Vaginal Thrush

What is vaginal thrush?

Vaginal thrush is a common infection caused by an overgrowth of a naturally occurring yeast. It is different to the yeast that is used in food. This yeast is normally found in small amounts in the vagina and bowel and is usually harmless. However, when this type of yeast grows too much, it can cause uncomfortable symptoms. This is known as vaginal thrush.

Around 75% of people with a vagina will experience vaginal thrush at least once in their lifetime. It is also known as candidiasis. There is treatment available.

Though vaginal thrush is not considered a sexually transmitted infection (STI), it can cause irritation in sexual partners with a penis, leading to something called balanitis.

What are the symptoms?

Symptoms of vaginal thrush can include:

• itchiness and discomfort on the vulva and vagina
• a burning sensation and pain when passing urine (weeing) and during sex
• a white, thick discharge that may look like cottage cheese
• redness and swelling of the area around the vulva or vagina
• cracks or splits in the skin of the genital area.

Most symptoms can be treated with over-the-counter treatments from a pharmacy, without a prescription.

You should see a doctor if:

• You’re not sure whether you have thrush.
  You think you’ve have had thrush multiple times over the past year.
• You’ve recently had sex without a condom with a new partner.
• You have other symptoms like pain in your lower belly (pelvic pain), vaginal bleeding that’s not normal for you, sores in the genital area, or unusual discharge.
• You notice a change in shape, texture or colour of your vulva.
• You tried thrush treatment and the symptoms didn’t get better.

How is thrush tested?

Thrush is tested using a swab.

What causes thrush?

Vaginal thrush occurs when a certain type of yeast overgrows in the genital area (usually Candida albicans, though other types can also be involved).

Sometimes it can occur for no obvious reason, but there are some things that make thrush more likely, including:

• antibiotics
• diabetes
• higher levels of the hormone oestrogen, such as for people with periods, during pregnancy or people who are using post-menopausal oestrogen therapy
• sweaty and moist skin (especially when there is friction, such as friction from cycling, or friction with sex)
• using perfumed soaps/gels and vaginal hygiene products on the genitals
• pre-existing skin conditions, such as eczema or psoriasis
• immune system disorders, or use of immunosuppressive medications.

Can thrush cause other problems?

While it can be very uncomfortable, thrush does not cause any long-term health problems such as infertility (inability to get pregnant) or issues with pregnancy.

If it’s not treated and keeps coming back, thrush can cause ongoing pain in the vulva or ongoing pain during penetrative sex, so getting treatment is recommended.

How is thrush treated?

Thrush is treated with anti-fungal vaginal creams, anti-fungal vaginal pessaries or a single dose oral tablet.

Thrush treatments are designed to reduce the yeast levels to help with symptoms.

Creams and pessaries (which are like a tablet) are applied inside the vagina using a special applicator. Treatments are taken from 1 to 7 days and can be bought from the pharmacy without a prescription from your doctor.

A single dose anti-fungal tablet you swallow has similar effectiveness to creams and pessaries. The tablet can also be bought from the pharmacy without a prescription but is more expensive and should not be used during pregnancy. If you are on other medications or are pregnant, speak to your doctor or pharmacist before using this treatment.

Before using these medications, it’s important to speak to your doctor if you’re uncertain about the cause of the irritation.

If the itching or pain continues or returns after treatment, you should seek medical advice.

While thrush is common, other conditions can also lead to similar symptoms. Using anti-thrush medication when you have a different problem could potentially worsen the situation.

There’s no evidence suggesting sexual partners with a penis (who don’t have symptoms) need treatment for thrush.

What if it’s not thrush?

Other conditions can cause symptoms similar to thrush, such as genital skin conditions, bacterial vaginosis, herpes simplex virus (HSV) or other STIs.

It’s a good idea to see your doctor if:

• You think you’ve had multiple episodes of thrush recently
• You’ve had unprotected sex with a new partner.
• You experience pain in your lower belly (pelvic area) or unusual bleeding, vaginal bleeding that’s not normal for you, sores in the genital area or unusual discharge.
• Over-the-counter thrush treatments haven’t worked.

How can I prevent thrush?

To help prevent thrush:

• Avoid using soap, wet wipes, vaginal douches, bubble bath or perfume in the vagina as these can disrupt the natural balance of vaginal yeast.
• Wear loose-fitting clothing and cotton underwear.
• Consider switching to a different laundry detergent if you’ve had thrush before
• Don’t use fabric softeners.

If you find you often get thrush after taking antibiotics, talk to your doctor about taking preventive treatments at the first sign of thrush symptoms.

There is no strong scientific evidence that dietary changes prevent or treat thrush.

Can you have sex when you have thrush?

You can still have sex with vaginal thrush, but it may be uncomfortable. You might feel a burning sensation during or after sex, so using plenty of lubricant (lube) is recommended.

Repeated painful sex can lead to ongoing vaginal and vulval pain, even after the infection is treated. Some people prefer to avoid sex during this time.

Although thrush is not an STI, sexual partners with a penis may sometimes experience redness or irritation of the penis.

Treatments for thrush can weaken condoms, so it’s best to apply treatments after sex.

How can recurrent thrush be managed?

If you have four or more episodes of thrush in a year, you may have recurrent thrush and it’s a good idea to speak to a doctor. About 5% of people with a vagina experience recurrent thrush, which may cause vaginal dryness and discomfort during sex, even without a visible discharge.

Most people with recurrent thrush are healthy and do not have anything wrong with their immune system. Recurrent thrush needs to be confirmed and treated by a doctor.

Treatment of recurrent thrush involves basic genital skin care and sometimes long-term anti-fungal medication. The usual minimum length of treatment is about 6 months. Episodes can still occur after this but should happen less often.

A doctor may also check for STIs or other things that could be contributing to the thrush.

Though uncomfortable, thrush outbreaks don’t lead to long-term health issues.

Where can I get more information?

• You can visit SHINE SA for further information, testing and treatment.
• Make an appointment with your local doctor, health care provider or Aboriginal Health Service.
• You can also contact Adelaide Sexual Health Centre:
  260 Currie Street, Adelaide
  Tel: 71117 2800
  www.sahealth.sa.gov.au/adelaidesexualhealthcentre

Updated March 2025