Vaginal thrush

Your health expert: Dr Samantha Wild, Clinical Lead for Women's Health and Bupa GP
Content editor review by Pippa Coulter, Freelance Health Editor, April 2023
Next review due April 2026

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. Vaginal thrush symptoms may also include a thick white vaginal discharge and pain when peeing or having sex.

About vaginal thrush

Vaginal thrush is caused by a type of yeast called candida. Normally, this lives harmlessly in or around your vagina alongside healthy bacteria.

Vaginal thrush is common – up to three-quarters of women report having it at some point in their lives. You can get thrush at any age, but it’s most common in your 20s and 30s.

Vaginal thrush isn’t a sexually transmitted infection (STI). But if you have a male partner, it’s possible for them to get thrush on their penis. There’s no evidence that it can be passed between women who have sex with women.

Causes of vaginal thrush

You get vaginal thrush if you have a reaction to candida yeast in your vagina or if it grows more than usual. It’s not always clear exactly why this happens. But there are several things that can increase your risk. These include:

  • taking antibiotics
  • being pregnant
  • having a weakened immune system – for example, due to poorly controlled diabetes, HIV (human immunodeficiency virus) or treatment with steroids or chemotherapy
  • taking the combined oral contraceptive pill or hormone replacement therapy (HRT), which increases your oestrogen level
  • using 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.

Vaginal thrush symptoms

Vaginal thrush symptoms may include:

  • your vagina or vulva feeling itchy and sore
  • a thick, white vaginal discharge (thrush discharge may look like cottage cheese and 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

If you’ve had thrush before and recognise the symptoms, you don’t always need to see a GP. You can get any treatments you need from a pharmacy. But if you have these symptoms for the first time or you’re not sure if it’s thrush, it’s best to get advice from a GP.

There are other times when you should always seek advice from a GP. These include:

  • 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 diabetes or other conditions affecting your immune system
  • your symptoms get worse or haven’t improved with treatment
  • you’ve previously had thrush in the past 6 months and haven’t seen a doctor for over a year
  • you or your partner have recently had an STI

Diagnosis of vaginal thrush

Your GP will ask you to describe your symptoms. Some of the symptoms of thrush can be similar to those of some sexually transmitted infections (STIs). They may also ask you questions about your medical history and sexual activity to see if thrush or an STI is more likely. Sometimes, your GP may ask to examine the outside of your vaginal and vulval area to help make a diagnosis.

You won’t usually need to have any tests for thrush. But when it’s not clear if you have thrush, your doctor may ask to take a swab (sample) of your vaginal discharge. They may also ask to do this if you keep getting infections or if treatments aren’t helping. Sometimes you may be able to take the swab yourself.

Sometimes your GP may ask you to do a urine test to check for cystitis or recommend you have further tests for STIs.

Self-help for vaginal thrush

If you have thrush, there are several things you can do to help relieve your symptoms. These include the following.

  • Don’t use soap, perfumed shower and bath products, wipes, or other hygiene products around your genital area. These may increase irritation.
  • You can use emollient (moisturising) creams, such as E45, as a soap substitute to wash and moisturise your vulval area. Don’t use this inside your vagina, and not more than once a day.
  • Avoid douching (washing inside your vagina).
  • Wear loose-fitting underwear. Tight-fitting or non-breathable underwear can increase irritation.

If you tend to get thrush regularly, these measures may also reduce the risk of it coming back.

Some people find that applying yoghurt to the affected area helps to soothe irritation, but there’s no evidence that it can treat or prevent infection. There’s also no evidence that products that claim to be natural antiseptics such as tea tree and other essential oils can treat thrush. They may irritate your skin too, so it’s best not to use them. There’s no evidence that making changes to your diet such as reducing your carbohydrate or yeast intake will help.

Vaginal thrush treatment

Antifungal medicines can help to get rid of thrush. 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:

  • fluconazole tablets (for example, Diflucan)
  • clotrimazole creams and pessaries (for example, Canesten)
  • econazole creams or pessaries (for example, Gyno-Pevaryl)
  • itraconazole tablets

There’s little difference in how well tablets work compared to vaginal creams and pessaries. Your doctor or pharmacist can advise you on which one might be best for you. This may depend on factors such as pregnancy, breastfeeding or having a weakened immune system. If you’re buying your own treatment from a pharmacy, it also comes down to your personal preference.

You may want to bear the following points in mind.

  • Both types of treatment can have side-effects. Oral tablets may make you feel sick and give you diarrhoea or a headache. Creams and pessaries that you apply to your vagina area can cause irritation and skin reactions.
  • Some creams and pessaries for vaginal thrush can damage condoms and diaphragms made of latex.
  • You shouldn’t use a pessary in your vagina if you’re on your period. You’ll need to use it before your period starts or wait until it’s finished.
  • You often just need a single tablet or pessary. But if you have a severe infection, you may have a second dose. If you’re pregnant or you keep getting infections, you may need a longer course of treatment. You often just need a single tablet or pessary. But if you have a severe infection, you may have a second dose. If you’re pregnant or you keep getting infections, you may need a longer course of treatment.
  • If you’re pregnant or breastfeeding, you should have creams or pessaries not tablets.
  • If you have a partner, there is no need to for them to have treatment unless they also have symptoms.

Whatever thrush treatment you have, it’s important to follow the instructions and take your medicine as directed. Most people who take treatments for thrush find that their symptoms clear within a week or two at most.

Complications of vaginal thrush

Vaginal thrush doesn’t usually cause any long-term problems. But in up to 2 in 10 people, initial treatment doesn’t work. If your thrush symptoms don't start to get better within a week or two, contact your GP or sexual health clinic. They might take a swab, if you haven’t already had one, to confirm the diagnosis. If it’s confirmed as thrush, your doctor may suggest a different treatment.

Around one in 20 women have repeated (recurrent) thrush infections. This means having thrush at least four times a year. You’re more likely to have recurrent thrush if you continue to be affected by any of the factors listed in our section on causes. You’re also more likely to get it if you haven’t taken treatment properly for a previous episode of thrush. Some people get a type of thrush that’s resistant to normal treatments.

If you have recurrent thrush, you may need a longer course of treatment. If you’re diagnosed as having a resistant form of thrush, your 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 your GP to get some support if this happens to you.

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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
  • continue to be affected by things that can increase your risk of getting thrush – for example, diabetes

If you continue to have problems, visit your GP or sexual health clinic to get support and advice. For more information, see our section on complications.

Vaginal thrush can make your vagina and vulva (the area outside your vagina) feel itchy and sore. You may have a thick, white discharge that looks a bit like cottage cheese. It can also be painful when you pee or have sex. For more information, see our section on symptoms.

Vaginal thrush is caused by a yeast called candida that grows in your vagina. Several things can make you more likely to develop it. These include taking antibiotics, being pregnant and having conditions that affect your immune system. Using products that irritate your genital area may also increase your risk. To find out more, see our section on causes.

You can use emollient (moisturising) creams to wash and moisturise the area around your vulva and vagina. Don’t use perfumed shower, bath or other hygiene products because these can increase irritation. You might find it helps to wear loose-fitting underwear too. Taking antifungal treatment will usually help to clear your thrush.

To find our more, see our sections on self-help and treatment sections.

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