Thrush, The Symptoms And The Treatment

The embarrassing itching caused by vaginal thrush affects most women at least once in their life. But why does it occur? And how can you prevent it?

Thrush: how to beat it

Vaginal thrush is due to an overgrowth of the yeast, Candida albicans. Candida spores are in the air and thrive in warm, moist places such as the groin. They can be found in the vagina of at least one in five women, when they are either present in an inactive state (as resting spores) or surviving quite happily in low numbers, kept in check by other healthy bacteria such as Lactobacillus acidophilus.

Whether the yeast cells come and go or are present all the time is not really known. Studies suggest that Candida remains in the vagina for at least several months, and possibly for years at a time without causing obvious harm. If the natural balance is tipped however - due to changing levels of hormones, acidity, sugar content or the numbers and types of bacteria present - Candida cells may suddenly overgrow to cause symptoms.

Who gets it?

Thrush is more likely around the time of a period due to changes in the acidity of vaginal discharge. It is also more likely in women who are pregnant, have uncontrolled diabetes mellitus, or who use oral contraceptives. Candida often occurs after taking antibiotics which kill off the healthy bacteria (eg Lactobacillus acidophilus) naturally found in the vagina which help to keep Candida at bay.

Slightly low levels of iron are also associated with recurrent thrush infections as iron is needed by white blood cells to make the chemicals used to destroy infections.

What are the symptoms?

The symptoms of thrush vary and can include the following:

Genital itching
Vulval and vaginal soreness or burning
A yeasty smell
A white, cottage-cheese-like discharge
Cystitis-like pain on passing urine (dysuria)
Frequency of urination
Enlarged, tender lymph nodes (glands) in the groin

Diagnosis

Candida can be suspected from the symptoms, but infection is best confirmed by examining discharge under a microscope (in a genito-urinary medicine clinic) or by sending swabs to a laboratory for examination. Diagnosing Candida from symptoms and examination alone is not always accurate as other conditions such as anaerobic vaginosis (imbalance of vaginal bacteria) cause similar symptoms but need different treatment.

Treatment

A variety of anti-fungal treatments are available. Some antifungal agents (eg clotrimazole, miconazole) are used as creams or pessaries. An oral antifungal agent (fluconazole) is taken as a single capsule by mouth.

Tips to prevent thrush recurring:

Avoid getting hot and sweaty - use pantliners and change them as necessary throughout the day.
Avoid wearing tight underwear, especially nylon tights, or tight trousers. Stockings and cotton underwear are recommended.
Boil cotton underwear or hot-iron gussets of underwear. Modern low-temperature washing machine cycles don't kill Candida spores and you may re-infect yourself from your underwear.
Avoid using bath additives, vaginal deodorants or douches which can upset your natural acid and bacterial balance.
Acidic conditions can be encouraged in the vagina by using a mildly acidic gel or replenishing wash available from pharmacies.
Eating an iron-rich diet and taking multivitamins and minerals with iron may help to prevent recurrent attacks. If you suffer from recurrent Candida, ask your partner to use an anti-fungal cream as men can harbour yeasts without developing symptoms.
Smearing live Bio yoghurt containing Lactobacillus acidophilus around the vulva will help to replenish levels of friendly bacteria.