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Vaginal thrush | Mateīhi

Also known as candida or yeast infection

Key points about vaginal thrush

Vaginal thrush (mateīhi) is a common yeast infection that affects most women at some stage. Symptoms include vaginal itching, discharge and pain.
Vaginal thrush is caused by an overgrowth of, or an allergic reaction to, a yeast called Candida albicans.
Vaginal thrush usually clears up within a week 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.

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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. Up to 3 out of 4 women will have at least one bout of thrush in their lives.

Vaginal thrush is sometimes called candidiasis or vaginal yeast infection or vaginal candidiasis.

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 sexually transmitted infections (STIs)
have recently been on a course of antibiotics or steroids
have diabetes and your blood glucose 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
wear tight fitting clothes
use vaginal deodorants, sprays, gels and wipes, perfumed bubble baths, douches or other products that change the natural acidity of your vagina.

In some women, vaginal thrush tends to occur quite frequently. If you experience 4 or more vaginal thrush infections per year, this is called recurrent vaginal thrush. Read more about recurrent vaginal thrush below.

For some women, vaginal thrush is more difficult to treat and tends to occur quite frequently, despite treatment.

Repeated vaginal thrush infections are more likely in women who:

have diabetes and their blood glucose level is not well controlled
use antibiotics often
are pregnant
are on long-term oral steroid treatment (such as prednisone) and immunosuppression (such as chemotherapy)
have iron deficiency
are taking oestrogen, including the combined oral contraceptives or hormone replacement therapy (HRT)
have a sexual partner who has untreated thrush.

Treatment

If you have recurrent vaginal thrush, see your doctor. They may need to do a vaginal swab and get it tested to see what treatment is best for you.

Your doctor may recommend using antifungal vaginal creams for a longer course, such as 10–14 days or for a few months. In some women, this may cause irritation or contact dermatitis.
In some women, using a vaginal antifungal cream or pessary before and after menstruation can prevent recurrent symptoms.
Your doctor may prescribe oral antifungals such as fluconazole for a few months.
There is no evidence that the use of probiotics (such as Lactobacillus acidophilus or other probiotics) is beneficial in the treatment of vaginal thrush. There is also no evidence of harm with their use.

Read more about vaginal thrush medications. Even if you take medicines, it's important to use self-care measures to reduce your risk of recurring infections.

Symptoms of vaginal thrush include:

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

Some people have no symptoms and thrush may be picked up when having a test for something else.

Because it’s so common and symptoms are well known, many women self-diagnose and self-treat thrush with over-the-counter products.

The signs and symptoms of vaginal thrush are a lot like symptoms of sexually transmitted infections (STIs) and bacterial vaginosis. These conditions can increase your risk of getting other STIs and can lead to problems getting pregnant. So if you are not completely sure if you have thrush, see your doctor.

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

Sometimes symptoms of vaginal thrush may be due to another condition. See your doctor if you have symptoms of vaginal thrush and you:

are having symptoms of thrush for the first time
are under 16 years or over 60 years old
are pregnant
have treated yourself with a thrush treatment from the pharmacy, but your symptoms have not gone away
have a history of, or are concerned about, sexually transmitted infections
have any of the following vaginal symptoms:
- discoloured or strong smelling discharge
- lower abdominal pain or vaginal bleeding that is not your period
- ulcers or blisters next to your vagina
- vaginal thrush symptoms that have not settled despite appropriate treatment
- vaginal thrush symptoms more than four times in a year
- vaginal thrush symptoms plus other symptoms such as fever, tiredness or nausea.

Antifungal medicine is the best treatment for 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.

Read more about the treatment of vaginal thrush using medicines.

The following measures have not been shown to help:

Special low-sugar, low-yeast or high-yoghurt diets
Putting yoghurt into the vagina
probiotics

Thrush does not damage the vagina and it does not spread to damage the womb (uterus). Having thrush while you are pregnant won't harm your unborn baby but if you have thrush when you are giving birth, it may be passed on to your baby. If this happens you will be given advice on how to treat it. Untreated thrush can cause problems so make sure you see a doctor if you think you have thrush to find out how best to treat it during pregnancy.

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 can also pass to the mouth during oral sex. Read more about oral thrush here.

Use barrier forms of contraception (eg, condoms) to avoid passing thrush to your partner.

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.

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.

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. Read more about recurrent vaginal thrush.

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 glucose 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.

Thrush (candida)(external link) HealthInfo, NZ
Understanding your vaginal swab results(external link) HealthInfo, NZ
Vulvovaginal candidiasis(external link) DermNet, NZ
Thrush in men and women(external link) NHS Choices, UK
Vaginal candidiasis(external link) CDC, US
Thrush in pregnancy(external link) NHS, UK