Thrush

Thrush is an overgrowth of the yeast Candida Albicans. It lives naturally in the vagina and bowel but can cause uncomfortable symptoms if the balance is disrupted and the yeast increases. It sometimes called monilia or candidiasis.

Is thrush an STI?

No. Thrush is not an STI but it can be triggered by sex or, on occasion, passed on to partner during sex.

Men can develop thrush too. The symptoms are burning, irritation and itching of the foreskin, red patches, and a cottage cheese type discharge.

Some women mistake bacterial vaginosis (BV) for thrush as the symptoms are similar. It's not known exactly what causes BV but it refers to an imbalance of bacteria in the vagina. BV causes a discharge that can be white, grey, thin and watery. It's often accompanied by a fishy smell.

BV cannot be treated with thrush treatment as it is a different type of infection. Thrush is fungal whereas BV is bacterial. If you think you have BV speak to your doctor. It can be treated with antibiotics.

Thrush symptoms worsen over time. You may start with an itching which develops into thick white discharge and skin splits. Here are the main symptoms of thrush:

• Itching and burning in the vulva
• A thick cottage cheese type discharge
• A yeasty smell
• Swollen or red vaginal lips
• Pain during sex – not deep pelvic pain but stinging and burning it in the outer areas
• Pain during urination as urine irritates sore skin
• Cracks and splits in the vulva

There are a number of conditions that appear similar to thrush, such as BV already mentioned above. You should see your doctor if you have recurrent 'thrush', you've had unprotected sex, you have deep pelvic pain, unexplained vaginal bleeding or you've treated thrush and the symptoms remain.

Urinating blood, raised areas, blisters, spots, coloured discharge, fever, or any unusual changes to the vagina are not symptoms of thrush and need medical investigation.

Thrush is caused by a fungus, but that doesn't mean there is a lack of hygiene, it can develop for a number of reasons. The thrush fungus is present naturally in the vagina, but problems occur when this balance is disrupted and the fungus multiplies.

Thrush can be caused by antibiotic use, tight clothing, pregnancy, diabetes, dry sex that irritates your skin, a weak immune system, some contraceptives, and skin conditions. Sometimes the reason cannot be uncovered.

You're more at risk if:

• You're fertile
• In your twenties and thirties
• Pregnant
• Diabetic
• Have treatment for HIV
• Have chemotherapy
• Are run down and tired

The link between thrush and sex

People often wonder if thrush can be passed on through sex. It can in some cases, but it is not classed as an STI. Thrush is a common fungal condition.

You are more likely to get thrush if your vagina is dry and your skin is irritated or damaged during sex. Your partner may develop thrush if some of the yeast spreads during sex.

Women using non-barrier methods of contraception may find they develop thrush with semen creating a damp, moist environment.

Your partner does not need an STI test or treatment for thrush if you have it, but if they develop itching, soreness or redness then they can use widely available thrush treatments too.

If you use condoms or diaphragms for contraception, thrush treatments can weaken the latex, so it's best to avoid sex or use another form of contraception whilst you have thrush.

Thrush is diagnosed easily by a genital examination or through a swab. If you have had thrush before you may recognise the symptoms and purchase treatment independently.

You should see a doctor if you haven't experienced thrush before, so you have a firm diagnosis.

You should also see a doctor if you are under 16 or over 60, pregnant or breastfeeding. Other reasons to see your doctor are:

• Unusual symptoms including sores, a bad smell or severe pain
• You are bleeding
• You're previous thrush treatment hasn't worked
• You have recurrent thrush
• You have had unprotected sex

If you recognise thrush symptoms and treat yourself you should notice a quick improvement. If you still have symptoms after seven to fourteen days book a checkup. Thrush is not dangerous, but your doctor will want to make sure there are no other underlying conditions. If you do have thrush they may change the way you treat it e.g. a pessary instead of a cream or a prescription thrush treatment.

Treating thrush is simple. It is usually cleared up quickly with antifungal medication within a week.

There are several ways to treat thrush with antifungal medications.

Pessary - A pessary is a large oval shaped medication that is inserted into your vagina. You can do this yourself with an applicator. It's similar to using a tampon. Pessaries work best if you are able to lie down afterwards. Some women choose to insert theirs at bedtime.

Creams - Creams are widely used. They are topical and soothing. Some are available with an applicator but other are applied with fingers. Always wash your hands after using thrush cream to avoid spreading thrush.

Tablets - Tablets are available if you don't like the feel of cream or pessaries. You simply swallow the tablet like regular medication. They work well, but you might experience stomachache, nausea or vomiting side effects.

The treatment method is entirely your choice but you should always follow the instructions. If you are pregnant speak to your doctor first.

• If you live with others use your own towels and washing flannels to avoid spreading thrush.
• If thrush does not clear after non-prescription treatment your doctor can prescribe a stronger treatment, either a tablet or cream.

Some women find they get thrush regularly. This is uncomfortable and can cause difficulties with sex or washing for example. If you find you get thrush regularly you should speak to your doctor to see if there is an underlying cause.

Some home remedies are effective. They include:

• Double rinsing your underwear after washing it. Some women are sensitive to washing powders.
• Wear cotton underwear and ensure it is loose. Tight trousers or underwear encourages dampness. Air can circulate so fungus cannot breed so easily.
• Do not over-wash. Thrush is not dirty and frequent washing can irritate your skin, making the symptoms worse.
• Don't use strongly scented shower gels or vaginal wipes. Do not douche or use vaginal deodorants as they upset the natural fungal balance.
• Some women find natural fungal treatments such as tea tree oil or lavender actually cause thrush as they kill the 'good' fungus allowing candida to breed. Check your bath foam or shower gel for these ingredients.
• Apply a greasy emollient such as Vaseline to your vaginal skin to protect it.
• You may notice an improvement if you cut down on sugar, including white bread and pasta. Substitute them for whole foods, wholemeal options and more fruit and vegetables.
• Drink more water. Dehydration dries out skin and causes irritation. Sugary drinks such as a cola contain a lot of sugar which can provoke thrush.
• Some women take probiotic drinks or supplements to prevent thrush. There is no scientific research this works, but anecdotal evidence suggests it may help.
• Use lubricants during sex if you have a dry vagina.
• If you use sanitary towels, swap to thinner versions or try tampons or a mooncup as they avoid getting blood on your skin which can irritate.
• Apply live natural yogurt to the affected area or put a tampon in yogurt and insert it for a few hours to soothe irritation.

If you find thrush is reoccurring it's advisable to speak to your doctor as there could be an underlying reason such as an STI or diabetes, both of which can be damaging to your health. If you do have thrush it may require a higher dose of antifungal treatment.