Vaginal thrush

Itching around the vulva, soreness during sex and thick white discharge can occur with vaginal thrush. The discharge usually has little smell. These symptoms also overlap with other vaginal infections, so a familiar pattern alone cannot tell you the cause.

Thrush is a yeast infection caused by an overgrowth of Candida. Small amounts of yeast can be present in the vagina without causing symptoms. Thrush is not classed as a sexually transmitted infection, or STI.

When to check before buying treatment

In the UK, pharmacy treatment can be an option if a clinician has confirmed thrush before and you recognise the symptoms. A pharmacist can help choose a suitable antifungal. Ask for a private conversation if you would rather not discuss symptoms at the counter.

Contact an urgent GP service or NHS 111 today (UK), or your doctor or urgent care service (US and elsewhere), if vaginal symptoms come with pelvic or lower tummy pain or fever. Get assessed before treating this as a familiar episode of thrush.

See a GP first if symptoms are new, treatment has failed, or episodes keep returning. The NHS also advises a GP appointment if you are pregnant or breastfeeding, under 16 or over 60, or have a weakened immune system. Tell the clinician about diabetes or treatment that affects your immunity.

US advice is more cautious about self-treatment: the Office on Women’s Health recommends talking with a doctor or nurse first. A medicine sold over the counter may still be the wrong treatment for your symptoms.

What a clinician may check

An appointment may include an examination and a swab of discharge, especially when the cause is unclear or symptoms keep returning. This helps the clinician check what is causing the discomfort and look for other infections.

You could say: “The itching is outside as well as inside, and the treatment I tried has not helped.” Bring the product name and note what changed after using it. You can ask what the clinician is checking for before an examination.

Treatment and pregnancy

Antifungal treatment can come as an oral tablet, a pessary inserted into the vagina, or a cream for irritation. Your pharmacist, GP or doctor can advise which option suits you. Follow the leaflet and the instructions given with your treatment.

Pregnancy changes the choice of medicine. Vaginal treatments containing clotrimazole or miconazole are options described by the Office on Women’s Health; oral fluconazole is not recommended for vaginal thrush in pregnancy. Ask your doctor or midwife to choose the treatment rather than reusing an earlier prescription.

Some antifungal creams and vaginal preparations can weaken latex condoms and diaphragms. Check the product information and ask a pharmacist about protection during treatment. Partners generally do not need treatment unless they have symptoms.

Comfort without more irritation

The NHS suggests washing the affected area with water and an emollient soap substitute, drying gently and wearing cotton underwear. Avoid shower gels, vaginal deodorants and douching. If sex hurts, wait until the thrush has cleared before trying again.

Probiotics and homeopathic products are not established treatments for thrush. CDC guidance finds no substantial evidence that they treat vaginal candidiasis. They are not a reason to put off assessment when discomfort continues.

If it keeps coming back

Contact an urgent GP service or NHS 111 today (UK), or your doctor or urgent care service (US and elsewhere), if vaginal symptoms come with pelvic or lower tummy pain or fever.

Antibiotics, pregnancy, poorly controlled diabetes and a weakened immune system can make thrush more likely. But many people have no clear trigger, including people with repeated episodes. Thrush returning does not, on its own, mean you have an underlying illness.

Book a GP or sexual health appointment in the UK, or see your doctor or nurse in the US and elsewhere, if symptoms persist or return after treatment. Further testing may identify the yeast involved, and a clinician can plan treatment around the findings.

Bring a few notes about previous episodes and treatments. You could ask: “Do we need to confirm the cause with a sample?” and “Who do I contact if this treatment doesn’t help?”