Vaginal thrush is a common infection caused by an overgrowth of Candida albicans yeast. This yeast lives naturally in the bowel and in small numbers in the vagina. It is mostly harmless, but symptoms can develop if yeast numbers increase. About 75 per cent of women will have vaginal thrush in their lifetime. Other names for this infection are candidiasis or monilia.Symptoms can include vaginal itching or burning, a white discharge and stinging or burning while urinating. Vaginal creams or vaginal tablets (pessaries) can help reduce the symptoms of thrush. Thrush can also occur in other parts of the body, such as the mouth.
Symptoms of vaginal thrush
Symptoms you may experience if you develop vaginal thrush include:
- vaginal discomfort – itching or burning
- a thick, white discharge with a ‘cottage cheese’ appearance and yeasty smell
- redness or swelling of the vagina or vulva
- stinging or burning while urinating or during sex
- splits in the genital skin.
Diagnosis of vaginal thrush
To make a diagnosis of vaginal thrush, your GP will need to:
- take a detailed history of your symptoms
- examine your genitals
- take a swab from the affected area.
Thrush is not sexually transmitted
Vaginal thrush is not a sexually transmissible infection (STI). It is caused by an overgrowth of the yeast Candida albicans which is normally found on the genital area.. This overgrowth may occur due to:
- antibiotic use
- oral contraceptive use
- menstrual cycle changes
- general illnesses like diabetes, iron deficiency and immune system disorders
- associated vulval skin conditions, such as eczema.
Sometimes, the reason for candida overgrowth cannot be identified.
Treatment for vaginal thrush
Treatment aims to reduce the number of yeasts so they no longer cause symptoms. Options that are available from your local pharmacist without a script include:
- antifungal creams or vaginal pessaries (tablets) – these are put inside the vagina with a special applicator and are used from one to six days, depending on the instructions. Occasionally a second course of treatment is required. Repeated topical treatments (applied to the skin) may occasionally cause skin irritation
- oral tablets – these are called fluconazole and are designed to be swallowed. This treatment is more expensive than other options and is not recommended for pregnant women or as a ‘first line’ treatment. If you are on other medications or are pregnant, consult with your doctor or pharmacist before taking fluconazole.
Sometimes symptoms only last for a short time (for example, the week before your period) and treatment is not necessary.
Prevention of vaginal thrush
To help prevent vaginal thrush:
- Wipe your bottom from front to back after going to the toilet. This will prevent the spread of Candida albicans from the anus to the vagina.
- Avoid using soap to wash the genital area. Soap substitutes can be used. Sorbolene (with or without glycerine) is probably the cheapest and is very effective.
- Avoid using antiseptics, douches or perfumed sprays in the genital area.
- Avoid using perfumed toilet papers and menstrual products.
- Avoid wearing tight-fitting pants and synthetic underwear.
- Consider changing your clothes-washing detergent and don’t use fabric softeners.
Vaginal thrush and sex
You can still have sex when you have vaginal thrush. However, it can be uncomfortable and you may experience a burning sensation during or after sex. Use plenty of lubricant to protect your skin.
Thrush is not an STI, but male partners can sometimes get redness and irritation after sex.
The treatment for thrush can weaken condoms, so apply the treatments after you have had sex if you are using condoms.
Ruling out other vaginal conditions
A number of other vaginal conditions result in symptoms that are similar to those of thrush. See your doctor if you:
- are not sure if you have thrush
- have had several episodes of thrush
- have had recent unprotected sex with a new partner
- have pain in your pelvic area or abnormal bleeding
- treated yourself with a thrush treatment and your symptoms haven’t gone away.
Management of recurrent thrush
If you experience repeated episodes of thrush, it is recommended that you see your GP to confirm that it is thrush and that you don’t have an STI. Your GP can check for the presence of other skin conditions that may have similar symptoms and exclude other conditions that can cause thrush (such as diabetes).
Any factor contributing to the overgrowth of Candida albicans should be identified and managed. If no contributing factors are found, a course of preventative treatment may be recommended.
There is no evidence to support the treatment of male partners of women who experience thrush. Thrush outbreaks, while uncomfortable, do not cause any long-term health issues. There is also no clear evidence that dietary changes prevent thrush, but the research is limited.
Where to get help
This page has been produced in consultation with and approved by:
Melbourne Sexual Health Centre
Content on this website is provided for education and information purposes only. Information about a therapy, service, product or treatment does not imply endorsement and is not intended to replace advice from your doctor or other registered health professional. Content has been prepared for Victorian residents and wider Australian audiences, and was accurate at the time of publication. Readers should note that, over time, currency and completeness of the information may change. All users are urged to always seek advice from a registered health care professional for diagnosis and answers to their medical questions.