Thrush

This is a very common condition especially in women who often develop vaginal thrush which is caused by a yeast infection. There is more than one type of thrush which includes oral thrush and a version which affects men caused by the Candida Albicans fungus.

Vaginal thrush causes itching and swelling around the vagina, and sometimes, a thick, creamy white discharge. It is harmless but can recur and is upsetting for many women.

The male version affects the mouth, skin or head of the penis in men. This causes swelling, a thick discharge, strong smelling odour and pain when having sex.

How common is thrush?

Around 75% of women will develop thrush at some point in their lives. And some of these will have more than one outbreak.

It is less common in girls who have not started to menstruate or conversely, post menopausal women. But it is common in women in their 20’s and 30’s.

Why is this? This is a time when women are sexually active plus this infection is also common during pregnancy due to changes in hormone levels. Pregnancy causes changes to the female hormone oestrogen which increases the risk of developing this infection.

Causes of thrush

Most women have a naturally occurring yeast fungus within their vagina which doesn’t cause any problems. The vaginal discharges plus ‘friendly’ bacteria within that area keep everything in balance. But if this balance is upset then this infection occurs.

A change in the environment such as hormonal fluctuations, trigger an overproduction of the yeast fungus which leads to this infection. Antibiotics can also cause an outbreak of this infection.

The majority of cases of thrush are caused by the Candida Albicans fungus and the remaining cases by other types of fungi.

Other risk factors include:

  • Chronic conditions such as diabetes
  • Poorly functioning immune system, e.g. from chemotherapy or HIV/AIDS.

Symptoms of thrush

These include:

  • Redness, soreness and itching around the vagina
  • Painful stinging sensation during urination
  • Discharge from the vagina which is thick and creamy white or thin and odourless.

The skin around the vagina becomes cracked and sore. This causes the vagina and vulva to swell which narrows the opening, making sex and urination painful.

Sores may also develop. But these are severe symptoms which develop in certain situations.

If this is your first bout of thrush then it is classed as ‘uncomplicated thrush’ which is usually mild.

But if you have suffered from several bouts which have also been severe then this is classed as ‘complicated thrush’.

Diagnosing thrush

If you develop any of these symptoms then visit your GP. Do this if you are:

  • Pregnant (or suspect you may be pregnant)
  • Breastfeeding
  • Under 16
  • Over 60 (post menopausal)
  • Have suffered from at least 2 bouts of thrush before
  • Irregular or problems with periods
  • Pain in the lower abdomen
  • You or your partner/spouse has suffered from a sexually transmitted infection (STI).
  • Have sores around the vagina and/or vulva
  • No improvement in your symptoms after 1 to 2 weeks

Your GP will ask you about your infection, discussing the symptoms in detail as well as asking you about your medical history. You will also be asked if you have suffered from thrush before and if so, when.

He or she will examine you before performing a vaginal swab. A vaginal swab is where a small sample is taken of the discharge from within your vagina for laboratory analysis. The aim is to determine if you have vaginal thrush or whether your infection is a sexually transmitted disease.

Another similar test checks the acid/alkaline balance within your vagina. It is performed in the same way and checks to see if there is a change in this balance. A high reading indicates a possible infection.

You may undergo a blood test as well if your GP suspects that you have diabetes.

Treatment for thrush

This takes the form of anti-thrush medication which is prescribed for mild cases of thrush. This is taken for 3 days and is available as tablets, pessaries and creams. All of these treatments are available over the counter from your pharmacist.

The only exception to this is pregnant women or women who are breastfeeding who will be given a prescription. If this applies to you then use this: do not buy anti-thrush products over the counter but use the prescription given by your GP.

A pessary is a small bullet shaped device which contains medication and is inserted into the vagina using a tampon like applicator. The cream is applied to the infected area around the vagina.

These are very effective in the vast majority of cases.

Severe cases will need to take this medication for a longer period of time.

You may prefer to take tablets rather than a pessary or cream which is understandable. But these have side effects which include:

  • Nausea
  • Vomiting
  • Headache
  • Bloating
  • Upset stomach
  • Wind
  • Diarrhoea

Tablets are usually prescribed for recurring cases of thrush only.

Pessaries cause fewer side effects but they are awkward to use and can cause a burning sensation. Plus they damage certain forms of contraception such as condoms. But if you do use them then follow instructions carefully.

If none of this treatment works then return to your GP.

Preventing thrush

If you are vulnerable to outbreaks of thrush wear cotton underwear and loose fitting clothing. Avoid lubricants and other sex related products if they cause an irritation. Keep the vaginal area clean with warm water and avoid scented products, deodorants and creams.