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What is Vaginal Thrush?

Thrush is a very common type of vaginal yeast infection that is caused when the fungus Candida Albicans overgrows. Fungus and bacteria naturally live in your vagina, however, there are occasions when good bacteria (called lactobacilli) can’t keep the fungus Candida under control.

Thrush is a very common condition that is experienced by most women (approx 75%) at least once in their lifetime. For some, it can be a passing irritation easily cured with over the counter remedies, while for others it can be a chronic condition that can have an impact on the quality of life.

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What does Thrush look like?

Vaginal Thrush looks like white cottage cheese like discharge.

image by GP Online 

What causes thrush? 

There are a certain set of microbes, including bacteria, viruses, and fungi, that live in the skin and mucous membranes of our bodies. These are known as the normal flora of the body. 

However, when the delicate balance in our body is compromised and the conditions permit, some of these microbes can overgrow. Candida, the fungus that causes Thrush and resides on the skin and inner lining of the gut, genital and urinary tract, is an example of such microbes that in the right quantity supports our health, however, can quickly cause an infection.

When are you most likely to get thrush?

There are times when you might be more prone to getting Thrush, some of which include:

  • If you are pregnant
  • If you have finished a course of antibiotics
  • If you have diabetes
  • If you are on your period
  • If you take birth control pills
  • If you have an HIV infection

Can sex cause thrush?

Although thrush is not a sexually transmitted disease, some women complain that their thrush develops and/or worsens after sexual intercourse.
However, it’s worth paying attention to the lubricants and condoms you are using as these may alter the vaginal PH. Semen may also do so.

If your vagina is dry or tight during sex, there is an increased risk of small tears being made on the vulva and vagina during penetration. These tears can enable the Candida to invade tissue and overgrow, causing infection.

It’s also worth noting that around 20% of women have higher amounts of candida and are therefore more likely to get a vaginal thrush infection.

Can lube cause thrush?

A common ingredient used in lubricants is Glycerin, which not only acts as a food source for the Candida fungus but has also been shown to kill dominant bacterial species within the vaginal microbiome that help to maintain a healthy acidic pH.

Be sure to read the label thoroughly when shopping for lube.

Can antibiotics cause thrush?

Taking antibiotics long-term to treat a bacterial infection, will not only kill the harmful bacteria but also the good ones in the normal flora. This disruption of the natural balance of microbes can lead to the overgrowth of Candida, which is kept under control by other bacterial microbes in the normal flora.

Can douching cause thrush? 

Douching is a practice of washing out the vagina with water or other fluids, including bleach and vinegar, to ‘clean’ it out. This is not necessary and can cause harm, and is linked to an increased risk of thrush, bacterial vaginosis, pelvic inflammatory disease, and other STIs.

Douching can remove our normal vaginal flora, which can allow pathogens to overgrow. If douching with a pressurised stream of fluid, this can actually work to help transport bacteria from the lower genital tract into the uterus, Fallopian tubes, or abdominal cavity.

Many women practice douching due to false beliefs that it can help prevent infection or that it’s good for their hygiene. This can translate into douching before or after sex to ‘cleanse’ the vagina. There are many complex reasons why beliefs like this persist, not in the least due to social pressures from physicians, partners, and the media.

 What are the symptoms of thrush?

Infection in the vagina or genital region is called genital or vulvovaginal candidiasis.

Symptoms include:

  • white vaginal discharge (often like cottage cheese), which does not usually smell
  • itching and irritation around the entrance of the vagina (itchy labia).
  • soreness and stinging during sex or when you pee

Does thrush cause bleeding?

Vaginal thrush can cause a number of symptoms, including bleeding.

Light bleeding or spotting is usually nothing to worry about. Frequent thrush infections can cause tears, cracks, or sores in vaginal tissue, which will naturally lead to bleeding or spotting.

However, if your bleeding is heavy — or if it continues after the infection clears — it may be a sign of a different underlying condition and you should see a medical professional.

 

Thrush treatments

How do you get rid of Thrush?

Treatments are available over the counter and should clear out the infection within 7 to 14 days of starting treatment. You can buy most thrush medicines from a pharmacy, without a prescription. These come in the form of tablets you swallow, or vaginal creams or pessaries. A pessary is a tablet that you put into your vagina, usually at night.

Examples of treatments include:

  • clotrimazole (Canesten) cream or pessary
  • econazole (Gyno-Pevaryl) cream or pessary
  • fenticonazole nitrate (Gynoxin) cream or pessary
  • fluconazole (Diflucan) tablets
  • itraconazole (Sporanox) tablets

What’s the best treatment for thursh? Oral, creams or passaries? 

Tablets work just as well as pessaries and creams but there are some differences in side-effects.

Oral treatments might make you feel sick, and give you diarrhoea or a headache, while pessaries can cause some irritation to the area and a discharge.

Whatever treatment you choose, it’s really important to finish the full course of your treatment or there’s a high probability that the yeast infection may come back.

If over-the-counter treatments haven’t helped, your doctor or nurse might perform a swab test to assess if you are indeed experiencing a yeast infection or another type of infection. 

A swab test is only usually necessary if:

  • you’re at risk of having a different infection
  • your treatment hasn’t worked
  • your symptoms keep coming back

 

How to soothe Thrush itching?

The best way to soothe irritation is to start treatment. Look for anti-fungal creams meant to treat yeast infections at your local pharmacy or supermarket that sell over the counter medication. Use them 2-3 times a day on the affected area for up to 2 weeks. You can apply these to your labia (the lips outside your vagina) but make sure not to insert them into your vagina.

Some people find using coconut oil or yogurt on the external areas that are irritated, soothing as they can help reduce itchiness while the treatment takes effect.

Does Thrush go away on its own?

A mild vaginal yeast infection may go away without treatment. If you have mild symptoms, you may want to wait to see if that happens. If you’re not pregnant and you know that your symptoms are caused by a yeast infection, you can treat it yourself with over-the-counter antifungal medicine.

image by mybillie.com

 

What can you do to help avoid getting Thrush?

There are a number of things you can do to help you avoid getting Thrush.

  • Stop using soap around your genital area.

Use water or non-perfumed moisturising cream instead – if you’re unsure what type to use ask a pharmacist for advice. You could try using an emollient cream or ointment such as E45 on your skin outside your vagina too.

  • Wear cotton underwear and loose clothing

Although there isn’t a lot of research behind this, Doctors do suggest that tight clothing could be a factor as aeration is important to avoid creating the right conditions for Thrush to thrive.

 

Frequently asked questions on Thrush

Can I have sex when I have thrush?

You can still have sex when you have vaginal thrush. However, it can be uncomfortable and you may experience a burning sensation during or after sex. Use plenty of lubricant to protect your skin. Thrush is not an STI, but male partners can sometimes get redness and irritation after sex.

It’s worth noting that, penetration can aggravate inflamed tissue, as well as increase itching and irritation. And inserting anything into the vagina — whether it’s a sex toy, finger, or tongue — can introduce new bacteria. This may make your infection more severe.

In short, if having sex doesn’t cause you discomfort while having thrush, it’s ok to have sex. Perhaps focus more on clitoral stimulation over penetration.

Why do I keep getting Thrush?

It’s estimated that around 20% of women are prone to yeast infections (aka Thrush).  It is not yet clear why some women experience recurrent Thrush, however some theories are:

  • It’s possible that thrush might keep coming back if you don’t take your treatment for thrush properly – it’s really important to complete the full course.
  • You might have a strain of Candida that’s resistant to treatment. This can happen if you’re infected with a type of yeast called Candida glabrata. Up to two in 10 women who get recurring thrush are infected with this type.
  • It might happen if you continue to be affected by things that can increase your risk of getting thrush. If you have diabetes and don’t get it under control, you might keep getting thrush, for example.

Yet despite these possible reasons, for half of the women who get recurrent thrush, there’s no apparent reason why. If you continue to have problems, go and visit your GP or sexual health clinic to get support and advice. They may prescribe a treatment that you take for longer, or look for other things that might be causing your symptoms.

Are there any home remedies for Thrush?

There isn’t any scientific research and evidence to suggest that the following home remedies are effective for Thrush treatment, however, some people have found relief when using the following:

Coconut oil

Coconut oil has antifungal properties and has been shown to combat the Candida Albicans yeast. Raw organic coconut oil can be applied internally or externally to ease symptoms.

Warmed coconut oil can also be used as a carrier oil for more powerful antifungal essential oils, including tea tree oil.

Natural Yoghurt

Natural, unsweetened, non-flavored yogurt contains beneficial bacteria, called probiotics. These contribute to health and help restore the balance of bacteria and yeast in the body.

 It has been theorised that eating yoghurt rich in lactobacilli or even directly applying it vaginally may rectify this imbalance. However, the evidence for these approaches is poor.

If you are going experiment with yoghurt, make sure you use one with no sugars as that could make the situation worse and even result in urinary tract infection.

Boric acid

Boric acid is a weak acid available usually as a pessary (an insertable, dissolvable pill) as a treatment for thrush. Boric acid disrupts favourable environment for yeats growth by destroying yeast enzymes and killing the cells off. A systematic review of all studies comparing boric acid to conventional treatments found that boric acid is a safe and effective alternative treatment for women with chronic thrush.

However, it’s important to be aware that, as an acid, this therapy can cause temporary irritation, burning sensations, watery discharge, and redness to the applied area. Typically, an effective treatment course runs from one to two weeks.

 

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