Thrush

Reviewed by Dr Keith Grimes, 29th July 2019

Thrush is an often itchy and uncomfortable infection of the vagina and/or vulva (vulvovagina) caused by yeasts.

Causes

Vulvovaginal thrush is usually caused by an overgrowth of the yeast (fungus) called Candida albicans. This occurs when the pH of the vagina is altered or there are changes to your sex hormones (i.e. during pregnancy, when using hormonal contraception).

Risk factors

  • Pregnancy
  • Hormonal contraceptives (i.e. the pill, implant, injection, ring or hormonal coil)
  • Uncontrolled diabetes
  • Antibiotic use
  • Using feminine hygiene products
  • Synthetic clothing
  • Sex (this can trigger thrush, but thrush is not a sexually transmitted disease)
  • Hormone replacement therapy
  • HIV or a weakened immune system

Typical Symptoms

  • Vulvovaginal itching
  • Soreness, or irritation of the vulvovagina
  • Redness of the vaginal area
  • Thick white vaginal discharge (typically described as looking like cottage cheese)
  • Pain when urinating
  • Pain when having sex
  • Symptoms are sometimes worse the week before a period

Common Treatment

  • Over the counter antifungal medications to treat the infection.

When to speak to a doctor

Thrush can often be initially managed by speaking to a pharmacist or purchasing thrush cream over the counter.

It is important to speak to a doctor if you are:

  • Not improving after using over the counter treatment
  • Experiencing severe pain
  • The vulvovaginal skin is raw or cracked
  • Having smelly vaginal discharge or discharge you are worried about
  • Worried you might have a sexually transmitted infection

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Prevention

Thrush can be managed and prevented by:

  • Treating any conditions that increase the risk of yeast infections
  • Using over the counter medications to control the infection
  • Avoiding vaginal douching
  • Not wearing tight fitting clothing
  • Using probiotics1

More information

SexWise - https://sexwise.fpa.org.uk/stis/thrush

NHS - https://www.nhs.uk/conditions/stye/

References

1. NICE Candida - female genital https://cks.nice.org.uk/candida-female-genital#!topicSummary [online] Last revised May 2017 Date Accessed 15/3/2019