Few things feel worse than having a yeast infection when you’re on your period—that deep, invasive itch you can’t scratch is extra uncomfortable when it’s coupled with achey cramps and a whole lot of blood. Even more annoying, the ways a person might typically manage menstruation—tampons, menstrual cups—might become untenably messy when you’re dealing with a yeast infection, too. So what’s a person to do when a yeast infection strikes at exactly the same moment their period arrives?
“There are tons of options for treating yeast infections, regardless of where you are in your cycle,” Jennifer Conti, M.D., a clinical assistant professor at Stanford University in obstetrics and gynecology, says.
That’s good news, as infections are exceedingly common: The National Institutes of Health estimates that 75 percent of women will suffer through a yeast infection in their lifetime. Typically characterized by intense itching, soreness, and/or clumpy white discharge resembling cottage cheese, yeast infections result when the vagina’s good bacteria—specifically, Lactobacillus acidophilus—are thrown out of whack, allowing the vagina’s natural yeast to flourish.
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Factors that can tip that delicate flora balance in yeast’s favor include, according to the Mayo Clinic, a compromised immune system; antibiotic use; uncontrolled diabetes; hormone therapy; and pregnancy, thanks to peaking estrogen levels that can predispose people to yeast infections. And while yeast infections are often attributed to menstruation shifting the vagina’s pH, according to Conti, that’s a misconception. In a healthy vagina, pH hovers between 3.5 and 4.5, fostering the growth of good bacteria and suppressing the overgrowth of infection-causing bad bacteria and yeast. Blood, meanwhile, has a pH of around 7.3. While pH imbalance does contribute to bacterial vaginosis, which sometimes presents with a similar itch, Conti explains that blood passing through the vagina once a month shouldn’t throw off vaginal pH enough to trigger an infection. Indeed, she adds, estrogen levels are low during menstruation, and blood might actually help flush out some of that yeast, providing relief.
What might also make an insufferably itchy vagina feel better? Fluconazole, an oral medication that often treats a yeast infection in one dose. Because it’s a pill rather than a vaginal insert, Fluconazole is likely the least messy and most convenient option for menstruating yeast infection sufferers, although it does require a doctor’s prescription. Unfortunately, the remedies that are widely available at drug stores—like Monistat and anti-fungal creams—might be less effective during a period, Conti explained, “because it’s hard to keep one fluid up there while another fluid’s trying to come out.”
And when it comes to containing menstrual blood, yeast infection sufferers can proceed as they normally would. “It’s totally fine to use tampons or pads if you’re bleeding and also have a yeast infection,” Conti said. The one thing you absolutely shouldn’t do? Douche. Attempting to clean out the vagina with an over-the-counter hygienic product can imbalance pH such that an infection does develop. Plus, they’re a waste of money: As Conti put it, “The vagina can clean itself, thank you.”
The bottom line: Yeast infections are super common and announce themselves with a few distinctive signs. But bacterial vaginosis could easily be mistaken for a yeast infection, as could trichomoniasis, symptoms of which include itching, irritation, and white discharge. If you have a vaginal complaint, it’s always better to check in with a doctor if you can, rather than seek an internet diagnosis. That’s true whether you’re menstruating or not.