Vaginal thrush is a common yeast infection that affects most women at some point.
It may be unpleasant and uncomfortable, but can usually be treated with medication available from pharmacies or on prescription from your GP.
However, for some women, vaginal thrush can be difficult to treat and keeps coming back.
Most women have been there. You’re distracted and squirming in your chair because it doesn’t feel right down there. Perhaps there’s a smell that’s a little, well, funkier, than usual. You want to do something to make it stop, now.
Although it can be darned uncomfortable, it’s not the end of the world. You could have an infection caused by bacteria, yeast, or viruses. Chemicals in soaps, sprays, or even clothing that come in contact with this area could be irritating the delicate skin and tissues.
It’s not always easy to figure out what’s going on, though. You’ll probably need your doctor’s help to sort it out and choose the right treatment.
Thrush or vaginal candidiasis are the general and medical terms used to describe a common vaginal yeast infection. Thrush occurs when there is an overgrowth of Candida albicans (yeast-like fungus) in your vagina. This occurs when the good bacteria in your vagina can’t keep the fungus (Candida albicans) under control, creating a suitable environment for Candida albicans to increase.
Just so you know, thrush is not a sexually transmitted infection. It can be really uncomfortable, but in the majority of cases it’s simple to treat.
Everyone is different, so your symptoms may differ from a friend’s. They may also change each time you get thrush, so watch out for these common symptoms and whether your symptoms are mild, moderate or more complicated.
In women with this disease usually affect the vagina and external genitals, the male head of the penis and the foreskin.
What causes vaginal thrush?
Vaginal thrush is caused by yeasts from a group of fungi called Candida.
Many women have Candida in their vagina without it causing any problems, but thrush can develop if the natural balance of micro-organisms in the vagina is disrupted and Candida multiplies.
You’re more likely to get thrush if you:
- are in your twenties and thirties – thrush is less common in girls who haven’t started their periods and women who have been through the menopause
- are pregnant
- have sex when you’re not fully aroused or you’re worried it may hurt – this can lead to vaginal dryness and tightness during sex, which can trigger thrush
- take antibiotics
- have poorly controlled diabetes
- have a weakened immune system – for example, because of a condition such as HIV or a treatment such as chemotherapy
Vaginal thrush isn’t classed as an STI, but it can be triggered by sex – particularly if you have trouble relaxing and your vagina is dry – and can occasionally be passed on to sexual partners.
Most people experience symptoms such as:
- An itchy vagina / vulva
- Soreness around the entrance to your vagina (vulva)
- Slight swelling of your vaginal lips (labia)
- Cottage cheese-like white discharge
These symptoms aren’t uncommon:
- Pain during sex
- Thick discharge
- Red and swollen labia
- Burning around your vulva
- Pain when you urinate
- Sores in your vaginal area
- Cracked skin around your vulva
You should see your doctor if:
- You are experiencing thrush for the first time
- You get thrush frequently, or if it returns in less than 2 months
- There is no improvement in your symptoms within three days, or if they’ve not disappeared within seven days
- You are pregnant or breastfeeding
- You have multiple sexual partners
- You are under 12 years old
- You have fever, chills, nausea, or vomiting
- You have a smelly or unusual discharge
- You feel abdominal pain
- You have previously had an allergic reaction to other thrush medications
What’s Normal? What Symptoms Aren’t?
A woman’s vagina makes discharge that’s usually clear or slightly cloudy. In part, it’s how the vagina cleans itself.
It doesn’t really have a smell or make you itch. How much of it and exactly what it looks and feels like can vary during your menstrual cycle. At one point, you may have only a small amount of a very thin or watery discharge, and at another time of the month, it’s thicker and there’s more of it. That’s all normal.
When discharge has a very noticeable odor, or burns or itches, that’s likely a problem. You might feel an irritation any time of the day, but it’s most often bothersome at night. Having sex can make some symptoms worse.
You should call your doctor when:
- Your vaginal discharge changes color, is heavier, or smells different.
- You notice itching, burning, swelling, or soreness around or outside of your vagina.
- It burns when you pee.
- Sex is uncomfortable.
Keep yourself clean and dry. But doctors don’t recommend vaginal sprays or heavily perfumed soaps for this area. Douching may cause irritation, too, and more importantly, could hide or spread an infection. It also removes the healthy bacteria that do the housekeeping in your vagina. Douching is never recommended.
Avoid clothes that hold in heat and moisture. Nylon underwear, tight jeans, non-breathable gym shorts and leggings, and pantyhose without a cotton panel can lead to yeast infections.
Eating yogurt with active cultures (check the label) might help you get fewer infections.
Condoms are the best way to prevent passing infections between sexual partners.
Get a complete gynecologic exam every year, including a Pap smear if your doctor recommends it.
If you get thrush frequently, you can:
- use water and an emollient (moisturiser) soap substitute to clean the vulva (skin around your vagina), but avoid cleaning this area more than once a day
- apply a greasier moisturiser to the skin around your vagina several times a day to protect it (but be aware that these moisturisers can weaken condoms)
- avoid potential irritants in perfumed soaps, shower gels, vaginal deodorants, wipes and douches
- avoid wearing tight-fitting underwear or tights – some women find that special silk underwear designed for people with eczema and thrush is helpful
- ensure your blood sugar level is kept under control, if you have diabetes
Some women eat probiotic yoghurt or supplements to prevent vaginal thrush, but there’s little evidence to suggest this works.