Vaginal Thrush

Vaginal thrush(sometimes called candidiasis) is a common syndrome. It is caused by an overgrowth of yeast organisms which live naturally in the bowel and in small numbers in the vagina. These organisms are mostly harmless, but symptoms can develop if numbers in the vagina increase. Candida albicans is the name of the most common of these organisms. Around 3 in 4 people with a vagina will have thrush at least once in their lifetime. The hormone oestrogen helps the yeast organism to grow, so thrush rarely occurs before puberty or after menopause when there is little oestrogen in your body. Vaginal thrush can be acute (a single episode) or chronic (recurring or persisting for a long time).

Why does a vaginal thrush infection occur

A vaginal thrush infection can occur for no obvious reason. However, some things make it more likely to occur. These include

• Taking certain antibiotics
• Being pregnant
• Having diabetes
• Having sweaty and moist skin
• Having another skin condition (e.g., eczema or psoriasis)
• Medication or treatment that suppresses your immunity

What are the symptoms of vaginal thrush?

Sometimes you can have a vaginal thrush and not have any symptoms. However, in most cases you will get some symptoms. They can include any or all of the following:

• Vulval itching that can be mild or quite severe
• A white, yeasty smelling discharge (that looks a bit like cottage cheese)
• Redness or swelling of the vulva
• Vulval soreness and burning pain when passing urine
• Skin splits
• Vulval pain and discomfort during sexual intercourse

Should I have a test for thrush?

If you have symptoms, you should see a doctor and have a vaginal swab taken for testing to see whether it is vaginal thrush or some other cause. It is also possible to have more than one infection at the same time (e.g., thrush and a sexually transmissible infection). If the problem recurs and the symptoms are the same, you may not need to repeat the swab before treating it. However, if anything is different from a previous episode, a repeat swab may be recommended.

What are the treatments available for thrush?

Sometimes symptoms may only last a short time, and treatment may not be needed. If you do need treatment, there are the following options:

Antifungal creams or vaginal pessaries

Antifungal cream or pessaries are inserted into the vagina at bedtime using an applicator that comes in the pack. You can also use the cream around the vulva. Treatment with cream or pessaries can vary from a single dose to a 3, 6, or 14-night course. It is essential to use the entire course, even if you get your period. These treatments are available from the pharmacist without a prescription.

Single dose oral tablets

Oral tablets are available as a single dose over the counter in pharmacies. They have the same effectiveness as the cream/pessaries. Sometimes your doctor may recommend that you use both the oral tablets and the cream/pessaries at the same time. Oral tablets for thrush are not recommended for use during pregnancy and breastfeeding.

What is chronic vaginal thrush?

Chronic vaginal thrush is when you have four or more episodes of thrush in a 12-month period.

The symptoms of chronic thrush may be constant. They often get worse the week before menstruation, then improve on the first day of bleeding. Although itching, soreness, and pain with intercourse can be present, most people do not have much discharge with chronic thrush.

If you are experiencing chronic thrush symptoms you should see a doctor so a test can be done to confirm it is thrush. Then a decision can be made about the best treatment options for you.

The treatment for chronic thrush often includes an extended course of oral tablets over a few months. You will need a prescription from a doctor for this.

How can I prevent vaginal thrush?

Thrush is common and affects most people with a vagina at some time in their life. While there is no known way guaranteed to prevent thrush, practicing good vulval care may be helpful. See SHFPACT’s Vulval Care factsheet.

Is Vaginal thrush a sexually transmissible infection?

No, vaginal thrush is not a sexually transmissible infection. The organism that can cause thrush occurs naturally in the vagina in low numbers. Anyone with a vagina can get vaginal thrush, including people who have never had sexual intercourse or who don’t have a partner. However, partners with a penis can sometimes experience some redness and irritation after sexual intercourse.

Can I still have sexual intercourse when I have thrush?

Sexual intercourse is possible when experiencing vaginal thrush, especially if you don’t have many symptoms, but keep in mind

• It may be uncomfortable as the vulva and vagina may already be irritated. You may experience a burning sensation during and after sexual activity. Using a lubricant can help to protect the skin.
• Treatment for thrush can damage latex condoms and increase the risk of them breaking.

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References:

• The facts about thrush ANZVS/ Australian and New Zealand Vulvovaginal Society
• Vulval Candida (Thrush) Factsheet/ Australian and New Zealand Vulvovaginal Society
• Thrush factsheet/ Melbourne Sexual Health Centre
• Reproductive & Sexual Health: An Australian Clinical Practice Handbook 2nd Ed. 2011