“Thrush is really common, with three out of four having it at least once in their adult life. Yet despite this, it isn’t spoken about publicly much, which can leave people too embarrassed to seek medical help. It also has negative connotations, with many people believing it’s caused by a sexually transmitted infection or bad hygiene. Both are untrue,” Taylor adds.
So what exactly is thrush and can you prevent it? Here, Claudia Estcourt, a professor of sexual health and HIV at Glasgow Caledonian University and spokesperson for the British Association for Sexual Health and HIV (bashh.org), and consultant gynaecologist Dr Caroline Overton, spokesperson for the Royal College of Obstetricians and Gynaecologists (rcog.org.uk), tell us more…
“Vaginal thrush infection is caused by an increased growth of candida albicans, a yeast which can be found in the healthy vagina,” explains Overton. “It’s very common and at least three out of four women will experience thrush at some point.
“It can be triggered by antibiotics, which kill friendly bacteria that naturally suppress candida. It can also occur during pregnancy because the change in hormones allows candida to thrive, and also following the menopause, in cases of skin irritation and damage, and in those with a weakened immune system – for example, due to chemotherapy.”
Women with diabetes and some other medical conditions can also be more prone to thrush, adds Estcourt.
What are the symptoms of thrush?“Typical symptoms of vaginal thrush include itching and soreness around the entrance of the vagina, a thick white discharge, pain during sex, and a stinging sensation when urinating,” explains Overton.
Estcourt adds: “Other conditions, which people haven’t necessarily heard of, can cause similar symptoms – but many people just assume their symptoms are candida/thrush.”
Why are some people embarrassed about getting thrush?
“Some people find any symptoms related to their genitals embarrassing and difficult to discuss,” says Estcourt. “Genitals are just a part of the body. Staff in sexual health clinics are very used to talking about genital health and problems. We don’t find it embarrassing at all.”
Is thrush a sexually transmitted infection?“Thrush isn’t classed as a sexually transmitted infection and partners aren’t routinely screened or treated for it,” says Overton, who points out that while the infection usually affects vaginas, it can affect the penis too.
Estcourt explains: “Men can get skin infections caused by candida, which tend to be on the head of the penis. It’s much less common that in women.”
Is thrush anything to do with poor hygiene?“No,” stresses Estcourt. “In many cases, people tend to over-wash. This strips the natural defence bacteria from the skin and vagina and makes it easier for the small amounts of yeast commonly present on the skin to cause symptoms.”
How should thrush be treated?
“Thrush can be unpleasant and uncomfortable, but is generally considered harmless,” says Overton. “It can usually be treated with anti-fungal medication available from pharmacies or on prescription from GPs. If your symptoms don’t get better after seven days then speak to your GP.
“For some women, vaginal thrush can be difficult to treat and keeps coming back. If symptoms persist, women should contact their healthcare professional for an examination. Bacterial vaginosis and other infections can give similar symptoms, and are treated with antibiotics rather than anti-fungals.”
Recurrent thrush could be a sign of an underlying condition such as diabetes, she adds, and Estcourt stresses: “Not every vaginal symptom is thrush, so it’s important to seek advice from your sexual health clinic if you have symptoms which don’t respond to the treatments.”
What are the best ways to avoid thrush?
Wearing large cotton knickers can help. Estcourt says: “Sleeping without underwear and avoiding tight-fitting underwear, tights and clothes may be beneficial to women with thrush, as the infection thrives in warm, moist parts of the body.”
It’s important to change your washing regime to reduce the risk of further episodes of thrush, and not to use perfumed soaps and bubble baths. Estcourt says: “Avoid using perfumed soaps, gels and antiseptics near the vagina, as these can affect the healthy balance of bacteria and pH levels in the vagina and cause irritation.
“Women are advised to use plain, unperfumed soaps to wash the area around the vagina (the vulva), not inside it, gently every day.” And she warns: “We would never recommend using feminine hygiene products, as these can harm healthy bacteria.”
3. The jury’s out on probioticsThe National Institute for Health and Care Excellence (NICE) suggests women should consider using probiotics, such as live yoghurts, orally or topically to relieve thrush symptoms. But Overton says: “It’s been suggested that probiotics, like yoghurt, can help in the treatment of vaginal thrush. However, there’s not enough robust evidence to support this. Putting yoghurt in the vagina may disrupt the vagina’s healthy bacterial balance, which may lead to infection and inflammation.”