While the health information and fact sheets on this website relate to world-wide situations, the drug names will vary between countries – therefore the advice of your local GP should be sought.
|The health information and factsheets on this website are produced by Bupa's health information team. The information is reviewed and approved by relevant healthcare professionals, including doctors, dentists, nurses, physiotherapists and dietitians.||
|Browse the a-z list of factsheets:||
Published by Bupa's health information team, May 2009.
This factsheet is for people who have vaginal thrush, or who would like information about it.
Vaginal thrush is an inflammation caused by a type of yeast called Candida albicans. Vaginal thrush is very common. Three out of four women in the UK will have it at some point during their life.
About vaginal thrush
Candida albicans can live on the skin, in the mouth, in the digestive system and in or around the vagina. It's usually kept at harmless levels by your body's immune system and healthy vaginal bacteria. However, if the Candida albicans in the vagina grows too quickly, this can cause vaginal thrush (vulvovaginal candidiasis).
Vaginal thrush can keep coming back. If you have thrush with symptoms more than four times in a year, it is known as recurrent vulvovaginal candidiasis.
Symptoms of vaginal thrush
Some women don't have any symptoms, so they may not realise that they have vaginal thrush. However, possible symptoms include:
itching which is often worse at night
soreness and irritation
a discharge which is usually odourless, white and thick, although it may be more watery
pain during sex or while passing urine
As well as the above symptoms, you may have some inflammation of the vulva, including:
Causes of vaginal thrush
Vaginal thrush is caused by an increase in the amount of Candida albicans in the vagina. There are a number of things which make vaginal thrush more likely, including:
poorly managed diabetes
a weakened immune system
You may also be more likely to develop vaginal thrush if you:
wear tight-fitting clothes, such as jeans or synthetic underwear
have sex with someone who has thrush
use products that might irritate the vagina, such as vaginal deodorant
Stress may also increase your chances of developing thrush.
There is no evidence that using tampons can cause vaginal thrush. However, there is a small amount of evidence that suggests a link between vaginal thrush and regularly using sanitary towels.
Diagnosis of vaginal thrush
Your GP will ask about your symptoms. He or she may also ask you about your medical history and whether you have had thrush in the past.
Vaginal thrush is normally diagnosed by your symptoms.
If your treatment doesn't work, your symptoms are severe, or if it keeps coming back, your GP may carry out a test to confirm your diagnosis. A swab will be used to collect a sample from your vagina. This isn't usually painful, although it may feel a little uncomfortable.
The results will show whether your symptoms are being caused by vaginal thrush or another condition, such as bacterial vaginosis or trichomoniasis.
Treatment of vaginal thrush
If you have mild symptoms, your GP may prescribe you a short course (one to three days) of an antifungal medicine. Antifungal medicines can be taken in two different ways, either orally or as an intravaginal treatment. Intravaginal treatments are either creams or pessaries. A pessary is a small tablet that is inserted into the vagina.
Whether you're prescribed an oral or intravaginal treatment will depend on several factors:
what treatment you would prefer to use
your age - intravaginal treatments aren't recommended for girls between 12 and 16 years old
whether you're pregnant or breastfeeding
what contraception you're using with your partner
It's important to remember that treatments for vaginal thrush that contain imidazoles may damage condoms and diaphragms. Imidazoles are a type of antifungal medicine often used to treat vaginal thrush. There are also reports that some oral treatments for vaginal thrush can stop oral contraceptives working properly. Speak to your GP or GUM (genito-urinary medicine) clinic for more advice.
If you're pregnant, have diabetes or have a weakened immune system, your vaginal thrush will be treated in a different way.
You won't be treated with oral antifungal medicines if you're pregnant. Your GP will prescribe an intravaginal treatment. If you're prescribed a pessary, it's best to take care when inserting it into the vagina. You may prefer to do this by hand to avoid hurting yourself.
If you have diabetes or a weakened immune system, your GP will prescribe you a longer course of antifungal medicine. This course will normally last between six and 14 days depending on how your vaginal thrush is treated.
If you still have symptoms seven to 14 days after starting treatment, you should go back to see your GP.
Always get advice from your GP before starting any treatment, and read the patient information leaflet that comes with the medicine. It's important to complete the treatment your GP gives you, even if your symptoms improve.
You can also buy some treatments over the counter in a pharmacy if you're sure you have vaginal thrush. Always read the patient information that comes with the medicine and if you have any questions, ask your pharmacist for advice.
Prevention of vaginal thrush
There are a number of things you can do that may help to stop your vaginal thrush re-occurring.
Wear cotton underwear and loose-fitting clothing.
Use un-perfumed soap or bath cream.
Don't use products that irritate the vulval area, including antiseptics or disinfectants.
Make sure you wipe from front to back after going to the toilet.
If you're prescribed antibiotics and have had vaginal thrush a number of times, ask for vaginal thrush treatment at the same time.
Vaginal thrush Q&As
See our answers to common questions about vaginal thrush, including:
- Candidiasis (vulvovaginal). BMJ Clinical Evidence. www.clinicalevidence.bmj.com, accessed 13 November 2008
- Vaginal infections: Thrush and Bacterial vaginosis. Family Planning Association. www.fpa.org.uk, accessed 13 November 2008
- Shaw RW, Soutter WP, Stanton SL. Gynaecology. Oxford: Churchill Livingstone, 1997:841
- What are the risk factors for vulvovaginal candidiasis? Clinical Knowledge Summaries. http://cks.library.nhs.uk, accessed 19 November 2008
- Clinical summary: Uncomplicated infection. Clinical Knowledge Summaries. http://cks.library.nhs.uk, accessed 17 November 2008
- Which factors influence the decision to use an oral or intravaginal imidazole? Clinical Knowledge Summaries. http://cks.library.nhs.uk, accessed 17 November 2008
- Joint Formulary Committee. British National Formulary. 56th ed. London: British Medical Association and Royal Pharmaceutical Society of Great Britain, 2008
- Clinical summary: Vulvovaginal candidiasis during pregnancy. Clinical Knowledge Summaries. http://cks.library.nhs.uk, accessed 17 November 2008
- Clinical summary: Vulvovaginal candidiasis and poorly controlled diabetes or immunocompromised. Clinical Knowledge Summaries. http://cks.library.nhs.uk, accessed 17 November 2008
This information was published by Bupa's health information team and is based on reputable sources of medical evidence. It has been peer reviewed by Bupa doctors. The content is intended for general information only and does not replace the need for personal advice from a qualified health professional.
Publication date: May 2009