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Thrush (candidiasis) is a fungal infection caused by a yeast called candida. Thrush can occur in the vagina, penis, skin folds, anus and mouth. It is not an STI but can worsen with sexual activity, and the infection can make sex uncomfortable. 

Candida usually lives on the skin and inside your body but can cause infections if it grows out of control. Thrush can develop due to hormonal changes, some medications, and medical conditions like diabetes. It can also be caused by a range of other factors, including:

• Wearing restricting clothing or using scented soaps or deodorants in the genital area
• Hormonal changes (for example, during your period or pregnancy)
• Taking antibiotics or other medication, such as the contraceptive pill or steroids
• Unstable sugar levels due to diabetes
• Having a weakened or compromised immune system

Signs and Symptoms

Thrush is not dangerous and some people will have no symptoms from it.

Vagina/Vulva

Signs or symptoms of a thrush infection may include:

• itching and/or burning
• thick, white or creamy vaginal discharge, which may look like cottage cheese
• redness and/or swelling
• Itch or soreness of vulva and/or vagina
• pain during sex

Penis

Signs or symptoms of a thrush infection may include:

• head of the penis (glans) being very itchy and red
• small, sore red spots on the head of your penis (glans)
• a ‘cheese-like’ substance that smells yeasty and collects under your foreskin
• In some people, thrush also causes their foreskin to swell and crack.

Anus/Rectum

Signs or symptoms of a thrush infection may include:

• intense and persistent itching
• burning sensation
• skin changes, such as red or irritated skin
• soreness, bleeding, or pain from scratching

Thrush can spread to sexual partners but is not considered an STI.

Throat

Signs or symptoms of a thrush infection may include:

• White coating or patches on the inner cheeks, tongue, roof of the mouth, tonsils, and throat
• Redness or soreness in the mouth and/or throat
• A cottony/dry feeling in the mouth
• Loss of taste
• A burning sensation on the tongue

Skin

Thrush can affect other areas of skin, such as the armpits, groin and between the fingers. Signs or symptoms of a thrush infection may include

• red, itchy or painful rash that scales over with white or yellow discharge
• This rash may not be so obvious on darker skin.

Common causes

• Thrush is not considered to be a sexually transmitted infection (STI), but candida can sometimes be passed between partners during sex. It may or may not overgrow to become thrush. 
• Candida can pass between partners during unprotected oral, anal and vaginal sex, rimming or fingering. Thrush can also live under the foreskin of an uncircumcised penis.
• Wearing restricting clothing or using scented soaps or deodorants in the genital area can encourage candida growth. 
• Other common causes include:
  • Hormonal changes (for example, during your period or pregnancy)
  • Taking antibiotics or other medication, such as the contraceptive pill or steroids
  • Unstable sugar levels due to diabetes
  • Having a weakened or compromised immune system

Prevention

To help prevent thrush, you can:

• Avoid wearing tight pants or synthetic underwear.
• Wear cotton underwear to reduce moist conditions that may encourage candida growth.
• Avoid excess soap, vaginal deodorants, deodorised or perfumed pads or liners, shampoos and bubble baths.
• Wash the genital area with water only, and gently pat the area dry.
• Wash your hands before touching the vaginal area.
• People with vaginas should wipe their genital area front to back after going to the toilet.
• Take a break from sex until the condition is healed to reduce further irritation in the area. 
• People who choose to have sex should use condoms and plenty of water-based lube.
• Always change condoms when switching from anal to vaginal sex or vaginal/anal to oral sex.
• Certain condoms and lubricants, including flavoured ones, may cause or worsen thrush. Be aware and change brands if necessary.
• If you take antibiotics or experience chronic yeast infections, probiotic supplements may help prevent or treat yeast infections.

People experiencing recurrent bouts of thrush are recommended to see a doctor as they may have a difficult-to-treat form of thrush or may have another condition.

It is recommended that you always change condoms when going from anal to vaginal or oral sex.

Testing 

Here’s some information about testing for thrush. You can view a list of sex worker-friendly sexual health clinics on our Where To Test page.

Testing Method

• Physical examination by a doctor/nurse.
• Swab test (you can often self-collect).
• You can purchase at-home vaginal thrush tests for $10-15 from pharmacies or online. 

When to Test

• You should see a GP or visit a sexual health clinic about a thrush infection if
  • you have a smelly discharge, sores on the skin around the vagina, abnormal vaginal bleeding or pain in your abdomen. 
  • this is the first time you’ve had symptoms of thrush.
  • the symptoms don’t clear up with over-the-counter treatments after 7 to 14 days.
  • you have 4 or more yeast infections a year.
  • you have diabetes.
  • you are pregnant or breastfeeding.
• You can perform an over-the-counter thrush test at any time, but it is most helpful to do this when you have symptoms. 

Other Info

• Thrush can be confused with other conditions that cause itching and redness with or without discharge. Visit your GP or sexual health clinic if you’re not sure. 

Treatment

Thrush is treatable. Here’s what you need to know about treating it.   

Treatment Method/s

• Anti-fungal creams and vaginal pessaries (over-the-counter)
• Oral tablets (available without a prescription)
• You can also buy over-the-counter creams to relieve soreness and itchiness. 
• People with penises should apply creams to their genital area, penis and under the foreskin (if uncircumcised)

Costs and Other Information 

• Over-the-counter treatments usually cost up to $20.
• Thrush should clear up within 7 to 14 days of starting treatment.
• Sometimes people develop a sensitivity to the cream, and this can make symptoms worse. 
• Cream treatment for thrush can weaken condoms, so apply the treatments after you have had sex if you are using condoms.
• You do not need to treat partners unless they have symptoms.

How might this impact my work? 

Practical Considerations

• Cream treatment for thrush can weaken condoms, so you may want to apply the treatment at a time when you’re not working/not using condoms. 
• Sexual activity can make thrush worse and make sex uncomfortable.