Vaginal thrush

About vaginal thrush

Vaginal thrush is a common infection caused by an overgrowth of the yeast Candida albicans. This yeast lives naturally in the bowel and in small numbers in the vagina. It’s mostly harmless, but symptoms can develop if yeast numbers increase.

About 75% 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
• splits in the genital skin
• stinging or burning while urinating or during sex.

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 transmitted infection (STI). It’s caused by an overgrowth of the yeast Candida albicans, which is normally found on the genital skin. This overgrowth may occur due to:

• recent antibiotic use
• oral contraceptive use
• pregnancy
• 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 can’t 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 prescription 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 product. Occasionally a second course of treatment is required. Repeated topical treatments (applied to the skin) may occasionally cause skin irritation
• oral tablets – 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 oral medication for thrush.

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.
• 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 laundry 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 few other vaginal conditions result in symptoms that are like those of thrush. See your doctor if you:

• have had several episodes of thrush in a short period
• have had recent sex without a condom with a new partner
• have associated 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’s recommended that you see your GP to confirm that it’s 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

• Your GP (doctor)
• Sexual Health Victoria (SHV). To book an appointment call SHV Melbourne CBD Clinic: (03) 9660 4700 or call SHV Box Hill Clinic: (03) 9257 0100 or (free call): 1800 013 952. These services are youth friendly.
• Melbourne Sexual Health Centre Tel. (03) 9341 6200 or 1800 032 017 or TTY (for people with a hearing impairment) (03) 9347 8619
• Thorne Harbour Health (formerly Victorian AIDS Council) Tel. (03) 9865 6700 or 1800 134 840
• Ballarat Community Health Sexual Health Clinic Tel. (03) 5338 4500
• Bendigo Community Health Sexual Health Clinic Tel. (03) 5434 4300 or (03) 5448 1600
• Gateway Health Clinic, Wodonga Tel. (02) 6022 8888 or 1800 657 573
• Sunraysia Community Health Services Tel. (03) 5022 5444
• Barwon Health Sexual Health Clinic Tel. (03) 5226 7489
• 1800 My Options Tel. 1800 696 784 (in Victoria) for information about sexual health, contraception and pregnancy options