What is it?
Vaginal thrush (A.K.A. vulvovaginal candidiasis) is caused by an overgrowth of a fungus called candida in the vagina. Small numbers of Candida commonly live on the skin and around the vaginal area and cause no issues. However certain changes or conditions can cause candida to multiply, leading to the classic symptoms of thrush. That is; “cottage cheese” discharge (their words, not mine), itchiness, burning and in some cases redness around the vulva.
Who gets it?
75% of women will have it at least once in their lives, and sometimes it happens for no reason but certain conditions and life stages make you more susceptible, such as; pregnancy, diabetes, steroid medications, or if you have a compromised immune system. It is important to note that thrush is not a sexually transmitted infection (STI) but sex can trigger an infection due to friction so if this happens to you, just ensure to use lubricant. Some women are prone to thrush in certain times of their menstrual cycle – for example, before a period. The hormone changes of pregnancy make thrush more likely. Combined oral contraceptives pill has also been associated with increased risk of thrush but evidence is conflicting.
How is it treated?
Most infections can be treated at home with over-the-counter antifungal medication (such as Clotrimazole) in the form of a capsule, pessary or cream. If it doesn’t go away after after 7 days or if you suffer from recurring infections (>3/year), then best to see your GP to rule out other infections or underlying conditions.
Is yoghurt an old wives tale?
Actually, there is some evidence for the use of live yogurt (due to the probiotics) in reducing the symptoms of thrush. And no you don’t eat it (well you can) but it’s best applied topically or vaginally.
A 2015 study compared a mixture of yogurt and honey and a standard anti-fungal treatment (clotrimazole) in reducing the symptoms of thrush in non-pregnant women (1). Both treatments were administered vaginally, and participants and researchers were blinded and therefore did not know who got which treatment (which reduces bias). They found a mixture of yogurt and honey was not only similar as the standard treatment in terms of symptom relief but was more effective in relieving some symptoms (itching, irritation and discharge). A similar study, this time on pregnant women, found the yoghurt and honey mixture was better at reducing symptoms, while the anti-fungal medication was more effective for eliminating fungi (2).
NICE Guidelines actually suggest trying yoghurt as it’s unlikely to do any harm and may do some good. (Ps. Go for plain live yoghurt, I wouldn’t try anything fruity up there.)
Probiotics can also be taken in supplement form alongside treatment. A Cochrane review found that, compared with conventional anti-fungal drugs used alone, probiotics as adjuvant therapy (add-on therapy) could enhance their effect in improving the rate of short‐term (within 5- 10 days) clinical cure, short‐term mycological cure (no abnormal laboratory results) and relapse at one month, but does not seem to influence the rate of long‐term (within 1-3 months) clinical cure or long-term mycological cure (3).
What can I do to prevent thrush?
- Avoid wearing tight-fitting clothing, especially underwear made from synthetic materials.
- Avoid using perfumed products around the vaginal area, such as soaps and shower gels or deodorants, as these may cause further irritation (your vagina is pretty good at self-cleansing so just showering as normal is all you need to do – no douching.)
(1) Darvishi, M., Jahdi, F., Hamzegardeshi, Z., Goodarzi, S. and Vahedi, M. (2015) The Comparison of vaginal cream of mixing yogurt, honey and clotrimazole on symptoms of vaginal candidiasis. Global journal of health science, 7(6), p.108.
(2) Abdelmonem, A.M., Rasheed, S.M. and Mohamed, A.S., 2012. Bee-honey and yogurt: a novel mixture for treating patients with vulvovaginal candidiasis during pregnancy. Archives of gynecology and obstetrics, 286(1), pp.109-114
(3) Xie, H.Y., Feng, D., Wei, D.M., Mei, L., Chen, H., Wang, X. and Fang, F., 2017. Probiotics for vulvovaginal candidiasis in non‐pregnant women. Cochrane Database of Systematic Reviews, (11).
feature image: Bianca Castillo via Unsplash