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What are the best treatments for vaginal thrush (yeast infections)?
Medically reviewed by
Craig Marsh, Specialist Pharmacist Prescriber (UK)
- Vaginal yeast infections are common, and affect around 75% of women.
- For frequent infections, antifungal medications can be used for up to six months.
- Creams and oral tablets or capsules are often prescribed together to manage the infection.
- You should seek help from a healthcare provider if you get symptoms for the first time, if you’re over 60, or if you have a compromised immune system.
Infections are caused by an overgrowth of the fungus candida albicans, and can develop for many reasons. It’s sometimes referred to as vaginal candidiasis.
Taking antibiotics, using contraceptive pills, being pregnant, or having poorly managed diabetes can all contribute to yeast infections. You might be more susceptible to it if your immune system is weakened, or if you use perfumed products that irritate the skin on and around your vagina. Sometimes, an infection occurs as a result of wearing clothes that trap moisture and heat, creating the perfect environment for fungi to grow in. Sex is also a trigger, and can make symptoms worse if you already have an infection.
When it comes to treatment, there are many options available. Internal and external creams, tablets, capsules, and vaginal suppositories (sometimes called ovules) are also commonly prescribed.
The right medication for managing a yeast infection will depend on your individual needs. Talking to a doctor or pharmacist can help you choose the one that seems like the best fit for you. In most provinces, pharmacists can now assess and prescribe for uncomplicated yeast infections. Here, we’ll take a closer look at the different options available, what to do if you get infections often, and whether they can lead to complications.
What treatments are there for yeast infections?
Azoles, which are a type of antifungal medication, are commonly used to treat vaginal thrush. Fluconazole and clotrimazole are two popular types that are prescribed to control fungal infections.
Treatments usually come in the form of oral tablets and capsules, or topical creams. Both work in a similar way, by targeting ergosterol. Ergosterol is a key component in the structure of fungi, and azoles work by weakening fungal cell membranes. Sometimes, creams and tablets or capsules are used together. The one that works best for you will depend on your symptoms — external infections might only affect your skin, and respond well to creams. Internal infections, where you have discharge or stinging while urinating, might respond better to systemic treatments or internal suppositories.
Best internal creams and suppositories
Internal creams are used with an applicator you insert into your vagina. Suppositories (ovules) are solid treatments that melt inside the vagina. They might be your preferred option for treating thrush if you can’t use oral tablets or capsules.
internal creams and suppositories
| Active ingredient | Brand names | How to use it |
|---|---|---|
| Clotrimazole | Canesten Internal Cream / Combi-Pak | Available over-the-counter. To work properly, you’ll need to avoid using tampons and other vaginal products that have the potential to remove the cream. |
| Miconazole nitrate | Monistat (1, 3, or 7-day versions) | Antifungal azole applied daily, usually before bed, for one, three, or seven days. This is a very common OTC (over-the-counter) medication. |
Best external creams for soothing
External creams can be applied to any affected areas of skin, usually in a thin layer. Formulas that are used externally are often used internally too, and a clinician might recommend you use them both ways.
External creams
| Active ingredient | Brand names | How to use it |
|---|---|---|
| Clotrimazole | Canesten External Cream | Can be applied several times a day to soothe itching and irritation. Sometimes used alongside a vaginal tablet for a more thorough treatment. |
| Miconazole nitrate | Monistat External Cream | Azole cream that treats infections and clears symptoms. Apply a thin layer twice a day to the vulva to relieve itching. |
Best tablets and capsules
Tablets and capsules treat the infection systemically and are absorbed into your bloodstream. They might be prescribed if your symptoms are moderate to severe.
tablets and capsules
| Active ingredient | Brand names | How to use it |
|---|---|---|
| Fluconazole | Canesten Oral Pill, Diflucan | Single-dose azole treatment in a 150mg capsule. Can clear an infection quickly and relieve symptoms. Also available as a generic capsule. |
| Clotrimazole | Canesten Vaginal Tablet / Ovule | One-dose suppository inserted directly into your vagina. Comes with an applicator for easy insertion. |
Best treatments for persistent yeast infections
If you get vaginal yeast infections more than four times a year, a clinician will try to help you find out what could be causing them.
Some conditions, like diabetes, can make you more prone to infection. With this in mind, you might be referred for tests to monitor your blood sugar levels and rule out diabetes. Further tests might also be suggested if you have other symptoms, such as coloured discharge or unusual bleeding.
If you get persistent infections, you might need to use a medication for longer than the usual course of treatment. This could mean taking medication for around six months, but it will depend on your symptoms and how you respond to the treatment you use.
Creams and tablets are sometimes prescribed at the same time to manage vaginal thrush. Canesten Combi, for example, is a dual-medication treatment — the packs contain an oral capsule (fluconazole) and a topical cream (clotrimazole). Both medications are azoles, a type of antifungal. The capsules target fungus systemically, while the cream can relieve itching and discomfort when rubbed into the affected area.
Although it’s not a sexually transmitted infection (STI), yeast infections can be triggered by sex. Having sex while you have an infection can also irritate and damage the skin around your vagina, which could leave you vulnerable to future infections.
A clinician might also ask you about your hygiene routine, and if any products you use regularly could be contributing to recurrent infections. Perfumed soaps and detergents are known to aggravate vaginal skin, so it might be worth switching to products that are gentler on your skin.
Will vaginal thrush go away on its own?
Mild yeast infections can clear up on their own. If you suspect thrush symptoms are developing, keeping the area clean and dry might be enough to stop them getting any worse.
Wear loose-fitting, breathable (ideally cotton) underwear and avoid anything that might irritate the area.
The severity of your symptoms is usually a good indicator of whether your infection needs treatment. Yeast infections can be unpleasant — the itching and burning it causes can interfere with your routine and be uncomfortable.
Sexual health clinics might also be able to help, especially to test to see if you have any other STIs that may mimic these symptoms.
It’s recommended you seek help when you get symptoms for the first time. This is especially important if you have a weakened immune system, or experience hormonal fluctuations. Anyone over the age of 60 should also get help from a medical professional, as they might find it harder to keep an infection under control.
How do you know when vaginal thrush is serious?
Most women won’t need to worry about a yeast infection becoming serious. They’re often uncomfortable while you have them, but can clear up without treatment, or respond well to antifungal creams and tablets.
In rare cases, candida albicans can cause sepsis, which can lead to septic shock. It infects the bloodstream and can be life-threatening for critically ill patients. Fungi are responsible for around 15% of infections in healthcare settings, and can pose a serious threat to people in intensive care units.
Sepsis is a risk for anyone with a weakened immune system. It can cause fever, a high heart rate, and shortness of breath. It’s usually caused by a bacterial infection, but fungal sepsis is possible and can be prevented by treating an infection early.
So while vaginal thrush won’t usually be a serious risk to your health, it’s important to manage an infection when it develops.
Reference Popover #ref1
Treated trusted source
Better Health Channel (2012).
Vaginal thrush. Vic.gov.au.
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HealthLinkBC (2022).
Recurrent Vaginal Yeast Infections | HealthLink BC. Healthlinkbc.ca.
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HealthLinkBC (2022).
Vaginal Yeast Infections | HealthLink BC. Healthlinkbc.ca.
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Delaloye, J. and Calandra, T. (2014).
Invasive candidiasis as a cause of sepsis in the critically ill patient. Virulence, pp.161–169.
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World Health Organization (2024).
Sepsis. World Health Organization.
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