Vaginal thrush

Published by Bupa's Health Information Team, November 2010.

This factsheet is for women who have vaginal thrush, or who would like information about it.

Vaginal thrush, also known as vaginal yeast infection, is an inflammation caused by a type of yeast called Candida albicans. Vaginal thrush is very common. Three out of four women will have it at some point during their life.

About vaginal thrush

Candida albicans lives harmlessly in or around the vagina. It's usually kept at safe levels by your immune system and healthy vaginal bacteria. However, a change in the vaginal environment can mean the yeast grows more than usual, causing thrush (vaginal candidiasis).

Vaginal thrush can keep coming back. If you have thrush with symptoms more than four times in a year, it is known as recurrent infection.

Symptoms of vaginal thrush

You may not have any symptoms, so you may not realise you have vaginal thrush. However, possible symptoms can include:

• itching, which is often worse at night
• soreness and irritation
• thick and white vaginal discharge
• pain during sex or while passing urine

You may also have some inflammation of the vulva, including:

• redness
• cracked skin
• swelling

It's important that you see your GP if you have any of these symptoms.

Complications of vaginal thrush

Persistent thrush infection may be difficult to treat and need repeat treatment. Recurrent infections can cause discomfort and affect your sex life. You may feel down or anxious because of this.

Causes of vaginal thrush

Vaginal thrush is caused by an increase in the amount of Candida albicans in the vagina. There are several things which make vaginal thrush more likely, including:

• taking antibiotics
• pregnancy
• poorly managed diabetes
• a weakened immune system
• taking the contraceptive pill

You may also be more likely to develop vaginal thrush if you:

• wear tight-fitting clothes, such as jeans or synthetic underwear
• have sex with someone who has thrush
• use products that might irritate the vagina, such as perfumed soaps or feminine hygiene sprays

There is little or no evidence to suggest that using tampons or sanitary towels can cause vaginal thrush. However, a soiled tampon or sanitary towel can provide an ideal environment for bacteria to grow, so it's important that you change them frequently.

Diagnosis of vaginal thrush

Your GP will ask about your symptoms. He or she may also ask you about your medical history and whether you have had thrush in the past.

Your GP will usually diagnose thrush from your symptoms.

If your treatment doesn't work, your symptoms are severe, or if it keeps coming back, your GP may take a swab from your vagina to confirm the diagnosis. This isn't usually painful, although it may feel a little uncomfortable. The sample is sent to a laboratory for testing.

Treatment of vaginal thrush

Medicines

Most thrush infections respond to antifungal treatments such as tablets, creams or pessaries. A pessary is a small tablet that is inserted into the vagina. Examples include Clotrimazole (Canesten) cream or pessary, or fluconazole (Diflucan) tablets. Both are available from your pharmacist without prescription.

Certain treatments for vaginal thrush may damage condoms and diaphragms. There are also reports that some antifungal treatments can stop oral contraceptives working properly. Always get advice from your pharmacist or GP before starting any treatment, and read the patient information leaflet that comes with the medicine. You should complete the full course of treatment even if your symptoms improve.

The infection clears up completely in most women. If your symptoms don't improve in seven to 14 days or the symptoms come back, see your GP. Your doctor may prescribe different antifungal medicines.

There isn't any evidence to suggest treating a male partner helps, unless he has a rash or a sore penis.

Special considerations

If you're pregnant
If you're pregnant, see your GP before taking any medicines to treat thrush. You won't be treated with oral antifungal medicines if you're pregnant. Your GP will prescribe a pessary to place directly into your vagina. When inserting a pessary into your vagina, it's important that you don't damage your cervix. You may prefer to do this by hand instead of via the applicator to avoid hurting yourself.

If you have diabetes or a weakened immune system
If you have diabetes or a weakened immune system, your GP will prescribe you a longer course of antifungal medicine - usually for six to 14 days depending on the type of treatment.

Prevention of vaginal thrush

The following tips can help to reduce your risk of vaginal thrush.

• Wear cotton underwear and loose-fitting clothing.
• Use un-perfumed soap or bath cream.
• Don't use products that irritate the vulval area, including antiseptics or disinfectants.
• Make sure you wipe from front to back after going to the toilet.
• If you're prescribed antibiotics and have had vaginal thrush in the past, ask for vaginal thrush treatment at the same time.

For answers to frequently asked questions on this topic, see Common questions.

For sources and links to further information, see Resources.