Vaginal candidiasis also known as vaginal thrush or vulvovaginal candidiasis. It is a common yeast infection that affects most women at some point during their lives. Both fungus and bacteria naturally live in your vagina. But when the fungus Candida albicans increases, it can cause thrush. This fungus may increase when your immune system is weak or when good bacteria (called lactobacilli) can’t keep the fungus under control.
It is usually harmless but can cause irritation and discomfort. It can usually be treated with OTC medication or prescription from your doctor. However, for some women, vaginal candidiasis can be difficult to treat and keeps coming back. Recurrent vaginal candidiasis may be a sign of an underlying health problem.
What causes vaginal candidiasis?
Vaginal thrush is caused by an overgrowth of, or an allergic reaction to, a yeast called Candida albicans. It is normal to have Candida in your vagina and most of the time it does not cause any problems. However, sometimes certain factors disrupt the natural balance, causing the Candida to multiply.
Although vaginal candidiasis is not an STI, it can be triggered by sex. Other factors that can increase the risk of developing thrush include:
- Wearing tight clothing – which prevents natural ventilation.
- Having poorly controlled diabetes
- Taking antibiotics – about 30 per cent of women will have thrush because of this.
- Using products that irritate the vagina, such as vaginal douches or bubble bath.
- Undergoing chemotherapy.
- Being pregnant
- Having a weakened immune system because of a condition such as HIV
- Having vaginal dryness such as having sex without arousal
Do I have vaginal thrush?
Typical symptoms of vaginal candidiasis include:
- genital itch – this is the most common symptom. It is specially worse before your period
- soreness or burning of the vagina during or after sex
- abnormal discharge – usually thick and white with a ‘cottage cheese’ appearance
- change in the smell of your vaginal secretions
- redness and inflammation of the vulva
- soreness or discomfort on urination
- pain – particularly if thrush is recurrent and inappropriately managed
- small white spots on the vaginal wall
You should see your doctor if you:
- are experiencing thrush for the first time
- get thrush frequently, or if it returns in less than 2 months
- there is no improvement in your symptoms within three days, or if they’ve not disappeared within seven days
- are pregnant or breastfeeding
- have multiple sexual partners
- you’re under 12 years old
- have fever, chills, nausea, or vomiting
- have a smelly or unusual discharge
- feel abdominal pain
- previously had an allergic reaction to other thrush medications
Diagnosis of vaginal candidiasis
Visit your doctor if you think you have thrush. Most doctors will treat thrush without a test because the symptoms are usually obvious. If unsure, your doctor will do a simple test using a cotton swab to confirm the diagnosis. The test will also show if the symptoms are being caused by other common conditions, such as bacterial vaginosis or trichomonas.
You can also self-diagnose and treat yourself with OTC because symptoms are common.
What is the treatment for vaginal candidiasis?
If symptoms are mild, your doctor will usually recommend a short course of antifungal medicine. It is usually for one to three days. But, if the symptoms are more severe, the treatment course will be longer.
A variety of treatment options are available including taking tablets orally, inserting them into your vagina (pessaries) or using a cream. Tablets and pessaries work equally well.
- Vaginal creams and pessaries (vaginal tablets) that you insert high into your vagina, such as clotrimazole, miconazole and nystatin.
- Oral capsules which are taken by mouth, such as fluconazole, itraconazole.
You can also get creams to apply to the skin surrounding the entrance of your vagina. These can help relieve itchiness and soreness, although you may find that an ordinary moisturizer works just as well.
What can I do to prevent thrush?
As well as using antifungal medicines, there are a number of things you can do to help ease thrush symptoms:
- Wash your vaginal area with non-perfumed soap and water, or water alone.
- Avoid using highly-scented soaps, shower gels, vaginal deodorants or douches.
- Avoid wearing tight-fitting clothes made of artificial fibers such as nylon.
- Sleep naked and spend time naked at home to air your genitals.
- Whenever possible, wear cotton underwear and loose-fitting clothing.
- Stop using latex condoms, spermicidal creams and lubricants if they cause irritation.
- Avoid stress and maintain a healthy lifestyle, doing so will keep your immune system strong
- Avoid high-sugar foods
- If you are taking antibiotics, consult your doctor before taking candidiasis treatments
- Change your tampons or pads frequently
- Ensure you wipe from front to back after going to the toilet
- Change your underwear after swimming and working out
- Avoid very hot baths
Sex and sexual partners
Vaginal candidiasis is not an (STI). Therefore sexual partners don’t need testing or treatment if they don’t have any symptoms. However, there’s a very small risk of passing the condition on during sex. So you may want to avoid having sex until it’s cleared up.
Some treatments can also weaken latex condoms and diaphragms, so you may want to avoid having sex or use another form of contraception during treatment and for a few days afterwards.
If candidiasis keeps coming back
Speak to your doctor if you experience frequent bouts of thrush. They might run some tests to confirm the diagnosis and check for any possible underlying cause, such as diabetes. They may also give you a prescription you can use whenever the symptoms return, or suggest trying a longer course of treatment lasting up to six months.