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Candida/Thrush contents

Essential facts

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Diagnosis and management

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Vaginal Thrush
(also known as Candidiasis and Monilia)
Essential facts

Thrush is a very common vaginal infection. It is caused by a yeast (Candida) which lives naturally in the bowel and, in small numbers, in the vagina.

Symptoms

Normally, Candida does not usually cause symptoms. Sometimes, overgrowth of Candida occurs and symptoms develop. Women with symptoms of thrush may experience:

• vaginal itch, discomfort or irritation
• a thick, clumpy discharge
• redness and/or swelling of the vagina or vulva
• stinging or burning when passing urine

Thrush is not the only cause of these symptoms. Other conditions such as genital herpes or urinary tract infection may have similar signs, so it is important to have the diagnosis confirmed before commencing treatment.

Diagnosis

Thrush can only be diagnosed when a doctor examines the genitals. Sometimes the doctor observes obvious inflammation and discharge and can diagnose thrush from the examination.

Swabs taken from the affected area may show yeast organisms under the microscope. At Clinic 275, this result is usually available "on the spot". Further tests to grow the organism in culture can take several days.

Causes of thrush

Sex is not important in the growth of thrush. Candida is present normally and symptoms occur because of excessive growth (overgrowth) of the yeast.

Overgrowth may be associated with:

• antibiotic treatment
• the oral contraceptive pill
• diabetes
• pregnancy
• immune system disorders and general illness

Sometimes the reason for the growth of thrush cannot be identified.

Treatment

Treatment reduces the number of organisms so they no longer cause symptoms. Sometimes symptoms only last for a short time (e.g. the week before a period) and treatment is not necessary.

Treatment is usually with an antifungal cream or suppositories such as miconazole (e.g. Monistat) or clotrimazole (e.g. Canestan).

There is no evidence that dietary changes help prevent thrush.

Notes on vaginal pessaries

• Place one suppository in the vagina each night until all the suppositories have been used.
• Wear old underwear to bed, as the suppository will melt and may soil your bedding.
• You may have sex during treatment, but insert the suppository after intercourse.
• If a period occurs during treatment, continue to use the suppositories.

Prevention

• Always wipe from front to back after using the toilet, to avoid spreading yeast from the anus to the vagina.
• Wash the genital area daily with mild soap or sorbolene-glycerine cream.
• Do not have vaginal intercourse immediately after anal intercourse.
• Avoid antiseptic or irritating douches and perfumed sprays.
• Do not wear tight fitting pants or synthetic underwear.

Recurrent thrush

Some women have repeated episodes of thrush, despite following the prevention guidelines. This may result in many courses of treatment. In such cases, it is important for a doctor to establish that the symptoms are really due to thrush, and not some other vaginal condition.

Once this is done, anything contributing to the growth of thrush should be identified and eliminated, if possible.

If recurrent thrush has been confirmed and no contributing factors are identified, a course of preventive treatment usually stops further episodes.

Treatment for recurrent thrush

If your doctor has diagnosed recurrent thrush, a common treatment is insertion of a single 500 mg pessary each week for 6 months. If this does not help, the doctor may prescribe an oral antifungal medication.

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