Vaginal thrush 

Introduction 

Vaginal thrush is a common yeast infection that affects most women at some point.

It may be unpleasant and uncomfortable, but can usually be treated with medication available from pharmacies or on prescription from your GP.

However, for some women, vaginal thrush can be difficult to treat and keeps coming back.

This page covers:

Symptoms of vaginal thrush

What to do if you have vaginal thrush

How to treat vaginal thrush

What causes vaginal thrush?

Preventing vaginal thrush

Symptoms of vaginal thrush

Typical symptoms of vaginal thrush include:

• itching and soreness around the entrance of the vagina (itchy labia)
• vaginal discharge – this is usually odourless and may be thick and white or thin and watery
• pain during sex, which may make you worry about having sex
• a stinging sensation when peeing

Sometimes the skin around the vagina can be red, swollen or cracked. Occasionally there may also be sores on the skin, although this is more often a sign of genital herpes.

You can use the vagina problems visual guide to help find out what could be causing your symptoms.

What to do if you have vaginal thrush

If you've had thrush before and think you have it again, you can normally treat it with medicines bought from a local pharmacy. See How to treat vaginal thrush below for more information.

It's a good idea to get medical advice from your GP or a sexual health clinic if:

• you have thrush for the first time
• you're under the age of 16 or over 60
• you're pregnant or breastfeeding – read more about thrush in pregnancy
• you have unusual symptoms, such as coloured or smelly discharge, or sores on the skin around your vagina
• you have abnormal vaginal bleeding or pain in your lower tummy
• you've had two episodes of thrush within the last six months
• you've reacted badly to antifungal treatment in the past, or it didn't work
• you or your partner have previously had a sexually transmitted infection (STI) and you think it might have returned
• your symptoms don't improve after 7-14 days of treatment

Thrush isn't usually anything to worry about in these cases, but your doctor may want to take a swab from your vagina to confirm the diagnosis and/or carry out tests to check for any underlying cause.

They can also advise you about the most suitable treatment and give you a prescription, if necessary.

How to treat vaginal thrush

Mild thrush can usually be treated with a short course of antifungal medication. The symptoms will usually clear up within a week or two.

Treatment may need to be continued for longer if you have repeated bouts of thrush.

Several thrush medicines can be bought over the counter from pharmacies, while others are only available on prescription from your GP.

The main types are:

• pessaries – a special pill that you insert into your vagina using a special applicator
• intravaginal creams – these are also placed into the vagina using an applicator
• capsules – these are swallowed and may be more convenient to use than pessaries or intravaginal cream, but can have more troublesome side effects, such as vomiting or an upset stomach

These treatments are all equally effective. You can usually choose the treatment you prefer, although pregnant or breastfeeding women shouldn't take the capsules.

You can also get creams to apply to the skin surrounding the entrance of your vagina. These can help relieve itchiness and soreness, although you may find that an ordinary emollient (moisturiser) works just as well.

Read more about treating vaginal thrush.

What causes vaginal thrush?

Vaginal thrush is caused by yeasts from a group of fungi called Candida.

Many women have Candida in their vagina without it causing any problems, but thrush can develop if the natural balance of micro-organisms in the vagina is disrupted and Candida multiplies.

You're more likely to get thrush if you:

• are in your twenties and thirties – thrush is less common in girls who haven't started their periods and women who have been through the menopause
• are pregnant
• have sex when you're not fully aroused or you're worried it may hurt – this can lead to vaginal dryness and tightness during sex, which can trigger thrush
• take antibiotics
• have poorly controlled diabetes
• have a weakened immune system – for example, because of a condition such as HIV or a treatment such as chemotherapy

Vaginal thrush isn't classed as an STI, but it can be triggered by sex – particularly if you have trouble relaxing and your vagina is dry – and can occasionally be passed on to sexual partners.

Preventing vaginal thrush

If you get thrush frequently, you can:

• use water and an emollient (moisturiser) soap substitute to clean the skin around your vagina, but avoid cleaning this area more than once a day
• apply a greasier moisturiser to the skin around your vagina several times a day to protect it (but be aware that these moisturisers can weaken condoms)
• avoid potential irritants in perfumed soaps, shower gels, vaginal deodorants, wipes and douches
• avoid wearing tight-fitting underwear or tights – some women find that special silk underwear designed for people with eczema and thrush is helpful
• ensure your blood sugar level is kept under control, if you have diabetes

Some women eat probiotic yoghurt or supplements to prevent vaginal thrush, but there's little evidence to suggest this works.