What is thrush?
Thrush is also known as Candida. It is normally present on our skin and in the genital area in low levels. In some circumstances, it can flourish and cause symptoms. Three in four women will get thrush during their lives but it is much less common in men. It is not a sexually transmitted infection (STI) but can develop and get worse after having sex.
Thrush in women is usually treated with medication but for some women it can keep coming back for no reason.
GP Sarah Jarvis describes the symptoms of thrush, who is most at risk and how it is treated.
What are the symptoms?
Many people will naturally have a certain amount of fungus at the genitals and, in most cases, this doesn’t cause any problems.
Women
For women with symptoms, these may include:
- Itchy and sore genitals and/or bottom
- Unusual vaginal discharge which can smell yeasty
- Painful sex, which can make you worry about sex
- Stinging when peeing
- General red, swollen or cracked skin around the vagina
- Occasionally, sores on the skin – although this is more commonly a sign of genital herpes
The NHS visual guide to vagina problems might help you to understand what might be causing your symptoms.
Men
Male partners of women with thrush may get some irritation and itchiness on their penis or other thrush-like symptoms after having sex without a condom. These will normally settle with normal washing and without further treatment.
How do you get it?
Thrush is caused by a type of yeast called Candida Albicans, which likes to live in warm, moist environments. This grows naturally in our bodies and many women have Candida in their vagina without it causing any problems. Thrush can develops when the Candida multiply.
Some common triggers for Candida multiplying are; antibiotics, pregnancy, uncontrolled diabetes, vaginal dryness, or tightness during sex. While it isn’t an STI, it can be triggered by sex and occasionally passed onto sexual partners.
How do you prevent it?
If you get thrush a lot, you can take some steps to reduce the chances of it coming back. These include:
- Using water and a moisturising treatment instead of soap to clean your genital area
- Avoiding excessive cleaning of your genitals
- Avoiding things that might irritate your skin like perfumed soaps and shower gels
- Not wearing tight fitting underwear or tights
- If you have diabetes, aim to keep your blood sugar level well controlled
How do you get tested?
If you’ve had thrush before and are confident that this is the same, you may prefer not to have any tests and to buy medicines directly from a pharmacy. However, you should get medical advice from your GP, practice nurse, sexual health or GUM clinic if you:
- Aren’t sure if you have thrush
- Reacted badly to treatment in the past or it didn’t work
- Have thrush for the first time
- Have had thrush two times or more within the last six months
- Are under 16 or over 60
- Are pregnant or breastfeeding
- Have unusual vaginal bleeding or pain in your lower tummy
- Aren’t seeing any improvement in your symptoms or they’re getting words using standard thrush treatment
The doctor or nurse will examine your genital area and take a sample from your vagina with a swab (like a soft cotton bud) to test.
What treatment options are available?
Mild thrush may get better on its own. If treatment is needed, you will be given anti-fungal medication in the form of vaginal creams, special pills that you put inside your vagina using an applicator, or tablets / capsules that you swallow. Symptoms normally clear up quickly (within 1-2 weeks) but you may be advised to continue your medication for longer if you have had thrush several times.
Some thrush treatments can be bought from pharmacies while others are only available on prescription. If you are pregnant or breastfeeding, you must let your healthcare professional (nurse, doctor or pharmacist) know because some options will be unsuitable for you.