Thrush

What is thrush?

Thrush is an infection with a yeast (a type of fungus), most commonly Candida albicans.

This yeast lives naturally on your body and is usually harmless. However, if it starts to multiply rapidly it can cause problems in many different parts of the body.

Like most fungi, Candida likes moist, warm places. Places where Candida is most likely to multiply and cause thrush include the vagina in women, the mouth, skin creases and the nappy area.

Most women will have at least one attack of vaginal thrush in their lives. The usual symptoms are intense itching of the vulva and a vaginal discharge. The discharge may be thick and cottage cheese-like or watery.

Oral thrush causes white patches on the tongue and inside the cheeks. It occurs especially in babies and also in people who wear dentures and those with a weakened immune system.

Causes of thrush

Thrush occurs when the balance of normal bacteria and fungi on your body is upset. This can happen after a course of antibiotics which may have been prescribed for some other infection. Many people wrongly blame antibiotics for 'causing' thrush, but this is not really the case. What happens is that by killing off other 'normal' bacteria, antibiotics allow thrush to multiply without competition.

Other factors that may make the vagina more prone to thrush are the changes that occur in pregnancy, when taking the oral contraceptive pill and during a period.

People with a poorly functioning immune system and people who have diabetes are also prone to thrush.

Thrush treatment

Treatment for vaginal thrush may consist of either creams or pessaries (dissolving tablets) which are inserted in the vagina. You can also take tablets by mouth to eradicate the fungus. Some of these creams and medicines are available from your pharmacist without prescription, but some are not suitable to use when you are pregnant.

It is important to remember that there are a number of things other than thrush that can cause vaginal discharge and discomfort. If this is the first time you have had vaginal thrush symptoms, if symptoms do not improve with over-the-counter medicines, or you have frequent attacks then it is important that your symptoms are checked by your doctor so that other, sometimes more serious, problems can be identified and treated.

When thrush occurs in children it is usually treated with creams (when it affects the skin) or oral drops (when it affects the mouth).

When oral thrush occurs in people with a weakened immune system it can spread, for example to the oesophagus (food pipe). It is usually treated with antifungal lozenges, tablets or mouthwash.

Last Reviewed: 9 March 2011
Your Doctor. Dr Michael Jones, Medical Editor.

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References

1. Spence D. Candidiasis (vulvovaginal). Clinical Evidence (online 5 Jan 2010). http://clinicalevidence.bmj.com/ceweb/conditions/woh/0815/0815_keypoints.jsp (accessed Mar 2011).
2. Vulvovaginal candidiasis (revised Feb 2009). In: eTG complete [Internet]. Melbourne: Therapeutic Guidelines Limited; Nov 2010. http://online.tg.org.au/complete/ (accessed Mar 2011).
3. MayoClinic.com. Vaginitis (revised 5 Feb 2011). http://www.mayoclinic.com/health/vaginitis/DS00255 (accessed Mar 2011).
4. MayoClinic.com. Oral thrush (revised 20 Apr 2009). http://www.mayoclinic.com/health/oral-thrush/DS00408 (accessed Mar 2011).
Dr Michael Jones

Dr Michael Jones

Medical Editor, Your Doctor.