To many women, vaginal itching and discharge mean one thing only: a yeast infection. But many women who buy over-the-counter yeast medications don’t have a yeast infection at all -- and some who do may also had another infection. Antifungals (Monistat, Gyne-Lotrimin, Mycelex) clear up only yeast, not other conditions (all easily treated with prescription drugs), such as:
Trichomoniasis, a parasite transmitted through intercourse. You may have this STD if you notice changes in vaginal discharge, itching, and pain during urination and sex.
Chlamydia, another sexually transmitted disease. Untreated, it can lead to pelvic inflammatory disease and sometimes infertility. Some women have no symptoms but others notice abnormal discharge, painful periods, bleeding between periods, stomach pain plus fever, pain during sex, an itching or burning sensation, and painful urination.
Bacterial vaginosis, an infection that's more common than yeast; if you're pregnant, it can trigger premature labor. Many women with bacterial vaginosis don’t experience symptoms, but call your doctor if you experience vaginal discharge with a bad odor (some describe it as “fishy”), which might be more noticeable after sex.
Yeast infections can be tricky to self-diagnose because symptoms vary widely. But that doesn't mean you always need to run to the doctor. "If it's your first vaginal infection, be sure you're seen and examined before you self-treat," says Daron Ferris, M.D., of the Medical College of Georgia. "But if your clinician has previously confirmed that you can correctly diagnose yeast, it's okay to treat it yourself in the future."
Make sure to see your doctor if:
Symptoms get worse or don't improve within three days of treatment. (Don't switch to another antifungal brand; if one doesn't work, none will.)
You're pregnant; though safe, anti-yeast drugs are best used under supervision during pregnancy.