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Vaginal thrush - symptoms and treatment

Vaginal thrush is a yeast infection of the vagina. Itchiness and a thick white discharge from the vagina are typical symptoms. Most cases of vaginal thrush can be treated with a short course of anti-fungal medication.

General information

Vaginal thrush, which is also known as vaginal candidiasis or vulvovaginal candidiasis, is a common yeast infection that affects most women at some point during their lives.

It is usually harmless but can cause irritation and discomfort and recurrent vaginal thrush may be a sign of an underlying health problem.

Causes

Vaginal thrush is caused by Candida yeast, which is a common type of fungus.

Candida yeast is a normally harmless inhabitant of the vagina. It resides in the vagina with a variety of other microbial organisms, including bacteria, which keep each other in balance. Vaginal thrush develops when the balance of yeast and other microbes is altered, leading to the overgrowth of Candida yeast.

Although vaginal thrush is not a sexually transmitted disease, it can be triggered by sex. Other factors that can increase the risk of developing thrush include:

  • Antibiotic or corticosteroid therapy
  • Diabetes that is untreated or poorly controlled 
  • Having a weakened immune system, e.g., due to human immunodeficiency virus (HIV) infection or chemotherapy
  • Hormonal changes associated with pregnancy, use of oral contraceptives, or menopause
  • Use of an intrauterine device (IUD) or spermicides for birth control
  • Wearing tight-fitting or damp clothing
  • Using hygiene products such as bubble-bath, vaginal sprays, or vaginal deodorant.

Candida yeast also causes infections in other moist areas of the body, including the mouth (oral thrush) and skin folds. It can also cause nappy rash.

Signs and symptoms

Vaginal thrush signs and symptoms include the following:

  • Thick, white discharge (resembling cottage cheese), which is usually odourless
  • Itching and burning around the opening of the vagina
  • Soreness or stinging during sex or when peeing
  • Redness and swelling (which indicates inflammation) around the opening of the vagina.

Diagnosis

Diagnosis of vaginal thrush involves taking a medical history and performing a pelvic examination.

Vaginal thrush can usually be diagnosed on the basis of its symptoms, but tests may be conducted to exclude other types of infection (e.g. bacterial) or if the vaginal thrush doesn’t get better with treatment or is recurs.

Treatment

Vaginal thrush is treated with anti-fungal medication.

Anti-fungal medications include over-the-counter (pharmacy only) skin creams (applied to the opening of the vagina), intravaginal creams (which are applied to the inside of the vagina), and vaginal pessaries (pellet-shaped pills that are inserted into the vagina with a special applicator). Prescription oral antifungal medications are also used to treat vaginal thrush.

Vaginal thrush should clear up within a week of completing treatment. Longer-term treatment may be necessary to successfully treat cases of recurrent thrush.

You should see your GP if you have thrush symptoms: 

  • For the first time
  • That keep coming back (e.g. having thrush three or more times in six months)
  • That persist despite treatment
  • You are pregnant or breastfeeding
  • You have diabetes or a weakened immune system
  • You have previously had, or are concerned about, sexually transmitted infections.

Self-treatment is appropriate if you recognise that you have a yeast infection and:

  • Symptoms are mild, and you do not have pelvic pain or a fever
  • This is not your first yeast infection and you have not had many yeast infections in the past
  • You are not pregnant or breast feeding
  • You are not concerned about sexually-transmitted infections from recent sexual contact.

Self-treatment includes:

  • Use of over-the-counter anti-fungal medication
  • Using water and a non-soap-based cleanser to wash around the vagina
  • Drying the affected area properly after washing
  • Wearing loose-fitting cotton underwear
  • Avoiding sex until the thrush has cleared up
  • Using pads rather than tampons if intravaginal creams or pessaries are being used to treat the thrush
  • Taking showers instead of baths
  • Avoiding douching, which may alter the natural microbial balance inside the vagina
  • Avoiding using feminine hygiene sprays and deodorants on your vagina
  • Keeping your blood sugar (glucose) level under control if you have diabetes.

Further information

Healthline 
Freephone (24/7): 0800 611 116
Web page: www.healthline.govt.nz

References

Mayo Clinic (2016). Vaginitis (Web Page). Rochester, NY: Mayo Foundation for Medical Education and Research. https://www.mayoclinic.org/diseases-conditions/vaginitis/symptoms-causes/syc-20354707 [Accessed: 18/09/18]
MedlinePlus (2017). Vaginal yeast infection (Web Page). Bethesda, MD: US National Library of Medicine (NIH). https://medlineplus.gov/ency/article/001511.htm [Accessed: 18/09/18]
NHS (2017). Vaginitis (Web Page). Redditch: National Health Service (NHS) 
England. https://www.nhs.uk/conditions/vaginitis/ [Accessed: 18/09/18]
NHS inform (2018). Vaginal thrush (Web Page). Glasgow: National Health Information Service, National Health Service (NHS) Scotland. https://www.nhsinform.scot/about-nhs-inform [18/09/18]

Updated: September 2018

 

 

 

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