Causes of vaginal thrush
Vaginal thrush is caused by an overgrowth of a yeast called Candida albicans in the vagina. This yeast lives naturally in our bodies, including in the vagina. It is prevented from growing too much and causing symptoms of thrush by the action of 'friendly bacteria' which help keep the internal environment of the vagina acidic.
When the vagina becomes less acidic, there is a change in balance of the friendly bacteria and growth of Candida albicans is stimulated. The yeast overgrowth causes thrush.
There are a number of factors that can disturb the acidity of the vagina and trigger episodes of thrush and these include:
- Medicines such as antibiotics and steroids. This is because antibiotics kill the friendly bacteria in the vagina that keep Candida albicans under control
- Physical trauma such as sexual intercourse and inserting tampons
- Stress
- Menstruation
- Using perfumed soaps and shower gels
- Wearing tight clothing
- Hormonal fluctuations due to menopause and pregnancySigns and symptoms of thrush The symptoms of thrush can include:
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- Vulval and vaginal itching and irritation
- Thick white vaginal discharge
- Redness, soreness and swelling of the vagina walls
- Pain during sexual intercourse
Treatments for thrush
Antifungal agents such as clotrimazole, fluconazole and econazole belong to a group of drugs called imidazoles and are used to treat vaginal thrush caused by Candida albicans. Imidazoles work by stopping the production of a substance essential for the yeast cells to grow.
There are several treatment formats available for you to choose from if you are suffering from symptoms of thrush, including:
- External cream
- Internal cream (coming with an applicator tube)
- Pessary (a tablet which is inserted into the vagina)
- Oral capsule
These formats can be divided into two categories relating to whether they relieve the external symptoms or treat the internal infection.
Relieve the external symptoms
These products will soothe the itching and irritation. However, it is important to note that these products will not treat the underlying infection. You should also treat the internal infection.
Treat the internal infection
To treat thrush, you should use a product that will clear the internal infection. There are different internal preparations such as cream, pessary and oral capsule, to suit your personal preference. Ideally, you should also use a topical product to treat the external symptoms (as well as an internal preparation to treat the internal infection). So you could use two products such as a pessary and external cream or a combination product.
It can be confusing knowing which product is the right one to use and you may need help from your pharmacist or doctor to help you decide which format would be suitable for you. However, for successful treatment you can choose a format that suits your lifestyle.
For example, an oral capsule would be a convenient treatment for a busy woman who can start her treatment immediately regardless of her whereabouts. Whereas a pessary may be more suitable for a woman who wants a treatment to start working during the night and to use an external cream during the day. Internal cream may be suited to first time sufferers or women who have vaginal dryness.
Self help tips
- Wear loose clothing and cotton underwear – avoid synthetic underwear and nylon tights
- Shower, wash or bathe immediately after exercising and cool off as quickly as possible
- Use non-fragranced soaps and shower gels
- Avoid friction in the vaginal area as this can cause candida to thrive. This can happen in situations such as:
- Scrubbing the genital area hard with sponges or flannels
- Trauma of sexual intercourse, often due to vaginal dryness
- Inserting a tampon
- Try to avoid stressful situations – stress can cause a thrush attack
Always consult a medical professional for further advice if you:
- are under 16 years of age or over 60 years
- have had more than two episodes of thrush in the past six months
- have additional symptoms such as pain or bleeding
- have offensive-smelling or blood-stained discharge
- are taking other medicines
- are allergic to antifungal treatments
- are pregnant
- have tried a treatment but the symptoms are still present a week later
- have never suffered from thrush before