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.

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 
• 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. However, 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.

However, for some women, vaginal thrush can be difficult to treat and keeps coming back. 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. Others are only available on prescription from your GP.

The main types are:

• pessaries – a special pill that you put 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

Your pharmacist or GP can help you decide which treatment will be best for you. Pregnant or breastfeeding women shouldn't take the capsules.

Care should be taken when using an applicator during pregnancy to avoid potential damage to the cervix. Some women prefer to put pessaries in by hand when pregnant.

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 moisturiser works just as well.

Causes of vaginal thrush 

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

Many women have Candida in their vagina without it causing any problems. However, 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 20s and 30s – thrush is less common in girls who haven't started their periods and women who have been through the menopause
• are pregnant
• 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
• receiving oral sex may increase the risk

Vaginal thrush isn't classed as an STI. However it can be triggered by sex – particularly if you have sex when you're not fully aroused and your vagina is dry. Thrush can occasionally be passed on to sexual partners.

Preventing vaginal thrush 

If you get thrush often, you can:

• use water and a 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
• make sure your blood sugar level is kept under control, if you have diabetes

More useful links

• How to use your health service