What is thrush?

Thrush (vulvovaginal candidiasis) is a common fungal infection of the vulva and vagina that affects most women at some time in their lives.

Thrush is caused by yeast called candida which normally lives harmlessly in the vagina without you even noticing it. 

Normally, there is a delicate balance between bacteria and yeasts that live naturally within the vagina. However, the natural pH balance of the vagina that keeps candida under control can be upset by many factors. If the natural pH balance is altered, the level of yeast increases and can develop into a thrush infection.

Thrush affects women of all ages but is most common in women aged between 25-35, pregnant women and menopausal women.

Causes of Thrush 

Thrush can be caused by a number of internal and external factors:

Internal factors:

- Poor health or diet: High sugar/yeast intake contributes to thrush by increasing urinary sugar. 

- Pregnancy: Hormone levels during pregnancy may create high levels of sugars in vaginal secretions.

- Periods: Menstrual blood affects the vagina by changing the acidity or pH.

- Diabetes: People with diabetes often have high blood sugar levels, including in their vaginal secretions.

- Emotional or physical stress: stress may increase the risk of thrush as it affects your immune system, making you more vulnerable to thrush.

External factors:

- Sexual Intercourse: External stimuli may change the balanced environment of the vagina. 

- Perfumed soaps and bubble baths: These products may increase the risk of thrush as they increase the natural acidity (pH) of the vagina.

- Wearing tight synthetic clothing: These can prevent the air from circulating and can create a warm, moist place for thrush to develop.

- Antibiotics: Antibiotics kill friendly bacteria which keep yeast in the vagina under control.

- Contraceptive pill: There is evidence to suggest that a high dose contraceptive pill can cause thrush.

- Chemotherapy: Chemotherapy weakens your immune system, making you more prone to thrush.

 Who gets thrush? 

Having thrush is normal- around 75% of women will experience it at least once in their lives, while many women may suffer from recurrent thrush. Thrush is not a sexually transmitted infection.

First time sufferers

If you’ve never had thrush before and you think you may have it, visit your doctor. Once you recognise your own symptoms and you know they’re not serious, it’s easy to treat with a range of over-the-counter products.

Thrush and pregnancy

Thrush will not stop you from getting pregnant. However, some of the symptoms may make having sex uncomfortable.

Pregnant women are up to three times more likely to have yeasts colonising in the vagina. About a third of pregnant women have yeasts detected and an estimated 60-90% of these women will have symptoms. It is important to visit your doctor if you are pregnant or breastfeeding before using any treatments.

Treatment for Thrush

Thrush isn’t usually serious but it can be really uncomfortable, which is why it’s important to treat it properly and help stop the infection from coming back. It is recommended to treat the infection internally as well as treating the external symptoms.

The good news is that you can easily and effectively treat with over the counter (OTC) products which come in the following forms: 

Canesten Combi is recommended as it consists of an internal and external treatment. The cream provides immediate soothing relief while the pessary treats the source of the infection. 

Other internal treatments for thrush include: 

- Internal pessary: This is a tablet that is inserted into the vagina and clears the infection at the site.

- Oral pills: These are oral tablets but are only available with a prescription.

External treatments for thrush:

- Antifungal external creams: Soothes and cools itching fast. 

NB External Creams shouldn’t be used alone as external creams merely treat the symptoms and do not treat the cause of the infection.

When to see your doctor

First-time sufferers

If you recognise the symptoms we’ve described and you think you might have thrush for the first time, it’s still important to see your doctor.

Pregnant sufferers

Pregnant women are up to 3 times more likely to have yeasts colonizing in the vagina. It is important you visit your doctor even if you have suffered from thrush before, as your pregnancy may mean that an effective treatment you have used in the past may, in fact, be unsuitable now.

Have had at least 2 episodes of thrush in the past 6 months but have not consulted a GP about the condition for more than a year: recurrent thrush is defined as four or more episodes of infection in a year and affects about 5% of healthy women. 

Frequently it is not possible to identify the factors triggering infections, however; sometimes a relapse due to incomplete eradication of thrush during treatment can be confused with a recurrence. In this case, it is best to consult your GP.