Itching or discomfort around the vagina, a white vaginal discharge, and stinging or burning during sex or while you wee are all signs of a yeast infection known as thrush.
Specifically, vaginal thrush occurs when an overgrowth of yeast-like fungus (medically known as Candida albicans) targets your genitals and surrounding area. It is not classed as a sexually-transmitted infection.
So how do you get rid of thrush and can you prevent it from returning? GP Dr Roger Henderson offers his expert advice on vaginal thrush causes, treatment and prevention.
What is vaginal thrush?
Vaginal thrush is medically referred to as Candida albicans, but is also known as candida or vulvovaginal candidiasis. It is normally kept under control by harmless bacteria, but sometimes conditions change and the yeast increases rapidly.
Thrush is often unpleasant and uncomfortable, but the good news is it can usually be treated with over-the-counter medication or a prescription from your GP.
However, for some women, vaginal thrush can be difficult to treat and will keep recurring. If this is the case, speak to your GP about recurrent thrush management options.
Vaginal thrush symptoms
In women, typical thrush symptoms include:
Vulval itching, soreness and irritation
Redness of the vagina and vulva
Vaginal discharge, often white (like cottage cheese) which this can be thick or thin but is usually odourless
Pain or discomfort during sex
Pain when passing urine
Vaginal thrush causes
Wearing tight clothing – which prevents natural ventilation.
Taking antibiotics – about 30 per cent of women will have thrush because of this.
Using products that irritate the vagina – such as vaginal douches or bubble bath.
Vaginal thrush diagnosis
Visit your GP if you think you have thrush. Most doctors will treat thrush without a test because the symptoms are usually obvious. If unsure, your GP will do a simple test using a cotton swab to confirm the diagnosis.
The test will also show if the symptoms are being caused by other common conditions, such as bacterial vaginosis or trichomonas.
Thrush is not viewed as a STI, so your partner will not need to be tested or treated unless he or she also has symptoms.
Vaginal thrush treatment
If symptoms are mild, your doctor will usually recommend a short course of antifungal medicine, usually for one to three days. If the symptoms are more severe, the treatment course will be longer.
A variety of treatment options are available including taking tablets orally, inserting them into your vagina (pessaries) or using a cream. Tablets and pessaries work equally well.
Tablet antifungal treatment is typically fluconazole (e.g. Canesten oral and Diflucan). They can be extremely effective, and one tablet taken once may be enough to cure an episode of thrush.
Occasionally they cause side-effects such as nausea and vomiting, diarrhoea or constipation and bloating. Pregnant or breastfeeding women are not usually prescribed tablet antifungal treatments because of the theoretical chance they may affect the baby.
Intravaginal pessaries do not cause as many side-effects as tablet treatments, but they can be awkward and messy to use, can cause local irritation, and can damage latex condoms and diaphragms.
The medicines clotrimazole (e.g. Canesten), econazole (e.g. Gyno-Pevaryl) and miconazole (Gyno-Daktarin) come in pessary form. If you are pregnant, don't use the applicator to insert the pessary because there is a risk of causing injury to the cervix. Instead, insert the pessary by hand.
Antifungal creams can be used in addition to pessary or tablet treatment if there is localised redness and soreness around the vagina and vulva.
When to see your doctor
You can purchase over-the-counter thrush treatments from the chemist, but if symptoms do not improve within 14 days, see your GP. Symptoms that should be checked out without delay include:
Abnormal menstrual bleeding
Lower abdominal pain
Vaginal ulcers or blisters.
Recurring vaginal thrush
For one in five women, short courses of antifungal medication may not work. If your symptoms don’t clear up within 7 to 14 days, your GP may recommend you take a regular ‘maintenance dose’ of antifungal treatment.
Recent studies have shown this strategy can significantly help reduce the recurrence of thrush. Using a tablet of fluconazole once a week appears to be effective in preventing thrush from coming back. Ask your GP for advice.
Vaginal thrush prevention
As well as using antifungal medicines, there are a number of things you can do to help ease thrush symptoms and prevent future flare-ups:
• Wash your vaginal area with non-perfumed soap and water, or water alone.
• Avoid using highly-scented soaps, shower gels, vaginal deodorants or douches.
• Instead, try using non-allergenic condoms.
• Avoid wearing tight-fitting clothes made of artificial fibres such as nylon.
• Sleep naked and spend time naked at home to air your genitals.
• Whenever possible, wear cotton underwear and loose-fitting clothing.
• Avoid using latex condoms, spermicidal creams and lubricants if they cause irritation.
Vaginal thrush home remedies
Some women who suffer regularly from vaginal thrush use live yoghurt – either as a cream or on a tampon – to help treat it. Although there is no firm medical evidence that this type of treatment is effective, there is no reason to believe it is unsafe and many women report significant relief of symptoms.
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