Thrush is a yeast infection caused by an increase in the growth of fungi: usually Candida albicans. Yeast typically lives in harmony with normal healthy bacteria in the gut and mucous membranes such as the vagina. However, under certain conditions, this balance is disrupted and it can multiply and cause symptoms.
Three out of four women will experience vaginal thrush at some point in their lives and up to half of these will see repeated attacks, particularly when they first start having sex.
A third of women will get a vaginal yeast infection following a course of antibiotics as the helpful bacteria that normally keep yeast under control are killed off. A weakened immune system can encourage the fungus, as can diabetes due to the presence of glucose in the urine. Sometimes a contraceptive pill will predispose to yeast overgrowth leading to recurrent thrush in some women. Although the two are often confused, thrush is quite different from cystitis, which is an inflammation of the inner lining of the bladder and urethra.
Your chances of getting thrush are higher if you:
• Wear lycra shorts or tight nylon clothes
• Take antibiotics, (thrush can develop in about a third of women who take antibiotics)
• Take steroids or immunosuppressive drugs
• Use too much vaginal deodorant or perfumed bubble bath or shower gel
• Are pregnant
• Damage the vaginal walls due to vaginal dryness during sexual intercourse or the excessive use of tampons
• Have sex with someone who has a thrush infection
Symptoms of vaginal yeast infection
• A lumpy, white vaginal discharge ‘like cottage cheese'
• Painful sex (but not always)
• Itching, pain or burning in the vulva especially when wiping after urination
• Pink vaginal discharge
• Needing to urinate frequently
Thrush can also affect other internal areas, for example the mouth. This is less common and may indicate that the immune system isn't working properly. In this case it is important to contact a doctor.
When babies develop oral thrush, it can lead to sore nipples for mothers and an angry looking nappy rash.
Yeast infection in men
Thrush can also affect men usually in the groin area and this is referred to as Jock itch or Dhobi’s itch. It is caused by a different fungus called Tinea cruris that can also produce athlete's foot resulting in cheesy, itchy and soggy skin between the toes.
Is thrush contagious?
Thrush is not contagious in the usual sense of the word, but it can pass between partners. If a woman has thrush it is advised that any male sexual partner apply some Canesten HC cream to the penis for five days and avoid sex whilst having treatment.
One consequence of Candida on the skin and vaginal tissues is an allergic response to the yeast itself, such that even after getting rid of the yeast you're still left with an unpleasant irritation.
Treatment for uncomplicated thrush is available without a prescription at any pharmacy and consists of a tablet of fluconazole taken orally or a pessary, containing clotrimazole that is inserted into the vagina. This is often used in combination with Canesten cream, which also contains clotrimazole.
Unfortunately, in some cases, this treatment is not effective and then you should consider seeing a doctor.
The doctor will probably provide a prescription that includes Canesten HC cream as well as a single dose of fluconazole (Diflucan). The 'HC' stands for hydrocortisone, a type of steroid that treats the inflammation that inevitably occurs in the delicate vulval and vaginal skin.
Persistent or recurrent thrush, which is defined as getting four or more outbreaks a year, can be a real nuisance. Around one in ten women may have recurrent thrush and up to one in one hundred may have it almost all the time. Various things predispose to recurrent thrush, such as diabetes and pregnancy.
To control recurrent thrush a doctor will probably advise you to take a six month course of treatment with the antibiotic fluconazole in combination, initially, with a clotrimazole pessary and five day’s use of Canesten HC cream.
How to avoid getting thrush
• Drink lots of water
• Do not douche or clean inside of vagina
• Avoid vaginal deodorants, bubble baths or perfumed soaps and shower gels
• Try not to wear nylon underwear, tights, or tight fitting trousers
• Change to a non-biological washing powder
• Take care with genital hygiene and wipe from 'front to back'
• Consider using pads and panty liners rather than tampons
• Avoid intercourse until all symptoms have disappeared as this will encourage healing of the lining of the vagina
Thrush is a fairly harmless, though irritating, condition. Occasionally the symptoms can be a sign of a more serious disorder, so see your GP if you also have a fever, there’s blood in your urine, you are pregnant, or have been experiencing vomiting. Also bear in mind that thrush is more likely if you have diabetes.