So you think you have a yeast infection and you buy an over-the-counter (OTC) treatment, but four days later you are still very itchy/irritated/burning like crazy. First of all you need this background information: If you were right then there is a 85-90% chance that you should be better. The next step, for most women, is to call their GYNO and ask for fluconazole, known by many under the brand name Diflucan, or to retreat with a OTC topical. If you guessed correctly and aren’t better more of the same (i.e. trying fluconazole/Diflucan or another OTC medication) is not likely to be any better because the oral and topicals work in the same way. If you are not feeling better after treatment (which will happen 75% of the time just looking at the statistics) there are five possible scenarios: Put another way, if 100 women use OTC medication for vaginal yeast, 70 will have persistent symptoms because they never had yeast to begin with and 5 will still have persistent symptoms related to yeast. That means if you have persistent symptoms there is a 93% chance you never had yeast and a 7% chance that you did, but need further information to treat. The chance that more of the same will help is very slim. Other clinical pearls: A bad yeast infection can take seven days to feel a lot better, An antihistamine, like Zyrtec or Claritin, will help you feel better faster and a low dose topical steroid on the vulva (labia and vaginal opening) will also help if there is a lot of external irritation But the OTC always fails for me and the Diflucan always works! This is unlikely related to the type of medication (OTC vs prescription) and more a mechanical issue – some women place the vaginal medication too low in their vagina (if the tissues are really inflamed it can be harder to get high enough). Allison is affluent young housewife and new mother. She leads a privileged life, tucked away in her sophisticated suburban oasis. The introduction of her newborn baby Trevor forces Allison to expand her focus beyond herself. While wholeheartedly embracing her new role as a parent and guardian of a future generation’s well-being she develops a strong sensitivity with regard to her new-found responsibilities. It is with this lens, one that compels her to be aware of and care deeply for the world around her, with which she begins to view her life. Over the course of the next few days she wrestles with the problem of removing the pest, something that becomes a moral dilemma for the young mother. 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I have had doctors who will prescribe Diflucan over the phone. Whenever I feel even the slightest tinge of a yeast infection, I buy.