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Vaginal thrush


Expert reviewer Miss Shirin Irani, Consultant Obstetrician and Gynaecologist
Next review due January 2023

Vaginal thrush is a yeast infection that can make you feel sore and itchy around your vulva and vagina. It’s also known as vulvovaginal candidiasis. As well as soreness, vaginal thrush symptoms may include a thick white vaginal discharge and pain when peeing or having sex.

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Thrush is an infection with a yeast called candida. You can get it many parts of the body, including the mouth, throat and skin. Vaginal thrush is common – about three-quarters of women will have it at some point in their lives. Up to one in 20 women has repeated (recurrent) thrush infections. You can get thrush at any age, but it’s most common in women who are in their 20s and 30s.

Symptoms of vaginal thrush

You might not have any symptoms of thrush, and not realise you have it or need treatment. If you do get symptoms, they may include:

  • feeling itchy and sore outside your vagina (an area called your vulva)
  • a thick, white vaginal discharge (it may look like cottage cheese)
  • pain when you have sex
  • pain when you go to the toilet (to pee)
  • red, cracked or damaged skin (if your thrush is severe)

If you think you might have thrush, go and see your pharmacist to get some advice. You can get treatments over-the-counter.

If your symptoms get worse or an over-the-counter treatment doesn’t help, contact your GP surgery, or go to your local sexual health clinic. Thrush isn’t a sexually transmitted infection, but does share some similar symptoms with other infections so it’s a good idea to rule these out. Thrush symptoms can also be triggered after sex.

Some people find that vaginal thrush comes back. If you have thrush with symptoms more than four times in a year, it’s known as a recurrent infection.

Diagnosis of vaginal thrush

If you don’t have any symptoms of thrush, it might be picked up by your GP or at a sexual health clinic in a test for something else. If you do have symptoms, your doctor, nurse or pharmacist will usually be able to diagnose thrush just by asking about them. They may also ask you about your medical history and whether you've had thrush before.

If over-the-counter treatments haven’t helped, your doctor or nurse might examine you, or do a swab test. A swab looks similar to a small round cotton bud and is used to collect a sample of cells or discharge from your vagina. This will check if you have thrush, and not another type of infection. The test isn't usually painful, although it might feel a little uncomfortable.

A swab test is only usually necessary if:

  • your thrush infection is very bad
  • you’re at risk of having a different infection
  • your treatment hasn’t worked
  • your symptoms keep coming back

If you’re sexually active, your doctor or nurse may take more swabs to test for other infections at the same time. And they might also check the acidity (pH) of your vagina with a swab as it might help to tell what’s causing your symptoms.

You might get the result immediately, but if the samples need to be sent to a laboratory to be tested – you’ll usually get them back within a week.

Self-help for vaginal thrush

If you have thrush, you might find it helps to stop using soap or perfumed shower and bath products around your genital area. Use water or non-perfumed moisturising cream instead – if you’re unsure what type to use, ask a pharmacist for advice. You could try washing with an emollient cream or ointment such as E45 on your skin outside your vagina too. Douching (washing out your vagina with water or special douching fluid) can increase your risk of thrush.

Other perfumed products such as feminine deodorants, biological washing powder and fabric conditioner may increase irritation and are best avoided.

Avoid spermicidal jellies and creams as these can increase your risk of thrush. Although there’s no proof it will work, you could wear loose clothing and cotton underwear while you have thrush, to help with any irritation.

Live yoghurt may help to soothe irritation but it isn’t a treatment. There’s no evidence that products that claim to be natural antiseptics, such as tea tree oil or garlic, can treat thrush and they may cause irritation.

Treatment of vaginal thrush

Medicines

If you get treatment for thrush with medicines, it will usually get better within a week or two at most. You can buy most thrush medicines from a pharmacy, without a prescription. These come in the form of tablets you swallow, or vaginal creams or pessaries. A pessary is a tablet that you put into your vagina, usually at night. Examples of treatments include:

  • clotrimazole (Canesten) cream and pessary
  • econazole (Gyno-Pevaryl) cream or pessary
  • fluconazole (Diflucan) tablets
  • itraconazole (Sporanox) tablets

Tablets work just as well as pessaries and creams but there are some differences in side-effects. Oral treatments might make you feel sick, and give you diarrhoea or a headache, while creams and pessaries can cause irritation and skin reactions.

Whatever treatment you choose, it’s really important to finish the full course. There’s a chance your thrush may come back if you don’t.

Thrush that doesn’t get better

If your symptoms don't start to get better within a week or two (or your symptoms come back), contact your GP surgery or sexual health clinic. They might take a swab to confirm the diagnosis. If you do have thrush, your doctor may prescribe a longer course of treatment or a combination of medicines that isn’t normally available over-the-counter. For more information, see our FAQ: Why do I keep getting thrush?

If you're pregnant or breastfeeding

Having thrush is no risk to your baby. But ask your GP, midwife or a pharmacist before you take any medicines to treat thrush. You should have creams or pessaries, not tablets, if you are pregnant or breast feeding. So that you don’t damage your cervix, you need to take care putting the applicator in. You can put pessaries in by hand instead if you prefer. If you’re worried about using treatments in your vagina, talk to your midwife, who will be able to reassure you.

If you have diabetes or a weakened immune system

You may need a longer course of treatment for thrush, so check with your GP.

If you're sexually active

Some creams and pessaries for vaginal thrush can damage condoms and diaphragms made of latex. If you use these for contraception or to protect you from sexually transmitted infections, ask your GP, nurse, or pharmacist for advice on what to use.

Causes of vaginal thrush

Vaginal thrush is caused by a type of yeast. Normally, this lives harmlessly in, or around your vagina, alongside healthy bacteria. But if it grows more than usual, this causes thrush.

There are several things that can make it grow more, which include:

  • taking antibiotics 
  • being pregnant
  • having diabetes that’s poorly controlled
  • having a weakened immune system – if you’ve had chemotherapy or have the human immunodeficiency virus (HIV), for example
  • using spermicidal jellies or creams

Doctors aren’t completely sure whether some types of contraception, such as the combined contraceptive pill, may increase your risk of getting thrush.

Complications of vaginal thrush

Vaginal thrush doesn’t usually cause any long-term problems. But some women get recurrent bouts of thrush. Fewer than five in every 100 women are thought to be affected by this. If your thrush keeps coming back, it can make you feel down or depressed, and it can affect your sex life too. See your GP to get some support if this happens to you. You can also read more about thrush coming back in our FAQ: Why do I keep getting thrush?

Frequently asked questions

  • Yes, men can get thrush too, and if they have symptoms they’ll need treatment.

    Symptoms of thrush in men include a:

    • red rash with white patches on their penis, which may be itchy
    • discharge – this might smell
    • tighter foreskin than normal

    These symptoms can also be caused by men’s health problems other than thrush, so it’s a good idea to visit a GP or sexual health clinic for advice.

  • Some women get thrush that keeps coming back. This is called recurrent thrush and affects fewer than five women in every 100.

    Doctors don’t know why thrush keeps coming back in some women, but they have some theories.

    • It’s possible that thrush might keep coming back if you don’t take your treatment for thrush properly – it’s really important to complete the full course.
    • You might have a strain of candida that’s resistant to treatment. This can happen if you’re infected with a type of yeast called Candida Glabrata. Up to two in 10 women who get recurring thrush are infected with this type.
    • It might happen if you continue to be affected by things that can increase your risk of getting thrush. If you have diabetes and don’t get it under control, you might keep getting thrush, for example.
    • Sometimes thrush is not a reinfection, but an ongoing one that has been retriggered.

    If you continue to have problems, visit your GP or sexual health clinic to get support and advice. They may prescribe a treatment that you take for longer, or look for other things that might be causing your symptoms.

  • Yes, you can get thrush anywhere in your body. You can get it in your vagina, or in your mouth, on your skin and nails, for example. You can even get an infection in your lungs. Most people carry yeasts on their body and it doesn’t cause any problems. But sometimes it can flourish and cause an infection, and this can happen in both adults and children, even in babies. Your local pharmacist can be a good person to speak to about thrush, as some thrush treatments are available over-the-counter. You can also speak to your GP.



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Related information

    • Candida – female genital. NICE Clinical Knowledge Summaries. cks.nice.org.uk, last updated May 2017
    • Vaginal and Vulval Candidiasis. PatientPlus. patient.info, last updated August 2019
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  • Reviewed by Liz Woolf, Freelance Health Editor, and Graham Pembrey, Head of Health Content Bupa Health Content Team, January 2020
    Expert reviewer, Miss Shirin Irani, Consultant Obstetrician and Gynaecologist
    Next review due January 2023

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