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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.
About thrush
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.
Men can also get thrush, including on the penis.
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 vaginal thrush 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 vaginal thrush 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.
Hello, I am Dr Naveen Puri, I am one of the GPs within Bupa Health Clinics.
Today I want to speak to you about embarrassing problems you might have and what we can do if you attend one of our clinics.
I want you to know that many people feel embarrassed or concerned about speaking about certain things with their doctors, but I'm here to reassure you these are the kinds of things we deal with every day.
For me, looking at someone's bottom or their breasts or their genitalia is no different to looking at their nose or elbow.
And that's true for all doctors as we train for many years in these parts of the body and are very used to having these conversations with people just like you.
So what I would encourage you to do if you have any concerns from your perspective, be it a change in your bowel habit, be it a lump, a rash, a swelling. Something on your genitalia or a part of your body you're not particularly familiar with or feel uncomfortable discussing.
Please be assured your doctor has done it all before.
Some of the ways we find patients find it easier to speak to a doctor is to either tell the doctor you feel embarrassed up front. That way a doctor can make extra effort to make sure you feel comfortable.
Or some patients come to us with pieces of paper and will write the problem down and hand it to us. That way we can help with whatever is going on for you as well.
You may also find it helpful to ask for a specific doctor, someone you're familiar with in your practice. Or you might want to ask for a doctor of a specific gender, or background to your liking as well.
I'd also say, doctors do this every day so don't be alarmed if we ask you certain questions around your symptoms. It is purely so we can help you get the best outcome for your enquiry.
And then finally, feel free to use language that suits you as well. We don't expect you to know the medical words for things, or a name for your diagnosis. That's our job to find out for you.
So, take your time, see a doctor, and hopefully we can help put your mind at ease.
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 vaginal thrush 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 thrush 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.
Treatment for thrush that doesn’t get better
If your thrush 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?
Thrush treatment 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?
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Why do I keep getting thrush? Why do I keep getting thrush?
Vaginal thrush might keep coming back if you:
- don’t complete the full course of your thrush treatment
- have a type of thrush that’s resistant to treatment
- continue to be affected by things that can increase your risk of getting thrush – for example, diabetes
Sometimes it might be that your thrush has been retriggered, rather than a completely new infection happening.
If you continue to have problems, visit your GP or sexual health clinic to get support and advice.
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What does thrush look like? What does thrush look like?
If you have vaginal thrush, the skin outside your vagina may be red, cracked or damaged. You may see a thick, white vaginal discharge (it may look like cottage cheese). For more information, see 'symptoms of vaginal thrush'.
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What does thrush feel like? What does thrush feel like?
Vaginal thrush can make you feel itchy and sore outside your vagina (an area called your vulva). You may find it painful when you use the toilet (to pee) and when you have sex. For more information, see ‘symptoms of vaginal thrush’.
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What causes thrush? What causes thrush?
Vaginal thrush can be caused by various things including:
- antibiotics
- pregnancy
- diabetes
- a weakened immune system
- spermicidal jellies or creams
See ‘symptoms of vaginal thrush’ for more information.
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Related information
Common vaginal infections
Fungal skin infections
Fungal skin infections are caused by different types of fungi and can be a common culprit of itchy skin.
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Other helpful websites Other helpful websites
- FPA
www.fpa.org.uk - Brook
www.brook.org.uk
- FPA
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Sources Sources
- 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
- Candidiasis. Medscape. emedicine.medscape.com, last updated April 2019
- Vaginitis. BMJ Best Practice. bestpractice.bmj.com, last updated October 2019
- 2014 UK National Guideline on the Management of Vulval Conditions. British Association for Sexual Health and HIV. bashh.org, published February 2014
- Thrush. Family Planning Association. sexwise.fpa.org.uk, last updated March 2018
- Emollient bath and shower products, paraffin-containing. Nice British National Formulary. nice.org.uk, accessed October 2019
- Clotrimazole. NICE British National Formulary. nice.org.uk, accessed October 2019
- Fluconazole. NICE British National Formulary. bnf.nice.org.uk, accessed October 2019
- Can thrush harm my baby during pregnancy? NHS Common Health Questions. nhs.uk, last updated February 2018
- Balanitis. NICE Clinical Knowledge Summaries. cks.nice.org.uk, last updated October 2018
- Candida – skin. NICE Clinical Knowledge Summaries. cks.nice.org.uk, last updated May 2017
- Balanoposthitis. BMJ Best Practice. bestpractice.bmj.com, last updated October 2018
- Balanitis. PatientPlus. patient.info, last updated April 2016
- Infections in the Immunocompromised Host. Medscape. emedicine.medscape.com, last updated April 2015
- Candidiasis. PatientPlus. patient.info, last updated January 2017
- Fungal nail infections. PatientPlus. patient.info, last updated July 2016
- Fungal lung infections. PatientPlus. patient.info, last updated July 2016
- Candida – oral. NICE Clinical Knowledge Summaries. cks.nice.org.uk, last updated August 2017
- Breastfeeding problems. NICE Clinical Knowledge Summaries. cks.nice.org.uk, last updated May 2017
- Spacers. Asthma UK. asthma.org.uk, last updated August 2019
- Canesten 10% w/w vaginal cream. emc. medicines.org.uk, revised August 2017. https://www.medicines.org.uk/emc/product/123/smpc
- Gyno-Pevaryl 150 mg vaginal pessaries. emc. medicines.org.uk, revised July 2016
- Gynoxin 2% vaginal cream. emc. medicines.org.uk, revised September 2010
- Diflucan 10mg/ml powder or oral suspension. emc. medicines.org.uk, revised April 2019
- Sporanox 10mg oral solution. emc. medicines.org.uk, revised December 2017
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Author information Author information
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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