Thrush is a fungal infection that can affect men and women, although it is more common in women. The infection causes white, thick discharge from either the vagina or penis as well as itching and irritation. Thrush is caused by an overgrowth of fungus that thrives in warm, moist environments. It is not a sexually transmitted infection (STI) but it can be triggered by sexual activity. Keeping your genitals clean and dry as well as wearing cotton underwear can help prevent thrush, however, to effectively treat the fungus an anti-fungal cream, tablet or pessary should be used.
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Vaginal thrush (normally known as thrush) is a very common yeast infection that will affect most women in their lifetime. It is more common amongst women in their twenties and thirties. It is less common in women who have gone through the menopause or for girls who have yet to start having periods.
Thrush is caused by the yeast-like fungus called Candida Albicans. Normally, vaginal secretions and ‘friendly’ vaginal bacteria keep this fungus at bay. However, if the natural balance within the vagina is upset, the Candida can multiply and cause vaginal thrush. The resulting infection is usually quite harmless, though it can prove to be irritating and uncomfortable.
Normal symptoms of vaginal thrush include swelling and itching of the vagina and the surrounding area. They may also include a white, cottage cheese-like discharge. Thrush is easy to treat with a wide array of prescription and non-prescription medicines.
Penile thrush (normally known as male thrush) is caused by the same fungus, Candida Albicans, as vaginal thrush. Thrush is less common in men than women, however, it can still be easily treated. Similarly to vaginal thrush, the Candida yeast lives normally on the genitals and only causes penile thrush when the normal balance of microbes is upset. This can be due to taking antibiotics, not drying your penis properly, using perfumed soaps or shower gels, or having a weakened immune system.
The condition known as thrush is a form of yeast infection caused by a fungus that is naturally occurring in the vagina and on the penis. In around 80% to 90% cases of thrush, the cause is the fungus known as Candida Albicans, while in other cases it is other types of Candida fungi.
Interestingly, around half of the women who have naturally occurring Candida in the vagina do not suffer from any of the symptoms associated with vaginal thrush. Therefore, it is a widely held opinion that the growth of Candida and symptoms of thrush are caused by a change in the natural balance within the vagina. This change can either be a hormonal change, such as occurs during pregnancy; or a chemical change as a result of taking antibiotics.
What is likely to increase the chances of you suffering from male or female thrush?
Increased risk of vaginal or penile thrush may occur if you:
• Have a weakened immune system
• Have diabetes
• Are pregnant
• Take antibiotics
A Weakened Immune System
You have a higher risk of developing vaginal or penile thrush if you have a weakened immune system, which you might experience as a result of having chemotherapy or suffering from an immunosuppressive condition like AIDS or HIV. The reason for this is that your immune system, which in normal circumstances fights off any infections that enter your body, is not as strong as it should be and cannot effectively control and prevent the spread of Candida fungi.
Diabetes
Diabetes is a condition that is caused by having unnaturally high levels of glucose in your bloodstream. It is a long-term condition that is managed rather than cured and is normally kept under control by maintaining a balanced and healthy diet, as well as having regular injections of insulin.
However, problems can occur if your diabetes is not properly controlled. If the levels of glucose in your blood go up and down a lot instead of staying at a more consistent level, you will be much more likely to develop vaginal or penile thrush.
Pregnancy
During pregnancy, the levels of female hormones in your body like oestrogen change, which increase the risk of you developing vaginal thrush. In this situation it is also more likely to become a recurring problem, even if you try to treat it.
Antibiotics
As antibiotics not only kill off the bad bacteria, but also the good bacteria; a third of women (it is less frequent in males) who have been prescribed antibiotics are likely to suffer from vaginal thrush.
Though your chances of developing a yeast infection are greatly increased when you are taking any form of antibiotic; in order for your body to develop the actual yeast infection, the Candida fungus needs to already be present inside your vagina or on your penis.
For the above reasons men & women should only self-treat thrush if they are aged between 18 and 60 and have had it previously diagnosed by a GP. Recurrent episodes of thrush should be investigated by a doctor for an underlying cause.
The main symptoms of thrush in women (vaginal thrush) include:
The main symptoms of thrush in men (penile thrush) include:
Symptoms of thrush can overlap or be confused with many conditions such as cystitis, bacterial vaginosis (BV), chlamydia, gonorrhoea and other sexually transmitted infections. If you have not been diagnosed with thrush previously or you are unsure about your symptoms, you should always check with your doctor.
Thrush (male & female) in many cases can be self-diagnosed and treated. Thrush, like cystitis, should always be diagnosed by a GP for the first time, subsequent cases can then be self-diagnosed if the symptoms are the same and none of the following points apply:
If you have self-diagnosed/treated thrush it may still be necessary to visit your GP if the medication used didn’t work, or if the thrush is ‘recurrent’ (it keeps returning – this can be common in a number of conditions, such as diabetes). If the doctor is unable able to diagnose based on a verbal or visual inspection, then he or she will usually rely on three methods to conclude a diagnosis;
The vaginal swab resembles a cotton bud and is used to obtain a secretion sample from inside the vagina. A penile swab is similar and used to collect a sample of discharge from the penis or under the foreskin. These swabs will then be sent to a laboratory for analysis. A blood test will usually be performed if the doctor suspects an underlying condition, which may make you more prone to developing thrush. The pH test is similar to the swab test, in that the inside of the vagina is swabbed. However, the swab is not sent to a laboratory for analysis, instead, it is wiped over a piece of specially treated paper. This paper is designed to detect and measure the pH level of the sample.
When presenting with a mild case of thrush (yeast infection) then a short course of anti-fungal thrush treatment is usually the best option. These can be purchased over-the-counter without the need for a doctor’s prescription. These anti-fungal medications come in a variety of forms, including; capsules, creams and pessaries.
Suitable for men & women
Suitable for women only
When deciding upon which of these treatments is the best for you, there are a few factors that need to be considered. The oral thrush capsule is the most convenient treatment, however, it is not suitable if you’re pregnant or breastfeeding.
The pessaries and creams are understandably less convenient than a simple single-dose capsule but they have the advantage of acting directly in the area of infection. External creams are suitable during pregnancy.
If your symptoms do not improve after five days of treatment, you should see your doctor.
To reduce the chances of developing thrush there are a number of simple techniques that you can use. These include:
No, thrush is generally caused by an upset in the normal microorganisms that populate the vagina. Whilst it is important to ensure you regularly wash your genitals with unperfumed wash products, there are many causes of thrush – not just hygiene reasons.
Thrush can clear up on it’s own as the normal balance of flora in your vagina is restored however without treatment this may take some time. As most cases of thrush can be very uncomfortable, it is usually advisable to seek treatment to lcear up your infection as quickly as possible. Using antifungal thrush treatments usually clears up most cases of vaginal thrush within five to seven days.
Yes, it is common to thrush on to sexual partners if you practice unprotected sex. Vaginal or penile thrush can also cause oral thrush if you engage in oral sex. Having unprotected sex if you have thrush can commonly lead to a re-infection cycle that can be hard to break where you infect your partner who in turn can re-infect you if you both are not treated.
No, thrush occurs commonly in pregnancy. It is thought to be de to changes in hormone levels. Thrush will not harm your baby, however women with thrush should always seek treatment for their GP or midwife.
There are a number of lifestyle measures you can adopt to help prevent thrush recurring. Washing your genitals with unperfumed soap, wearing loose-fitting, breathable, cotton underwear and trousers, ensuring you are properly lubricated before sex and urinating immediately after, will all help to prevent recurrent thrush. If you are experiencing regular episodes of thrush it is important to discuss this with your GP as it can be a sign of an underlying condition such as diabetes or a weakened immune system.
No, there is no medical evidence that using natural yoghurt will help to treat thrush. Using proven antifungal treatments containing clotrimazole or fluconazole will help to cure your infection.
Discharge that is coloured or has a strong odour is unlikely to be due to thrush. It is more common with bacterial infections such as Bacterial Vaginosis (BV). If you have either of these symptoms or you suspect BV you should see your GP for antibiotic treatment.
Authored by
Dr Don Grant is The Independent Pharmacy's original online prescriber and has advanced in his role to become the Clinical Advisor, using his wealth of experience to advise on our clinical polices and prescribing guidelines.
Reviewed by
Dan is an experienced pharmacist having spent time working in both primary and secondary care. He currently supports our clinical team by providing robust clinical governance review of our internal processes and information.
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