Vaginal thrush: self-care

by | Pharmacy Care, Women's Health

General Information

Vaginal thrush is a common condition and many women will be affected by it at some time in their lives. Some women suffer from recurrent episodes.

Thrush is a fungal infection caused by a yeast called Candida albicans. Symptoms include itching, irritation or a burning sensation in your genital area, and pain may be present during sexual intercourse. There may be a thick, white or creamy vaginal discharge.

Thrush can be triggered by taking a course of antibiotics, pre-menstrual changes in vaginal acid balance, hot weather or wearing tight-fitting synthetic clothes. It can also be brought on by using vaginal deodorants, bath salts and some soaps. Sometimes sexual intercourse and using tampons can lead to thrush, especially if your vagina is dry.

Taking oral contraceptives, being pregnant, having poorly controlled diabetes and having conditions that affect the immune system, can also make thrush more likely.

See Your Pharmacist or Medical Professional

Most products used to treat vaginal thrush are ‘pharmacist only’ or ‘prescription only’ medications, so you will need to talk to your pharmacist or doctor to obtain treatment.

You also need to see your doctor if:

  • this is the first time you have had symptoms of thrush
  • you have had more than three thrush infections in the past year, or an infection within the last two months
  • your symptoms have not gone away, despite treatment
  • you are pregnant or breastfeeding
  • you also have lower abdominal pain, fever, vomiting or diarrhoea
  • you are under 16 or over 60 years old
  • you have diabetes or are taking medicines that suppress the immune system, such as prednisone
  • you have a coloured or smelly vaginal discharge
  • your symptoms are different to previous thrush episodes
  • you have had a recent change in sexual partner
  • you have spotting between periods or a blood-tinged discharge
  • you have blisters or sores in your vaginal area
  • there is burning on urination

Treatment Tips

  • do not use soap, especially perfumed soap, on sore or irritated skin
  • Pinetarsol Gel used externally can soothe irritation and reduce itching

Things you can do to avoid recurrent thrush

  • wear loose cotton underwear and avoid tight clothing
  • wipe from ‘front to back’ after going to the toilet
  • avoid soaps, deodorants or talcum powder in the genital area
  • avoid deodorised panty liners, bath foams or salts, or vaginal douches
  • using a water-based lubricant during intercourse, or when inserting tampons if your vagina is dry
  • avoid spermicidal condoms
  • shower after exercising
  • try Aci-Jel, which helps maintain the correct vaginal acidity; it may help prevent thrush that occurs at a particular time during your menstrual cycle
  • taking probiotics after having a course of antibiotics can help put back good bacteria in the system and potentially prevent the re-occurrence of thrush

Treatment Options

Imidazole antifungal vaginal preparations (creams, pessaries, ovules)

e.g. clotrimazole (Canesten Clotrimazole Thrush Treatment: 6 Day Pessary; Once Pessary ; 6 Day Cream; 3 Day Cream; Once Cream; Once Pessary + Cream)

  • these products are available in single-dose, three-day or six-day treatments
  • the single-dose treatments are more convenient
  • longer treatment may be required, especially if the infection is well established
  • creams and pessaries are supplied with disposable applicators; they should be inserted into the vagina, preferably at bedtime
  • treatments can be used during menstruation
  • a combination pack is available which includes an oral tablet and a tube of cream for external use on the genital area; this can be useful for reducing itching and should be applied two or three times a day
  • some of these products may damage diaphragms and condoms; check the manufacturer’s directions
  • it is important to complete the full course of treatment
  • apart from butaconazole, all antifungal vaginal products are safe in pregnancy; however, the applicator should not be used to administer the cream or pessary – instead it’s recommended to use a finger to apply the cream to the vagina
  • treatment of your sexual partner is not necessary as thrush is not sexually transmitted. Males should be treated only if they have thrush themselves

Oral antifungal medicines

e.g. fluconazole (Canesoral, Diflucan One, Flufeme)

  • these are single-dose treatments; the medicine stays in the body for up to 72 hours and is shown to be as effective as the vaginal imidazole treatments
  • these oral antifungal medicines should not be used by people aged under 18 years old unless recommended by a doctor
  • these products should not be used during pregnancy or breastfeeding, or by people with a history of liver disease or certain heart conditions
  • these products can also interact with some other medicines; check with your pharmacist
  • combination products, such as Canesoral Duo, also include an antifungal cream which can reduce itching
  • onset of relief may be expected within one day, and complete relief is possible within two days; if symptoms persist after 3 days seek medical advice

Other antifungal medicines

e.g. nystatin (Nilstat Vaginal) vaginal cream or pessary

  • nystatin is less effective than the vaginal imidazole antifungals and oral fluconazole, but can be used if other treatments have been unsuccessful
  • treatment courses are for a minimum of 14 days
  • do not use with diaphragms or condoms
  • nystatin may stain clothing

More Information

Availability of medicines

  • GENERAL SALE available through pharmacies and possibly other retail outlets.
  • PHARMACY ONLY available for sale through pharmacies only.
  • PHARMACIST ONLY may only be sold by a pharmacist.

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