Guest Contributor: Dr E on the Real Deal with Thrush…

My dear friend Nana has persuaded me (read guilt tripped me) into writing a post as I ‘m a GP and she wanted some clarification on a few points about vaginal thrush.  Here goes!

The most common yeast that causes thrush is present in a proportion of women and doesn’t need treatment unless you’re displaying symptoms.  These include:

A non-offensive smelling creamy or curdy discharge

Itchiness of the vaginal area

Redness and inflammation of the vaginal area which can lead to soreness and pain during sex or passing urine

Men can also get a characteristic itchy rash usually to the tip (glans) of their penis

The most common cause is ‘no cause’ it just happens but other predisposing factors are:

Antibiotic treatment which can alter the balance of bacteria in the vagina and allow overgrowth of yeasts

Oral contraceptives

Pregnancy

Poorly ventilating clothing

Diseases such as diabetes

It is common practice to treat suspected thrush without further investigations in the presence of typical symptoms. If however a person is at high risk of STIs or has recurrent (four or more episodes in a year) or resistant infection then a swab should be taken from the vagina.

Treatments range from a one off dose of oral tablet to a course of vaginal pessaries lasting 3-14 nights.  General advice should also be given to avoid tight fitting synthetic clothing and soaps especially if perfumed.  Creams are also used in conjunction with these treatments to soothe the skin.  In recurrent infection treatment is with standard medicines but is repeated until symptoms subside then regular (either weekly or monthly )treatments for 6 months.

The over-riding messages are that thrush is not sexually transmitted  and usually doesn’t have a cause .

References:

Handbook of Family Planning and Reproductive Healthcare (5^th Edition )  Anna Glaiser and Ailsa Gebbie