by Dr. Punam Krishans
Thrush is one of the more common problems I see as a GP, but what I often discover is that women suffer with it over a period of time before seeking help, at which point the symptoms have often become much worse. In fact, a recent survey by Multi-Gyn FloraPlus found that the average UK woman puts up with thrush symptoms for 5 days before
seeking medical advice! When I ask why patients didn’t present to the pharmacy or doctor earlier, I usually get one of two answers; the first is one of embarrassment and the second, a fear of wasting a doctor’s time.
I therefore want to lay this topic out for us all to be more open and comfortable about what thrush is, why it is not something to feel embarrassed about and most of all to state that it is an important condition to seek treatment for, because if left untreated, it can cause complications which are easy to prevent.
Vaginal thrush or vaginal candidiasis is a yeast infection that affects up to 75% of women worldwide at least once in their lifetime. It can live in the vagina without causing any issues because the other normal bacteria, which also live in the vagina, can combat and control its overgrowth. However, the balance and health of our normal bacteria which line the vagina tend to fluctuate during our lifetime depending on various factors including our hormones during pregnancy, some medications such as antibiotics, and/or health conditions like diabetes and even stress! These events support and promote the growth of this fungus which can lead to symptoms including:
- Usually an odourless but a white/creamy coloured discharge (like cottage cheese)
- Itching and irritation around the vulva and vagina
- Pain around the vagina during sex
- Stinging or burning sensation when passing urine or during intercourse
- Redness or swelling of the vulva or vagina
You can have one or all of these symptoms – the important thing is to not ignore them!
During pregnancy women often get thrush because of all the changes taking place in the body and these tend to promote the growth of the fungus, especially in the third trimester. This is nothing to worry about, as there is no evidence that it can cause any harm to the baby, but it is important to speak to your midwife or GP to get this treated as soon as you recognise the symptoms. Do not try to self-medicate.
Whilst vaginal thrush is not classified as a sexually transmitted infection (STI), it can be triggered by sex. This is nothing to feel embarrassed about. When you contact your GP, they will take a thorough history from you, to try identify the cause and will likely issue a treatment for it if the history supports a clear case of thrush. We tend to examine patients if they have symptoms which may indicate other causes - if the diagnosis is unclear or if there are concerns that it could be an STI, we would invite you into the practice for a vaginal examination to take swabs and tests to find out the root cause.
We commonly prescribe antifungal tablets, creams and pessaries to treat vaginal thrush and often symptoms will clear up within 7-14 days. But there are other things you can also do to alleviate the symptoms and prevent getting thrush in the first place – this includes washing the vagina/vulval area with water alone or with emollients which are chemical free. Avoid soap, shower gels and other fragranced products to clean down below, because these disrupt the balance and PH of the normal bacteria, encouraging growth of the yeast instead. Do not wear tight fitting underwear either, instead stick to cotton-based loose underwear; remember fungus thrives in warm, tight and moist environments. It is important to dry the vulval/vaginal areas properly after washing and avoid having sex until your symptoms have completely cleared away. Stress is a trigger for the development of thrush too so do look at your diet and lifestyle.
It is important to speak to your GP if you are experiencing recurrent episodes of thrush – especially if it's more than 4 times in a year or if the treatment has not worked. Recurrent thrush can sometimes be a sign of another underlying health problem so it’s best not to ignore it.
Please do remember, there is nothing a doctor has never seen or heard of before! And, we manage all conversations and consultations with the utmost confidence. As women, we need to encourage one another to speak up about our health and empower one another to seek help and support when needed. Vaginal health is just as important as any other system of our bodies, so take care of it like you do for the rest of you.