Skip the Monistat and try these better-for-you yeast infection treatments

Many years ago, while visiting a cousin in Germany (the first time I’d gone abroad), I developed a yeast infection. I tried to ignore it, which only led it to rage harder. Eventually I had to seek help and asked my 23-year-old Midwestern male cousin to take me to a pharmacy and translate my request for medicine. We were both mortified.

That was pretty high on the yeast infection embarrassment scale. But they’re almost always something women (at least those who aren’t Hannah Horvath) find awkward to talk about.

Yet most of us get them from time to time, so dealing with them is going to be a fact of life. What’s the best (and healthiest) way to deal? I got the lowdown from Eden Fromberg, MD, an integrative OB-GYN, holistic women’s health specialist, osteopathic clinical professor, and founding director of Lila Yoga, Dharma & Wellness in New York City, where she teaches and curates programs and trainings for women.

Here are some holistic ways to deal with the not-so-pleasant surprise of a yeast infection.

Yikes, what do I do now?

Don’t go running to the nearest drugstore for Monistat, cautions Dr. Fromberg, noting that over-the-counter and prescription antifungal creams and suppositories can cause burning and irritation, aren’t always effective, and may even lead to drug resistance. And stay far away from Vagisil, which does not treat yeast, and contains not-so-clean ingredients like methylparaben, a possible endocrine disruptor, and propylene glycol, which can trigger inflammation. The most common gyno-prescribed treatment, Difulcan (AKA fluconazole) covers only certain yeast strains and can come with side effects like nausea, diarrhea, or even hair loss.

Fortunately, there are other options. Dr Fromberg suggests:

• Boric acid vaginal suppositories. A 600mg dose once or twice a day lowers the vaginal pH to an acidic range in which yeast can’t survive. Another common remedy many women rely on? Antifungal tea tree oil suppositories.

• Vinegar douche. This is a milder way to acidify the vagina that often works alone or as an adjunct treatment. But note that douching in the case of an STD or bacterial infection may spread the infection. If you aren’t sure, get tested.

• Oral probiotics. These supplements may help to positively influence the gut and therefore the vaginal microbiome. Some people will tell you to insert probiotics vaginally, but studies show that it does not seem to cause a permanent microbiome shift (although there are some anecdotal reports of women successfully treating infections vaginally with yogurt).

Then, figure out: what was the culprit?

“Yeast infections are caused by disruptions in the vaginal microbiome (a mix of normal and pathogenic microorganisms),” says. Dr. Fromberg. Those imbalances may be caused by antibiotics, gut health issues, and a weakened immune system caused by anything from stress on up to cancer.

Over-the-counter and prescription antifungal creams and suppositories can cause burning and irritation, aren’t always effective, and may even lead to drug resistance.

Other contributors: eating a diet high in sugar and simple carbohydrates, and low in vegetables and fiber—which is credited with major yeast-fighting power because it contains oligosaccharides that feed healthy female flora and discourage yeast. Another reason to skip the sugar, pile on the veggies, and keep up that meditation practice.

And the idea that sex causes yeast infections is not off base, actually. Dr. Fromberg says semen, friction, or a partner’s disrupted microbiome (as in, jock itch—yikes) can all mess up the balance of flora in the vagina.

How can you prevent them altogether?

Since antibiotics were the first cause that Dr. Fromberg mentioned, it’s not surprising that avoiding them is her first defense strategy. Use them only as a last resort for a true medical need, and never take them daily to prevent acne or UTIs.

In addition to maintaining a diet that’s robust in vegetables, fiber, healthy protein, and healthy fats and low in sugar and simple carbs, she advises eating fermented foods such as sauerkraut, kimchi, and live-culture yogurt. Bone broth is high in a substance called glycosaminoglycans, which are important for vaginal immune function. And you can decrease your sexual risk by making sure your partner isn’t carrying around his or her own yeast surprise (TMI, but true).

Originally published November 16, 2016; updated July 16, 2018.

While we’re in the TMI zone, women’s hormone expert Alisa Vitti explains how to make sure your lady parts aren’t aging ahead of schedule. And an under-appreciated all-around health booster? Masturbation.