Vaginal thrush: symptoms, what triggers it and when to see a doctor
Vaginal thrush is a common yeast infection caused by Candida – a fungus that is usually harmless, but grows in warm, moist conditions when the balance of bacteria is disturbed. According to the NHS, the typical signs are white, thick discharge with no smell, itching and burning around the vulva and vagina. It is treated with antifungal medicines and usually clears up within 7 to 14 days, but for a first episode, in pregnancy or with more than 4 episodes a year you should see a doctor.
- According to the NHS, thrush is not classed as a sexually transmitted infection, although it can be triggered by sex.
- Triggers include antibiotics, poorly controlled diabetes, pregnancy, hormone replacement therapy, a weakened immune system and irritated skin.
- With antifungal treatment the infection usually clears up within 7 to 14 days.
- More than 4 episodes in 12 months count as recurrent thrush and need a doctor's assessment.
- Antifungal creams can damage condoms and diaphragms, so your contraception may not work during treatment.
How do I recognise vaginal thrush?
According to the NHS, in women thrush usually shows as:
- white vaginal discharge, which often looks like cottage cheese and usually does not smell;
- itching and irritation around the vulva and vagina;
- soreness and stinging during sex or when peeing.
The fungus can also affect other areas of skin – armpits, groin, between the fingers – as a red, itchy or painful rash that scales over and may have white or yellow discharge. On darker skin the rash is harder to see. Some people have no symptoms at all.
What triggers the yeast infection?
The NHS explains that thrush is caused by Candida – a fungus that normally lives in the body without causing harm. The problem comes when the balance of bacteria changes and the fungus grows in warm, moist conditions.
This explains why the infection often appears after a course of antibiotics or at times of hormonal change – not because you did something wrong, but because the environment in the vagina has changed. The factors that, according to the NHS, can trigger it are:
- irritated or damaged skin;
- taking antibiotics;
- poorly controlled diabetes;
- a weakened immune system – for example with HIV or chemotherapy;
- hormone replacement therapy (HRT);
- pregnancy.
Is thrush sexually transmitted?
According to the NHS, thrush is not classed as a sexually transmitted infection. However, sex can trigger it, and less often it can be passed on to a partner during sex. Your partner does not need treatment unless they have symptoms.
If the infection is causing you discomfort, the NHS advises avoiding sex until it has cleared up. Also bear in mind the NHS warning: antifungal creams can damage the latex in condoms and diaphragms, so during treatment your contraception may not be reliable.
How is it treated and how long does it take?
According to the NHS, an antifungal medicine is usually needed – a tablet, a vaginal pessary or a cream. The infection should clear up within 7 to 14 days of starting treatment.
If you have been diagnosed before and recognise the symptoms, you can buy an antifungal remedy without a prescription from a pharmacy – the pharmacist will recommend the most suitable one, and many pharmacies have a private area for a discreet conversation. An important limit from the NHS: do not use antifungal medicines more than twice in 6 months without talking to a pharmacist or doctor. For recurrent thrush (more than 4 episodes in 12 months), treatment can last up to 6 months, and the doctor will check for triggers such as your period or sex.
How can I reduce the risk of it coming back?
Thrush is harmless in most cases, but it can come back. The NHS gives simple everyday rules that help keep the area dry and free from unnecessary irritation:
- wash the affected area with water and an emollient (a moisturising cream) instead of soap;
- dry thoroughly after washing;
- wear cotton underwear;
- do not use soaps or shower gels in the genital area;
- do not use vaginal douches or deodorants;
- avoid tight underwear and tights.
When should you see a doctor?
According to the NHS, book a doctor's appointment (it is not urgent) if:
- you have symptoms of thrush for the first time;
- you are under 16 or over 60;
- the infection comes back more than 4 times in 12 months;
- the treatment has not worked;
- you are pregnant or breastfeeding;
- you have a weakened immune system – for example because of diabetes, HIV or chemotherapy.
You can also go to a sexual health clinic. At the appointment the doctor usually confirms the diagnosis from your symptoms, and in an unclear or recurring case they may examine the area and take a sample of the discharge with a cotton swab for testing.
Frequently asked questions
Does my partner need to be treated too?
According to the NHS, partners do not need treatment unless they have symptoms.
Can I buy medicine without a prescription?
Yes, if you have been diagnosed before and recognise the symptoms. However, the NHS advises not to use antifungal remedies more than twice in 6 months without consulting a pharmacist or doctor.
Why does thrush discharge not smell?
The NHS describes the typical discharge in women as white, like cottage cheese and usually without a smell. An unpleasant smell is among the symptoms the NHS lists for men, not for women – if your discharge smells or you are not sure what it is, get checked.
Sources
- NHS – Thrush in men and women – last reviewed by the NHS: 28 July 2023
Informational article retold in our own words from the sources listed. It does not replace a consultation with a doctor; in an emergency call 112. If you spot an inaccuracy, write to [email protected].