WHAT CAUSES THRUSH?
Thrush is caused by an overgrowth of yeast within the vagina. It is very common and about 75% of women will have thrush at some time in their life. It is usually caused by a yeast called "Candida albicans" (these are not the same type of yeasts that are in your diet).
Yeasts often live in small numbers in the vagina and cause no problems - it is only when they overgrow that they cause symptoms. The yeasts are very irritating to the sensitive vaginal and vulval skin. Thrush can occur for no obvious reason, but there are some things that make thrush more likely or being on certain antibiotics, being pregnant, having diabetes, having sweaty and moist skin (eg cycling) or lots of friction (eg after sex). Having another skin condition in the area will also make you more prone to having thrush with symptoms eg eczema or psoriasis.
Symptoms usually include itch and discomfort around the opening of the vagina, a burning sensation and pain when passing urine and during sex. Sometimes a thick white lumpy discharge occurs which is described as ‘like cottage cheese’. The area around the vulva and vagina may look red and swollen and there may be small skin cracks or splits. Sometimes women experience swelling of the vulva after sex.
IS THRUSH SEXUALLY TRANSMITTED?
Most people carry yeasts in their mouth and bowel without any symptoms and it is not sexually transmitted, but male partners can sometimes get redness and irritation of the penis after sex.
HOW IS THRUSH TREATED?
Thrush can be treated easily by anti-fungal creams and pessaries (a pill that is inserted into the vagina) which you can buy without a script at the chemist. The treatments take from 1 to 7 days and are put inside the vagina with a special applicator. Some women need a second course of treatment.
There is also a tablet available at the chemist that you can take once by mouth called fluconazole, which is more expensive. It has similar effectiveness to vaginal treatments.
If you take any other medications discuss with the pharmacist before using fluconazole because it can interact with certain medications..
Fluconazole is safe to use if you are on the contraceptive pill.
WHAT IF I AM PREGNANT?
Only vaginal treatments are used in pregnancy.
Oral treatments are NOT used.
SHOULD I SEE MY DOCTOR?
If your symptoms fit with the typical description of thrush you can usually treat yourself from the chemist. However, you should see you doctor if:
- You are not sure you have thrush
- You have had several episodes of thrush
- You have had recent unprotected sex with a new partner
- You have pain in your pelvic area or abnormal bleeding
- You have tried the thrush treatment and didn't get better
CAN I STILL HAVE SEX?
Yes. If it is not too uncomfortable you can have sex though you may experience a burning sensation during or afterwards. Use plenty of lubricant to protect your skin. The thrush treatments can weaken condoms so if you are using condoms don’t put the treatments in until after sex.
IS THRUSH DANGEROUS?
No. Thrush can be very uncomfortable but it does not cause long term damage.
RECURRENT VULVO VAGINAL CANDIDIASIS (RVVC)
This is where there are more than four diagnosed episodes of candidiasis per year. It affects about 5% of women in the reproductive years. Often symptoms do not resolve completely after treatment and there may be a resultant dermatitis, for instance with skin splitting, or pain with or after intercourse. This condition can be quite different to acute candidiasis, as discharge is not always present. Women often complain of vaginal dryness and lack of lubrication with sexual activity. Often symptoms are worse before periods or only occur before periods. (Cyclic vulvitis).
Most women with RVVC are healthy and do not have anything wrong with their immune system. It is not uncommon to have a previous history of hayfever, eczema or asthma. It seems that there is a specific vaginal hypersensitivity to candida, which can be reversed with long-term suppression of the amount of candida present (but not complete elimination).
TREATMENT FOR RVVC
Treating RVVC requires good basic skin care and long term antifungal medication to suppress yeast growth. Whilst none of the currently available antifungal medications kill yeasts, they suppress growth while medication is being used This is whether they are taken by mouth (oral fluconazole or ketoconazole) or per vagina (pessaries or cream).
The usual minimum length of treatment is about 6 months. Episodes will still occur after this, but should be less frequent.
Please talk to a doctor if you feel you may suffer from chronic or recurrent candidiasis
This fact sheet is designed to provide you with information on Thrush. It is not intended to replace the need for a consultation with your doctor. All clients are strongly advised to check with their doctor about any specific questions or concerns they may have. Every effort has been taken to ensure that the information in this pamphlet is correct at the time of printing.
Last Updated February 2016