What is vaginal thrush?
Vaginal thrush is a very common vaginal infection caused by an overgrowth of a type of yeast called candida. This yeast lives naturally in the bowel and in small numbers in the vagina. It is mostly harmless, but symptoms can develop if yeast numbers increase.
How do I know I have vaginal thrush?
In some instances the vaginal thrush infection can be present and cause no symptoms at all.
In most cases symptoms are experienced and can include any or all of the following:
- vulval soreness, pain during intercourse
- vulval itching that can be mild or severe
- a white, yeasty smelling discharge (that looks like cottage cheese)
- redness or swelling of the vulva
- stinging when passing urine
What causes a vaginal thrush infection?
A vaginal thrush infection can occur when the normal yeast levels of the vagina increase. The vagina is normally mildly acidic and if the acid balance changes, yeasts which naturally occur in the vagina, can multiply and cause the symptoms listed above. Thrush can occur for no obvious reason however there are some things that make thrush more likely:
- Taking certain antibiotics
- Being pregnant
- Having diabetes
- Having sweaty and moist skin
- Having another skin condition (e.g. eczema or psoriasis)
Vaginal thrush is not a sexually transmissible infection
Anyone with a vagina can get vaginal thrush. If thrush is present some practices can contribute to the severity of thrush symptoms, but it should be noted there is little to no evidence they cause the infection. These include:
- Being run down (eating badly, eating a diet higher in sugars, stressed etc.)
- Frequently using vaginal douches or taking bubble baths
- Frequently wearing tight pants/ jeans or pantyhose
- Frequently wearing synthetic underwear (i.e. not cotton) or Lyrica swimwear
It is recommended that a swab of the vagina be taken for testing, to determine whether it is vaginal thrush or some other infection. It is 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 exactly the same, it may not always be necessary to repeat the swab test but if anything is different from a previous attack, a repeat swab may be recommended.
Antifungal creams or vaginal pessaries - creams come with applicators, which should be filled and the cream inserted inside the vagina at night. The cream can be used externally at the same time. Pessaries are tablets or capsules, which can be inserted in the vagina with your finger or with an applicator. It is important to use the full course of cream or pessaries, even if you get your period. These treatments are available from the pharmacist without a script.
Oral tablets – This treatment is used for resistant infections or difficult cases. These drugs are not recommended for use during pregnancy and breast feeding. They are available over the counter at pharmacies.
Treatment is not always necessary
Sometimes symptoms may only last a short time and treatments may not be needed.
What about sex?
Sexual intercourse is possible when experiencing vaginal thrush, but keep in mind-
- It may be uncomfortable as the vulva and vagina may already be irritated. A burning sensation may be experienced during and after sexual activity. Lubricant can be used to help protect the skin.
- Vaginal thrush is not considered a sexually transmissible infection, but the thrush cells can be passed onto partners resulting in redness and irritation for them afterwards.
- Treatment for thrush can damage latex condoms
Recurrent/ chronic vaginal thrush
Recurrence of symptoms should not be ignored. Recurrent/ chronic vaginal thrush is defined as 4 or more episodes in a 12 month period. Although itching, soreness and pain with intercourse can be present there is generally not a great deal of discharge experienced. The symptoms may be constant and often get worse in the week before menstruation, improving quickly on the first day of bleeding. Treatment of recurrent/ chronic vaginal thrush includes a prolonged treatment with an oral antifungal medicine. Anyone experiencing symptoms of recurrent/ chronic thrush should see their doctor so tests can be done to ensure the thrush cells are present and the best treatment options explored.
Thrush factsheet/ Melbourne Sexual Health Centre
The facts about thrush ANZVS/ Australian and New Zealand Vulvovaginal Society
Vulval Candida (Thrush) Factsheet/ Australian and New Zealand Vulvovaginal Society