AN OVERVIEW OF VAGINAL THRUSH (CANDIDA) - a patient's guide
Dr Paula Weadon - Family Doctor
- Three quarters of all women will experience a thrush
infection during their lives
- It is caused by an overgrowth of yeast (candida) in the
- It is not a sexually transmitted disease but can occur after
- The symptoms include itching, burning and a vaginal
- It is not wise to base a diagnosis on symptoms alone, and
tests are needed.
- Some women experience recurring infections
- Most men do not have symptoms
- Local creams or pessaries usually cure the condition
What is vaginal candida? (also known as "thrush")
Vaginal thrush is caused by a fungal infection with candida and is
a very common infection for women.
It is estimated that 75 percent of all women will experience a
thrush infection at least once in their lives. It is also important
to realise that candida may be present in the vagina in approximately
30% of woman (called a commensal) and cause no symptoms at all, as
the amounts are small and held in balance by the natural acidity of
Other bacteria called lactobacilli are normally present in the
vagina and they maintain the vaginal secretions slightly acid, which
does not favour the growth of candida.
Thrush is caused by an overgrowth of yeast in the vagina. It is
not a sexually transmitted disease, but sexual intercourse can
irritate the vagina, causing the condition. Sperm is also alkaline
(opposite of acid) and thus favours the growth of candida.
A virgin could have a thrush infection. Babies can sometimes get a
mild thrush infection in their mouths or on their bottoms.
Other factors linked to the infection include pregnancy,
uncontrolled diabetes, the use of oral contraceptives or antibiotics.
Antibiotics alter the natural bacterial balance in the vagina
(killing the normal lactobacilli) and allow an overgrowth of thrush.
Some women find treating themselves promptly for thrush helpful, when
they are on antibiotics.
Wearing tight underwear, douches, and the use of perfumed feminine
hygiene sprays may increase the chance of developing an
What are the symptoms?
The symptoms of a yeast infection occur in the genital area. Women
complain of itching, burning and pain during urination and/or
It is important to realise that these symptoms may occur with many
conditions and that up to 75% of patients who see doctors thinking
they have thrush, actually have a different condition or another
condition as well.
A vaginal discharge is common but not always present. It has been
described as having a cottage-cheese, white appearance but it can
vary from watery to thick.
Most men do not experience any symptoms of the infection, but
about 20 percent of partners of women with thrush have complained of
a rash and burning sensation on the penis.
What is the treatment?
Applying an anti-fungal cream (e.g. miconazole cream) to the
affected area is likely to be effective, with cure rates of 80 to 90
percent. Many of the common creams may damage condoms and make then
Common treatments include nystatin, miconazole, clotrimazole.
Pessaries that are inserted in the vagina area also effective.
Wash your hands before inserting a pessary or applicator.
A single dose may be all that is needed for mild disease but those
with severe conditions should be treated for five to seven days
A single dose of oral medication, fluconazole, can be effective,
but is usually not used as a first line of treatment. It can be
useful in difficult cases or when creams have not worked in proven
An acidic gel may be helpful to restore the correct acidity in
Bathing in warm salty water can relieve the itch and aid recovery.
A doctor may be able to prescribe creams to relieve the pain.
No study has been able to prove that treating the male partners of
women will stop reinfection, although it may be advised particularly
if the male has some symptoms which have not settled.
Women with recurrent unexplained thrush should see a specialist.
Women with HIV may have severe yeast infections that are difficult to
Accurate diagnosis of the condition requires a laboratory test of
the vaginal discharge.
Over the counter non-prescription treatments are intended for use
only by women with a confirmed history of recurrent thrush due to the
common yeast (candida albicans). Self treatment by women thinking
they have thrush may delay correct diagnosis and encourage resistant
forms of thrush.
How can it be prevented?
Wash and thoroughly dry the genital area at least once a day.
Avoid perfumed and coloured soaps, bubble baths and vaginal
Wipe with toilet paper from front to back after a bowel
Do not wear tight clothes or underwear. Some people believe the
use of tampons should be avoided because the organism thrives in
warm, moist, dark places.
Eating acidophillus yoghurt is recommended by some women to stop
Some women also use plain lacto-bacilli yogurt to the vaginal
area, although there is not much scientific evidence to support this
(it won't do any harm!).
Having some cream available during a course of antibiotics may be
Creams that increase the vaginal acidity (acigel) may be tried to
reduce recurrent thrush.
Effective oral medications have recently become available to cure
yeast infections. Factors that lead to recurrent thrush are being
Thrush treatment is available over the counter in pharmacies.
However, as symptoms may not be an accurate guide, an
examination and tests are needed to make an accurate diagnosis andexclude other conditions. The condition is best to be seen by a
Dr Paula Weadon
- Family Doctor
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