high blood sugar or diabetes.

What you eat does not seem to affect the chance of getting recurrent yeast infections, nor does treatment of male sex partners for yeast infections.

The first treatment your doctor will try for recurring vaginal yeast infections is still an antifungal medication – as a cream applied to the vagina and/or a pill – taken for 10 to 14 days, followed by an antifungal pill taken weekly for 6 months. (Antifungal pills should not be taken by women who are pregnant.) For more than 90% of women on this treatment, symptoms will go away.  

An antifungal medicine has been FDA approved for postmenopausal or permanently infertile women (including women who have had a hysterectomy, tubal ligation on both sides,  or removal of the ovaries and fallopian tubes on both sides.) Oteseconazole (Vivjoa) is a pill taken alone or with fluconazole at intervals over a period of 12 to 14 weeks.

For uncommon types of yeast organisms, doctors may recommend treatment with boric acid capsules inserted into the vagina daily for 2 weeks.

Recurrent yeast infections typically cause intense discomfort.  If your symptoms don’t improve with treatment, you should see your doctor for more testing to determine if something else is causing your recurrent yeast infections. This may include tests for diabetes and HIV.

After the yeast infection clears up, you may need to take medicine regularly in order to prevent recurrent infections or to take it periodically (from time to time). Stick with long-term treatment. Between 53% and 63% of women who stop taking their medication are likely to get another yeast infection.

Make an appointment with your doctor if:

  • You’re not sure you have a yeast infection.
  • The symptoms you’re having are different from previous yeast infections.
  • The medication that worked for previous yeast infections is not working.  
  • Your symptoms get worse.

Your doctor may examine a small amount of vaginal discharge under a microscope to identify the specific type of yeast infection you have.