Vaginal thrush

Key points

• Symptoms of vaginal thrush 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 vaginal thrush 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 vulvovaginal candidiasis because it’s caused by candida (a type of yeast). It’s a common infection – three-quarters of women report having it at some point. You can get thrush at any age, but it’s most common between the ages of 20 and 40.

Vaginal thrush isn’t a sexually transmitted infection (STI). But it can transfer to a partner’s penis during sex, causing inflammation and discomfort. There’s no evidence that it can be passed between women who have sex with women.

What causes vaginal thrush?

You get vaginal thrush if:

• you have a reaction to candida yeast in your vagina
• 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
• things that raise your oestrogen levels – such as hormone replacement therapy (HRT) and, possibly, the combined oral contraceptive pill

There’s 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 these 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're under 16 or over 60
• 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’ve previously had two episodes of thrush in the past six months and haven’t seen a doctor for over a year
• you or your partner have recently had an STI

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, wipes, or other hygiene products around your genital area.
• Use emollient (moisturising) creams to wash and moisturise your vulval area once a day.
• Avoid douching (washing inside your vagina).
• Wear loose-fitting underwear.

Vaginal thrush treatment

The treatment for vaginal thrush is antifungal medicines. Treatments usually work within a week.

You can get vaginal thrush treatment from a pharmacy without a prescription. It comes in three different forms:

• oral tablets (for example, fluconazole)
• vaginal creams (such as clotrimazole)
• vaginal pessaries (tablets you put inside your vagina) containing clotrimazole

There can be side-effects of vaginal thrush treatments. You may want to bear the following points in mind:

• 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. You should also avoid using pessaries on your period.

How can I soothe vaginal thrush itching?

Getting treatment for thrush can also help to soothe vaginal itching. There’s no evidence that complementary therapies, such as yoghurt and tea tree products, treat or prevent infection.

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, 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.

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.