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Candida/Thrush contents
Essential facts
More information
Diagnosis and
management
 Pamphlet
(pdf format)
STD
information for students
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Vaginal Candidiasis
("Thrush", Monilia, Yeast)
More details/information for students
Definition
Signs and Symptoms
Testing
Treatment
Prevention
The yeast-like organisms that cause candidiasis are very
common and normally occur in the vagina as well as the mouth and in the
intestines of most healthy people. Candida is not a classic STD, but is
seen most commonly in sexually active people. The presence of candida does
not usually cause symptoms, but a change in the pH of the vagina may cause
a disturbance in the balance of normal flora. As a result, candidal
overgrowth can occur and then cause symptoms. Heat, moisture, diabetes,
steroid medication, and lowered resistance from, for example, cancer,
chronic infection, and malnutrition can also lead to symptoms.
Men can also get candidiasis, which is one of the causes
of balanitis (inflammation of the
glans penis). This is usually seen in uncircumcised men who still have a
foreskin to provide moist conditions for candidal overgrowth.
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Itchiness in the anal and genital area, which
intensifies at night.
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Vaginal discharge - ranging from white and
cheese-like to mucopurulent.
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Inflamed, split, and abraded skin.
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Inflammation of the glans penis (balanitis
- best treated and prevented by proper hygiene).
A swab can be taken from the wall of the vagina and
examined by microscope, and the organisms can be grown by culture.
It is possible to change some factors that
predispose the organism to spread.
Acute vaginal candidiasis is treated with an anti fungal
agent in the form of either a pessary (capsule) of nystatin which is
inserted into the vagina, or a vaginal cream.
As an alternative, natural yoghurt can be inserted into
the vagina or a vinegar and water douche can be used—one part vinegar to
five parts water.
A combination of genital and oral antifungal therapy can
be effective in recurrent infections by eradicating reservoirs of the
infection, however thrush can always recur because candida naturally lives in the
bowel and genital tract. Candida cannot be permanently eradicated.
Careful washing and drying of the anal and genital area
using minimal soap, are important in management of the infection. It is
also important when using toilet paper after both urination and
defecation, to wipe from front to back to reduce the risk of reinfection.
Loose-fitting cotton underwear is best, and nylon pantyhose and tight
trousers need to be avoided.
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As the pill can enhance candidal overgrowth, the use of
a different contraceptive may help to prevent thrush.
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It is important to avoid the use of chemical
preparations. Women should avoid so-called feminine hygiene products, and
spermicides that may alter the pH balance in the vagina.
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Some antibiotics should be avoided where possible.
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It is important to wear cotton
underpants, and avoid wearing tight trousers.
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A generally healthy lifestyle is important.
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To prevent balanitis,
men need to keep the glans penis clean and dry.
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