Antifungal Resistance Is Getting Worse—And It Could Make Treating Yeast Infections Even More Hellish

If you’re a human with a vagina, you probably know a thing or two about yeast infections—and how they’re a total b*tch. Even b*tchier: They’re getting harder and harder to treat, thanks to the threat of antifungal resistance.

On Friday, Newsweek called antifungal drug resistance “as serious as the antibiotic apocalypse.” Yikes.

The news comes from a review published in the journal Science, which outlines the problem. The authors call out a class of antifungal medications called azoles (the first-line treatment for vaginal yeast infections, among other things), for being way overused, which speeds up fungus’ ability to resist the drugs and making those drugs less effective.

Since about 75 percent of women will experience the extreme itchiness, burning, and cottage cheese-like discharge of a yeast infection in her lifetime, according to U.S. Department of Health and Human Services, it’s likely your biggest current worry with antifungal resistance.

Wait a sec—antifungal resistance? What is that?

Antifungal resistance happens in the exact same manner as antibiotic resistance. Using antifungal drugs too often or incorrectly kills off good yeast present and encourages the growth of harmful yeast, so if/when you do get an infection, it’s more difficult to treat.

yeast infection or std

Here’s an example: Let’s say you call your doctor about a yeast infection. Typically, they’ll prescribe a one-day course of an oral antifungal med to nip the problem in the bud. Or, you can head to the drugstore and get a topical over-the-counter treatment like Monistat.

However, because of resistance to azoles, those drugs aren’t as effective anymore—forcing some doctors to prescribe stronger drugs or use remedies like boric acid (!!!) in order to fully kill the fungus.

This antifungal resistance also means that there are some women whose yeast infections just can’t be treated effectively at all, says Emily Landon, M.D., Medical Director of Antimicrobial Stewardship and Infection Control at the University of Chicago Medicine. Basically, they live with a constant, low-level yeast infection—something that’s totally life-disrupting, to say the least.

How can I protect myself against these hard-to-treat yeast infections?

Use the full course of medication (yes, even if you’re feeling better), whether it’s an oral prescription from your doc or the OTC topical vaginal meds, and always follow directions. “Under-treating a yeast infection creates a problem,” she says.

If it doesn’t go away, see your doctor, who may give you a culture test. Other conditions, like bacterial vaginosis and the STD trichomoniasis, can saddle you with similar symptoms.

woman in bed

Also, use these antifungals only when truly needed. Landon points out that most women who’ve had a yeast infection diagnosed by their doctor know when they get another one. In that case, grab an OTC antifungal. But don’t dash to the store every time you have a little discharge. “You want to make sure it’s real before you expose the natural yeast in your vagina to medication,” Landon says.

A worse practice is keeping these meds on hand and using them when you think you might have the beginnings of a yeast infection or to prevent them altogether. If you have two or three yeast infections every year, you probably need a longer course of treatment (three to seven days) rather than taking the one-off antifungal medication, says Landon.

The bottom line: The uptick in antifungal drug resistance is particularly scary when it comes to yeast infections, but you can still protect yourself by treating any yeast infection fully and correctly.

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