What is vaginal thrush?

Thrush is a common yeast infection caused by having too much candida (yeast) in the vagina. It is also called vaginal candidiasis.

Candida exists in many areas of your body, especially in your vagina, gastrointestinal tract (gut) and mouth. Candida can cause problems when it grows out of control. It can cause infections such as vaginal or oral thrush.

Vaginal thrush can happen at any age, but it is most common in people who have regular periods. It is uncommon before puberty and after menopause.

What are the symptoms of vaginal thrush?

Symptoms of vaginal thrush include:

• itching or burning around your vulva
• a thick, white or creamy vaginal discharge that may look like cottage cheese
• pain or discomfort during sex
• pain when urinating (weeing)
• swelling or redness around your vulva
• splitting or cracking in the skin of your vulva

Vaginal thrush can be present without symptoms. This does not usually need treatment.

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What causes vaginal thrush?

Most thrush is caused by a yeast called Candida albicans, which lives naturally in your body.

Overgrowth of candida can occur and may cause symptoms. Thrush can happen suddenly or when there is a change to the bacteria of your vagina.

You are more likely to get thrush when you:

• have higher oestrogen levels
• are taking antibiotics
• are pregnant
• have other health conditions, such as diabetes or immune system conditions
• are taking menopausal hormone therapy

Thrush is not considered a sexually transmitted infection (STI).

When should I see a doctor?

You should see a doctor if you have symptoms of thrush and:

• this is the first time you have had symptoms of thrush
• over-the-counter treatments are not working
• you have had 4 or more yeast infections a year (recurrent thrush)
• you are pregnant or breastfeeding
• you have pain in your lower abdomen (tummy) or vulval area
• you have abnormal vaginal bleeding
• you are worried you may have an STI

Thrush can be confused with other conditions that cause vaginal itching and redness with or without discharge. These include herpes and bacterial infections.

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How is vaginal thrush diagnosed?

Your doctor will ask about your symptoms and medical history. They will also examine your vulva. They may take a swab from your vagina and send it for testing to confirm the diagnosis.

You have the right to ask for a female doctor and for a support person to be with you during a medical examination.

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How is vaginal thrush treated?

Treatment for vaginal thrush is usually an antifungal:

• pessary (a tablet you put in your vagina)
• cream
• oral tablet

You can buy most creams and pessaries as over-the-counter treatments in a pharmacy.

It is generally safe to treat thrush yourself without seeing a doctor if you have had thrush before and treated it successfully and you are certain of your symptoms.

Treatment time will depend on the product you use and how bad your symptoms are.

It is important to complete the full course of treatment. In most cases, treatment for thrush will relieve your symptoms. However, some people may have thrush that keeps coming back (recurrent thrush). In these instances, you should see your doctor. You should also see your doctor if treatment is not improving your symptoms or symptoms are different from previous thrush infections.

If you are pregnant or breastfeeding, speak with your doctor or pharmacist before starting any treatment.

Self-care for vaginal thrush

During treatment for vaginal thrush, you should look after your vulva. Try to avoid irritants such as:

• soaps
• bubble baths and bath oils
• vaginal hygiene products and lubricants

Thrush and sex

Sex can make your symptoms worse. If this happens, you may want to avoid sex until you have finished your treatment.

Thrush treatments can damage latex contraceptive devices such as condoms, diaphragms and cervical caps.

Male sexual partners of females with thrush do not usually need treatment.

Babies and thrush

Babies can develop thrush as a type of nappy rash, which can be easily treated. You should visit your doctor or ask your community health nurse for advice.

What are the complications of vaginal thrush?

Untreated vaginal thrush can lead to ongoing vulval discomfort. Some people may experience burning pain during or after sex, which may need specific pain treatment.

Recurrent thrush can lead to ongoing irritation of the vulval skin, causing itching, redness and soreness. It might also cause small breaks in the skin of your vulva, which may get infected.

It is important to see your doctor if you think you have recurrent thrush. They will check if other conditions are causing your thrush. They can also refer you to a specialist experienced in vulval medicine.

Can vaginal thrush be prevented?

Not all cases of vaginal thrush can be prevented. To help prevent vaginal thrush you can:

• wear loose clothing
• wear cotton underwear
• wash your hands before touching your genital area
• wipe yourself from front to back after going to the toilet
• wash your hands after going to the toilet
• avoid soaps and sprays in your genital area
• use a new condom each time you switch between oral, anal or vaginal sex

Resources and support

If you would like more information or support, the following organisations and services can help:

• Jean Hailes for Women's Health has more information about vulval and vaginal thrush, as well as resources for Aboriginal and/or Torres Strait Islander peoples.
• The Royal Women's Hospital has information about thrush (candidiasis).
• You can also call the healthdirect helpline on 1800 022 222 (known as NURSE-ON-CALL in Victoria). A registered nurse is available to speak with you 24 hours a day, 7 days a week.

Languages other than English

• Family Planning Australia has information on common vaginal and vulval conditions, which can be downloaded as a PDF fact sheet in different languages.
• Jean Hailes for Women's Health has fact sheets on vulval and vaginal health in several community languages.