Lots of women grab Monistat at the first sign of intense itching. “The problem is that only one-third of the time is a yeast infection the true culprit,” says Mary Jane Minkin, MD, clinical professor of ob-gyn at Yale School of Medicine. Two common issues that frequently mimic it are bacterial vaginosis (BV), which often results in a fishy odor, and contact allergies. “Some of the most sensitive tissue on the body is the perineum, the area between the vaginal opening and the anus,” says Dr. Minkin. “If you have a new soap, that tissue can get irritated and itchy and even cause a thin, watery discharge.”
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A cottage cheese-like discharge is the clearest sign of a yeast infection. Go ahead and use an OTC antifungal, but if the symptoms don’t clear up after one treatment or if they recur within a week, call your doctor. She can write you a script for a stronger antifungal—or figure out if something else is causing your symptoms.
And keep in mind those seven day treatments aren’t stronger or reserved for severe infections. Whether you pick a one-, three-, or seven-day treatment is more about personal preference, says Lauren Streicher, MD, clinical associate professor of ob-gyn at Northwestern University and author of Sex Rx. “Some women assume that more days is better, but the science doesn’t show that,” she says.