Everything you need to know about thrush

Reviewed by our clinical team

Thrush is the common name for a yeast infection. It's usually caused by a certain yeast called "Candida". It can affect the genitals, as well as other areas of the body. It’s particularly common in women – three out of four women will experience vaginal thrush at least once in their lives. It’s even more common in pregnant women. 

The good news is, thrush is usually harmless and easy to treat with antifungal medication (in case you are wondering, antifungal medication works because yeasts are a type of fungus.) If you think you might have thrush, read on to find out about the symptoms and what you can do about it.

What is thrush?

Candida is a harmless yeast that everyone carries on their skin and genitals.

Most of the time, the amount of candida in and on our bodies is kept in check by certain types of normal skin bacteria. These bacteria are harmless and help to keep our skin healthy. However, if this balance changes, candida can start to multiply. It particularly thrives in warm, moist areas of the body such as skin folds, underneath the breasts, in the groin, in a baby's nappy area, underneath the foreskin or inside the vagina.

In rare cases, thrush is passed on during sex – however thrush is not considered a sexually transmitted infection (STI). 

Symptoms of thrush 

Thrush of the vagina and vulva 

Usually when we talk about thrush we’re referring to thrush that affects the vagina and vulva. This type of thrush causes:

• Thick, creamy vaginal discharge with a texture similar to cottage cheese – this discharge isn’t usually smelly 
• Itching and irritation around your vagina and vulva 
• Soreness or stinging when you urinate or have sex

In a more severe case, thrush might cause redness and swelling around the vagina and vulva. 

Thrush of the penis 

Although thrush is most common in women it can also affect men, and you might notice one or more of the following symptoms:

• White, thick discharge underneath the foreskin or on the head of the penis 
• Irritation and redness around the head of the penis and the foreskin 
• Difficulty pulling your foreskin back 
• An unpleasant smell

Find out more about thrush in men here. 

Thrush in the mouth and other areas

Yeasts prefer moist, warm conditions, so any area that doesn't get a lot of air can be affected by thrush: this could be skin folds under your breast or the tummy, inside the groin or in a baby's nappy area. In these areas it usually causes a red, very itchy rash.

Thrush can also develop inside the mouth – this is most common in babies and in people who use preventer (steroid) inhalers incorrectly, people who have a low/weak immune system or people who wear dentures. 

In adults, oral thrush causes: 

• Redness in the mouth 
• White patches that rub away leaving red spots, which might bleed 
• A bad taste in the mouth 
• Pain and problems eating and drinking 
• Cracks at the corners of the mouth

The symptoms are similar for babies – you may notice a white coating like cottage cheese on their tongue, and they may not want to feed. 

How do you get thrush?

Thrush is usually caused by a change to the natural balance of bacteria in the body, which allows the candida fungus to multiply. The balance of bacteria in your body can be affected by lots of things including:

• Pregnancy 
• Taking antibiotics 
• Damage to the skin 
• Having diabetes that is poorly controlled 
• Having a weakened immune system (e.g. you have HIV or you’re having chemotherapy to treat cancer) 
• Having hormone replacement therapy (HRT)

Thrush is not considered a sexually transmitted infection, however, it is thought that vigorous sex or frequent sex without a condom can trigger thrush. Occasionally it can be passed to a partner during sex. 

Thrush treatments

If you’re having the symptoms of thrush for the first time, the NHS advises that you visit your GP or go to a sexual health clinic. It’s also a good idea to seek help for thrush from a doctor or nurse if you:

• Are under 16 or over 60 
• Have had thrush more than four times in the past year 
• Have tried treatment and it hasn’t worked 
• Are pregnant or breastfeeding 
• Have a weakened immune system 

If you’ve been diagnosed with thrush before and it’s responded well to treatment, you can go straight to your local pharmacy for treatment or browse the LloydsPharmacy website. 

Intravaginal treatments for thrush 

Because it's best to just treat the area that's affected by thrush rather than the whole body, an internal tablet (called a pessary) is often recommended. A pessary is inserted into the vagina. The treatment pack contains an applicator, but you can insert it without if you prefer. You can either have a one-off dose or a short course. The pessaries usually contain clotrimazole or econazole.

This type of treatment is usually safe for pregnant and breastfeeding women. 

Creams for thrush 

A cream containing the antifungal medication clotrimazole can be applied to the affected area to reduce itching and irritation. A thrush cream can be used on any skin areas as well as the head of the penis, the vulva and the entrance of the vagina. 

Antifungal tablets for thrush

Another type of treatment for thrush is a tablet (taken orally) that contains antifungal medication. You might be offered fluconazole (given as a single dose) or itraconazole (given as two doses in one day). 

These antifungal tablets can be taken by women and men who have genital thrush, however neither are suitable for women who are pregnant or breastfeeding. 

Combination treatments for thrush

Sometimes a combination of treatments will be recommended to treat the symptoms of thrush. This is usually recommended if you have external itching or redness as well as discharge. The available combinations are an oral tablet plus a cream or a vaginal pessary plus a cream.

Treatment for recurring thrush

If you keep getting thrush, you’ll need to speak to your GP or a doctor or nurse at a sexual health clinic. They might be able to help you identify triggers for thrush, so you can make some changes if need be. They might also check you for diabetes. Recurrent thrush is often treated with a longer course of antifungal medication.

Treatment for oral thrush

If you have thrush in your mouth, you can go straight to your local pharmacy. lease have a think about potential triggers, such as using inhalers, medication that suppresses your immune system or ill-fitting dentures. Have you had any blood tests to check for diabetes or could your immune system be low? The standard treatment is a type of mouth gel. 

How to prevent thrush

It’s not always easy to avoid thrush, especially if you’re pregnant or have a weakened immune system, but there are a few things you can do to reduce your risk:

• Don’t use soaps or shower gels to wash your genitals 
• Don’t use douches or vaginal deodorants 
• Avoid wearing very tight underwear or tights 
• Make sure you dry properly after having a bath or shower 
• Wear cotton underwear

If you’re prone to vaginal thrush after sex, try using lubricants. Increased lubrication reduces friction, which can cause small cuts inside the vagina. It is thought that this encourages yeasts. Some women also report that having lots of sex without a condom makes them more likely to have thrush. This might be because semen changes the natural balance inside the vagina and can encourage the growth of yeasts.​​​​​​​

References

https://www.nhs.uk/conditions/thrush-in-men-and-women/
https://patient.info/sexual-health/vaginal-discharge-female-discharge/vaginal-thrush-yeast-infection
https://www.bupa.co.uk/health-information/healthy-skin/fungal-skin-infections
https://www.nhs.uk/conditions/oral-thrush-mouth-thrush/
https://www.nhs.uk/common-health-questions/sexual-health/can-a-man-catch-thrush-from-a-female-partner/
https://www.medicines.org.uk/emc/files/pil.4960.pdf
https://cks.nice.org.uk/topics/candida-female-genital/prescribing-information/topical-antifungals/
https://www.medicines.org.uk/emc/files/pil.2598.pdf
https://www.nhsinform.scot/illnesses-and-conditions/sexual-and-reproductive/thrush/