Vaginal thrush

Also known as candida or yeast infection

Vaginal thrush is a common yeast infection that affects most women at some stage. Common symptoms include pain, itching and vaginal discharge.

Key points 

  1. Vaginal thrush is caused by an overgrowth of, or an allergic reaction to, a yeast called Candida albicans.
  2. Vaginal thrush usually clears up within a week or two of treatment with antifungal medication. This is available at your pharmacy or on prescription from your doctor.
  3. For some women, vaginal thrush is more difficult to treat and tends to occur quite frequently, despite treatment. Read more about recurrent vaginal thrush.

What causes vaginal thrush?

Vaginal thrush is caused by an overgrowth of, or an allergic reaction to, a yeast called Candida albicans. It is normal to have Candida in your vagina and most of the time it does not cause any problems. However, sometimes certain factors disrupt the natural balance, causing the Candida to multiply.

What are the symptoms of vaginal thrush?

Symptoms of vaginal thrush include:

  • itching or irritation around your vagina and vulva
  • burning or stinging when weeing
  • vaginal discharge – this can be thick and white or thin and watery, without any smell
  • pain during sex.

Are some women more at risk of vaginal thrush?

Vaginal thrush can affect women and girls of all ages, but it is rare before puberty or after menopause. Your risk of getting vaginal thrush increases if you:

  • are pregnant
  • have a history of STIs
  • have recently been on a course of antibiotics or steroids
  • have diabetes and your blood sugar is not under control
  • use a type of hormonal birth control that has higher doses of oestrogen
  • have a weakened immune system, such as from chemotherapy
  • have a skin condition such as eczema or dermatitis
  • have sex when you are not fully aroused, as vaginal dryness during sex can trigger thrush
  • use vaginal deodorants, sprays, gels and wipes, perfumed bubble baths, douches or other products that change the natural acidity of your vagina.​

Can I self-diagnose vaginal thrush?

Because it’s so common and symptoms are well known, many women self-diagnose and self-treat with over-the-counter products. However, one study showed that only 33%1 of women made the correct diagnosis – the rest did not actually have vaginal thrush.

Seeing your doctor is the only way to know for sure if you have vaginal thrush. The signs and symptoms of vaginal thrush are a lot like symptoms of sexually transmitted infections (STIs) and bacterial vaginosis. If left untreated, these conditions can increase your risk of getting other STIs and can lead to problems getting pregnant.

Should I see a pharmacist or my doctor about treatment for vaginal thrush?

If you've had vaginal thrush diagnosed in the past and you know the symptoms, you can buy antifungal treatment from a pharmacist.

See your doctor if you have symptoms of vaginal thrush and you:

  • are under 16 years or over 60 years old
  • are pregnant
  • have a history of or are concerned about sexually transmitted infections
  • have not had abnormal vaginal discharge before
  • have any of the following:
    • discoloured or strong smelling discharge
    • lower abdominal pain or vaginal bleeding that is not your period
    • vaginal thrush symptoms that have not settled despite appropriate treatment
    • vaginal thrush symptoms more than twice in 6 months
    • vaginal thrush symptoms plus other symptoms such as fever, tiredness or nausea.

What is the treatment for vaginal thrush?

Antifungal medicine is used to treat vaginal thrush. It comes in the form of vaginal creams, pessaries (tablets you insert into your vagina) or capsules that are taken by mouth (fluconazole). The choice of treatment and the dose will depend on different factors such as:

  • whether your symptoms are mild or severe
  • how often you get vaginal thrush
  • whether you are pregnant.

Symptoms should clear up within a few days of using the treatment. You may need a longer course of treatment if your vaginal thrush is difficult to treat or keeps coming back. You shouldn't use antifungal medicine more than twice in 6 months without speaking to a pharmacist or doctor.

Read more about the treatment of vaginal thrush.

Can I have sex when I have vaginal 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.

Some vaginal creams can weaken condoms, so apply the treatments after you have had sex if you are using condoms, or use alternative forms of contraception.

Will sexual partners need treatment? 

It is possible to pass thrush to your partner during vaginal, oral or anal sex.

  • If your sexual partner is a man, the risk of infection is low. He should see a doctor if he gets an itchy red rash on his penis. Read more about thrush in men.
  • If your sexual partner is a woman, she may be at risk. She should be tested and treated if she has any symptoms.

How can vaginal thrush be prevented?

The best way to prevent vaginal thrush is to identify what triggers it. If you get recurrent vaginal thrush and are unsure what is causing it, discuss your symptoms with your doctor. They can investigate the underlying causes and suggest ways you can manage it. 

Things you can do to ease discomfort and prevent vaginal thrush returning:

  • Dry the affected area properly after washing.
  • Wear loose cotton underwear and avoid tight clothing.
  • Always wipe from the front (vagina) to the back (anus) after toileting.
  • Use only water-based lubricants.
  • Use soap substitutes such as water-based emollients.
  • Consider changing your laundry detergent.
  • Ensure your blood-sugar level is kept under control if you have diabetes.

Avoid the following: 

  • Avoid using soap to wash your genital area.
  • Avoid irritants such as deodorants, talcum powder, bubble bath solutions, deodorised panty shields or vaginal douches.
  • Avoid spermicidal condoms.
  • Avoid fabric softeners.

Learn more

Vulvovaginal candidiasis DermNet NZ, 2014
Vaginal thrush NHS Choices, UK, 2017

References

1. Vulvovaginal health in premenopausal women BPAC 2011

Reviewed by

Dr Jeremy Tuohy is an Obstetrician and Gynaecologist with a special interest in Maternal and Fetal Medicine. Jeremy has been a lecturer at the University of Otago, Clinical leader of Ultrasound and Maternal and Fetal Medicine at Capital and Coast DHB, and has practiced as a private obstetrician. He is currently completing his PhD in Obstetric Medicine at the Liggins Institute, University of Auckland.
Reviewed By: Dr Jeremy Tuohy Last reviewed: 28 May 2019