Medicines for Vaginal thrush

What it is

Vaginal thrush is a very common infection caused by an overgrowth of a yeast, usually Candida, which normally lives harmlessly in small numbers in the vagina and on the skin. When the natural balance changes, the yeast can multiply and cause symptoms such as itching and soreness around the vagina and vulva, a thick white discharge that is often described as cottage-cheese-like, and discomfort or stinging when passing urine or during sex. It is not classed as a sexually transmitted infection and is rarely serious. Several factors can make thrush more likely, including pregnancy, diabetes, recent antibiotics, a weakened immune system and hormonal changes. Most episodes are straightforward and self-limiting once treated, but symptoms can overlap with other conditions, so diagnosis is confirmed from the typical symptoms and an examination, with a swab sometimes taken when the picture is unclear, when treatment has not worked, or when infections keep recurring.

How it is treated

The aim is to clear the yeast overgrowth and relieve the itching and soreness. Treatment is with an antifungal medicine, which can be given as a pessary inserted into the vagina, as a cream applied to the vulva, or as an oral azole tablet, and many people can choose whichever suits them best, with a soothing cream often used alongside for external itch. Particular care is needed in pregnancy, where an oral antifungal tablet is generally avoided and a vaginal (local) treatment is preferred; a healthcare professional should guide treatment in this situation. Recurrent thrush, defined as several proven episodes in a year, is approached differently and may need a longer or repeated antifungal plan and a look for any underlying cause, sometimes with specialist input. If symptoms do not settle with standard treatment, it is important to reconsider the diagnosis rather than simply repeat the same medicine.