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.

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.

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 are the symptoms of vaginal thrush?

Symptoms of vaginal thrush in women include:

  • itching or irritation around the 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.

Can I self-diagnose vaginal thrush?

Because it is 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% of women made the correct diagnosis and 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.

See your doctor if you:

  • are less than 16 years or over 60 years
  • are pregnant
  • have a history of or are concerned about sexually transmitted diseases
  • 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
    • thrush symptoms that have not settled despite appropriate treatment
    • thrush symptoms more than twice in six months
    • thrush symptoms plus other symptoms such as fever, tiredness or nausea.

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.

Are some women more at risk of vaginal thrush?

Some women appear to be more prone to thrush than others. 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 vaginal dryness, e.g. having sex when you are not fully aroused
  • have skin conditions such as eczema or dermatitis
  • wear tight clothing that promotes excessive sweating, e.g. wetsuits, synthetic underwear
  • use vaginal deodorants, sprays, gels and wipes, perfumed bubble baths, douches or other products that change the natural acidity of the vagina.

What is the treatment for vaginal thrush?

Mild thrush can be treated with a short course of antifungal medication. Symptoms should clear up within a week or so. You may need a longer course of treatment if your thrush is difficult to treat or keeps coming back.

Some thrush medications can be bought from your pharmacy; others are available on prescription from your doctor. 

Anti-fungal treatments come in the form of:

  • Vaginal creams and pessaries (vaginal tablets) that you insert high into your vagina, such as clotrimazole, miconazole and nystatin.
  • Oral capsules which are taken by mouth, such as fluconazole, itraconazole.

See your doctor or nurse to make sure that you have vaginal thrush and not another type of infection. 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.

Read more about the treatment of vaginal thrush.

Vaginal thrush and sex

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.

The treatment for thrush 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 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.
  • If your 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 thrush is to identify what triggers it. If you get recurrent 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.

Some of the following suggestions may be helpful:

  • Wear loose cotton underwear and avoid tight clothing.
  • Always wipe from the front (vagina) to the back (anus) after toileting.
  • Avoid using soap to wash the genital area. Soap substitutes can be used such as water-based emollient.
  • Avoid irritants such as deodorants, talcum powder, bubble bath solutions, deodorised panty shields or vaginal douches.
  • Avoid spermicidal condoms and use only water-based lubricants.
  • Consider changing your clothes-washing detergent and don’t use fabric softeners.
  • Request thrush treatment when prescribed antibiotics.
  • Ensure your blood-sugar level is kept under control, if you have diabetes.

Learn more

Vulvovaginal candidiasis DermNet NZ, 2014
Vaginal thrush NHS Choices UK