Vaginal thrush
- Dr Samantha Wild, Clinical Lead for Women's Health and Bupa GP
Key points
- Symptoms of vaginal thrush in women include itchy and sore vaginal and vulval areas, and a thick white vaginal discharge.
- Vaginal thrush treatment involves antifungal tablets, creams, or pessaries.
- Home remedies for yeast infection in women might soothe discomfort, but there’s no evidence they can prevent or treat infections.
What is vaginal thrush?
Vaginal thrush is a type of yeast infection. It’s sometimes called vaginal candidiasis because it’s caused by candida (type of yeast). It’s a common infection - three-quarters of women report having it at some point. It’s most common in your 20s and 30s.
Vaginal thrush isn’t a sexually transmitted infection (STI). But it can transfer to a partner’s penis during sex. There’s no evidence that it can be passed between women who have sex with women.
What are the causes of vaginal thrush?
You can get vaginal thrush if you:
- have a reaction to candida yeast in your vagina
- if candida yeast grows more than usual in your vagina
It’s not always clear exactly why this happens. But there are several things that can increase your risk. These include:
- antibiotics
- pregnancy
- having a weakened immune system
- the combined oral contraceptive pill or hormone replacement therapy (HRT)
- products that irritate your vagina or vulva (the area surrounding your vagina), such as soaps, shampoos, and shower gels
There is mixed evidence about whether or not other types of contraception – for example, the intrauterine device (IUD) or intrauterine system (IUS) – increase your risk.
What are the symptoms of vaginal thrush?
Vaginal thrush symptoms may include:
- your vagina or vulva feeling itchy and sore
- a thick, white vaginal discharge (that doesn’t smell)
- pain when you have sex
- pain when you pee
- red, cracked, or damaged skin (if your thrush is severe)
You might find your symptoms are worse just before your period and get better during your period.
When to see a doctor for thrush
You don’t always need to see a GP for vaginal thrush. But if you have thrush symptoms for the first time or you’re not sure if it’s thrush, it’s best to get advice from a GP.
Always see a GP if you:
- you're under 16 or over 60 years old
- you're pregnant or breastfeeding
- your symptoms are different from before – for example, the discharge smells bad
- you have a weakened immune system
- your symptoms get worse or haven’t improved with treatment
- you or your partner have recently had an STI
What should I do if I'm embarrassed to talk to my doctor?
Seeing a doctor when you're embarrassed | Watch in 2:08 minutes
Dr Naveen Puri talks about how to make it easier to see a doctor about a health issue when you are feeling embarrassed.
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
A GP may:
- ask you to describe your symptoms
- ask you questions about your medical and sexual history
- examine the outside of your vaginal and vulval area
You won’t usually need to have any tests for thrush. But a doctor may take a swab (sample) of your vaginal discharge to confirm it. They may also ask to do this if:
- you keep getting infections
- treatments aren’t helping
Sometimes you may be able to take the swab yourself.
Self-help for vaginal thrush
If you have thrush, there are several things you can do to help yourself. These include the following.
- Don’t use soap, perfumed shower and bath products, or wipes round your genital area.
- Use emollient (moisturising) creams, such as E45, to wash and moisturise your vulval area once a day.
- Avoid douching (washing inside your vagina).
- Wear loose-fitting underwear.
How can I soothe vaginal thrush itching?
Some women find that applying yoghurt to the affected area helps to soothe irritation and itching, but there’s no evidence that it can treat or prevent infection. Tea tree products won’t help either and may irritate your skin. Getting treatment for thrush can also help to soothe vaginal itching.
Vaginal thrush treatment
The treatment for vaginal thrush is antifungal medicines. Treatments usually work within a week.
You can get vaginal thrush treatment from the pharmacy. They come in three different forms:
- tablets such as Diflucan
- vaginal creams such as Canesten
- pessaries (tablet you put inside your vagina) such as Gyno-Pevaryl
Side effects of vaginal thrush treatments:
- oral tablets may make you feel sick and give you diarrhoea or a headache
- creams and pessaries can cause irritation and skin reactions
- some creams and pessaries for vaginal thrush can damage condoms and diaphragms made of latex
If you’re pregnant or breastfeeding, you should use creams or pessaries instead of tablets. Also avoid using pessaries on your period.
Complications of vaginal thrush
Vaginal thrush doesn’t usually cause any long-term problems. But if your thrush symptoms don't start to get better within a week, contact a GP or sexual health clinic.
Recurrent thrush
If you have recurrent thrush, you may need a longer course of treatment. If you’re diagnosed as having a resistant form of thrush, a GP will refer you to a specialist for treatment.
If your thrush keeps coming back, it can make you feel depressed, and it can affect your sex life too. See a GP to get some support if this happens to you.
Why do I keep getting vaginal thrush?
Vaginal thrush might keep coming back if you:
- don’t take your thrush treatment properly
- have a type of thrush that’s resistant to treatment
- have another risk factor for thrush – for example, diabetes
Vaginal thrush can be treated so don’t be embarrassed about seeking help for this condition – support is available.
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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.
Sexually transmitted infections (STIs)
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- Candida – female genital. NICE Clinical Knowledge Summaries. cks.nice.org.uk, last revised July 2022
- Vaginal and vulval candidiasis. Patient. patient.info, last edited 16 August 2019
- Saxon C, Edwards A, Rautemaa-Richardson R, et al. British Association for Sexual Health and HIV national guideline for the management of vulvovaginal candidiasis (2019). Int J STD AIDS 2020; 31(12):1124–44. doi: 10.1177/0956462420943034
- Sexual health and contraception. Oxford Handbook of General Practice. Oxford Academic. academic.oup.com, published online June 2020
- Vaginal and vulval conditions. NICE British National Formulary. bnf.nice.org.uk, last updated 29 March 2023
- Denison HJ, Worswick J, Bond CM, et al. Oral versus intra-vaginal imidazole and triazole anti-fungal treatment of uncomplicated vulvovaginal candidiasis (thrush). Cochrane Database Systematic Reviews 2020; 8(8):CD002845. doi: 10.1002/14651858.CD002845.pub3
- Canesten 100mg pessary. Electronic medicines compendium. www.medicines.org.uk, last updated 7 July 2022
- Pippa Coulter, Freelance Health Editor
