Vaginal thrush

Itching around the vulva, soreness during sex and thick white discharge can all happen with vaginal thrush. The discharge usually has little smell. These symptoms can also happen with other vaginal infections, so a familiar pattern alone can’t tell you the cause.

Thrush is a yeast infection caused by too much of a yeast called Candida. Small amounts of yeast can live in the vagina without causing symptoms. Thrush isn’t classed as a sexually transmitted infection (STI).

When to check before buying treatment

In the UK, treatment from a pharmacy can be an option if a clinician has confirmed thrush before and you recognise the symptoms. A pharmacist can help you choose a suitable antifungal. Ask to talk in private if you’d rather not discuss symptoms at the counter.

Contact an urgent GP service or NHS 111 today (UK), or your doctor or urgent care service (US and elsewhere), if vaginal symptoms come with pain in your pelvis or low in your tummy, or a fever. Get checked rather than treating it as a usual bout of thrush.

See a GP first if your symptoms are new, treatment hasn’t worked, or it keeps coming back. The NHS also advises seeing a GP if you’re pregnant or breastfeeding, under 16 or over 60, or have a weakened immune system. Tell the clinician if you have diabetes or treatment that affects your immune system.

US advice is more careful about treating yourself. The Office on Women’s Health recommends talking to a doctor or nurse first. A medicine sold over the counter may still be the wrong one for your symptoms.

What a clinician may check

An appointment may include an examination and a swab of discharge. This is more likely if the cause isn’t clear or symptoms keep coming back. It helps the clinician find what’s causing the discomfort and check for other infections.

You could say: “The itching is outside as well as inside, and the treatment I tried hasn’t helped.” Bring the product name and note what changed after you used it. You can ask what the clinician is checking for before an examination.

Treatment and pregnancy

Antifungal treatment can come as a tablet to swallow, a pessary you put into the vagina, or a cream for irritation. Your pharmacist, GP or doctor can tell you which suits you. Follow the leaflet and the instructions with your treatment.

Pregnancy changes which medicine you can use. The Office on Women’s Health describes vaginal treatments with clotrimazole or miconazole as options. Fluconazole tablets aren’t recommended for vaginal thrush in pregnancy. Ask your doctor or midwife to choose the treatment, rather than using an old prescription again.

Some antifungal creams and vaginal treatments can weaken latex condoms and diaphragms. Check the product information, and ask a pharmacist about protection during treatment. Partners usually don’t need treatment unless they have symptoms.

Comfort without more irritation

The NHS suggests washing the area with water and an emollient (a moisturising soap substitute), drying gently and wearing cotton underwear. Avoid shower gels, vaginal deodorants and douching. If sex hurts, wait until the thrush has cleared before trying again.

Probiotics and homeopathic products are not proven treatments for thrush. CDC guidance finds no strong evidence that they treat vaginal thrush (candidiasis). They aren’t a reason to put off getting checked if discomfort carries on.

If it keeps coming back

Contact an urgent GP service or NHS 111 today (UK), or your doctor or urgent care service (US and elsewhere), if vaginal symptoms come with pain in your pelvis or low in your tummy, or a fever.

Antibiotics, pregnancy, diabetes that isn’t well controlled and a weakened immune system can make thrush more likely. But many people have no clear trigger, including people who get it again and again. Thrush coming back doesn’t, on its own, mean you have another illness.

Book a GP or sexual health appointment in the UK, or see your doctor or nurse in the US and elsewhere, if symptoms don’t go away or come back after treatment. More tests may find which yeast is involved, and a clinician can plan treatment around the results.

Bring a few notes about past bouts and treatments. You could ask: “Do we need a sample to confirm the cause?” and “Who do I contact if this treatment doesn’t help?”