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Thrush is a fungal condition caused by an overgrowth of the yeast candida albicans, which lives naturally all over the body, including the mouth, vagina and anus. Candida albicans is the most common cause, but other candida species can cause thrush and maybe harder to treat.

It may appear or get worse when:

• Wearing restricting clothing, or when using perfumed soaps or deodorants in the genital area
• Hormonal changes
• Taking antibiotics or other medication, such as the contraceptive pill and steroids
• People with diabetes have unstable sugar levels
• People have weakened immune systems 

Signs and symptoms

Content warning: click to show images of symptoms

The usual symptoms are:

• Itching and burning of the genital area
• Redness or swelling of the vulva or vagina
• Redness on the head of the penis under the foreskin
• A cheesy white vaginal discharge with a ‘yeasty’ smell
• Discomfort during and/or intercourse and/or pain when urinating
• Stinging or burning when urinating

Transmission

Candida species are common bacteria that will thrive in the right conditions and is not always sexually transmitted. However, it may be transmitted during unprotected oral and vaginal sex. Thrush can also live under the foreskin of an uncircumcised penis. Condom and dam use is recommended.

Treatment

Anti-fungal creams and vaginal pessaries are very effective – but they can damage condoms, so it is recommended that they are used after receptive sex (or an alternative service should be offered until treatment is finished). There are also tablets that can be swallowed. Treatments are available at a pharmacy without a prescription, but the symptoms of thrush are similar to symptoms of other conditions. So, it is recommended that for people who may have been exposed to an STI or other infection to check with a doctor first. A salt bath will be soothing without causing harm to the skin.

Prevention

• Avoid wearing tight pants or synthetic underwear.
• Avoid excess use of soap, vaginal deodorants, deodorised panty shields, shampoos and bubble bath solutions.
• People with vaginas should wipe their genital area front to back after going to the toilet.
• Taking a break from sex until the condition is healed can reduce irritating the area further. 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.
• Certain condoms (such as flavoured) and lubricants may aggravate the condition. Be aware and change brands if necessary.
• People who are experiencing recurrent bouts of thrush are recommended to consult a doctor as they may have a difficult to treat form or may have another condition.