What you need to know about thrush.

Itchiness. Burning. Discharge. Stinging pain. Redness.

As women we share a lot of things, but when it comes to issues ‘down there’ we’re often strangely silent. While itching or unusual discharge from your vagina aren’t exactly your, ahem, traditional dinner conversations, far too many of us are too shy/embarrassed/reluctant to talk about it at all.

It’s even more concerning given the fact that the large majority have or will experience exactly the same thing at some point.

So now we’re just going to say the word out loud; shout it, in fact. Thrush! THRUSH! THRUUUUSSSHH! Not so bad after all, right?

Obviously you don’t have to shout it from the rooftops, but knowing exactly what thrush is and what to do about it is important – and not half as scary as you might think.

What exactly is it?

Officially known as vulvovaginal candidiasis – try saying that fast three times – thrush is a fungal infection that can affect the vagina and vulva (aka the outer lips of the vagina). Also referred to as a ‘yeast infection’, it’s way more common than you think, affecting around 75 per cent of women at some time in their life.

Thrush affects 75 per cent of women at some time in their life. Image: iStock.

What causes it?

There are a number of different causes of thrush, which can affect any age group. It’s also important to note that it doesn’t necessarily indicate poor hygiene and it’s not sexually transmitted.

While a small amount of yeast is found normally in the body, thrush is caused by an overgrowth in this yeast (normally a variety called Candida albicans). Even something as seemingly harmless as wearing tight clothing during sports for an extended period of time can create a warm, moist environment that encourages the fungus to grow.

While for many women there is no obvious cause of thrush, it can occur due to the use of some antibiotics, steroids used for pain, inflammation and lung disorders, poorly controlled diabetes, pregnancy, or illnesses that disrupt the immune system such as leukaemia or HIV. While a common belief that oral contraceptives may be a root cause of thrush, there is little evidence that this is the case.

How do I know if I have it?

Notable symptoms include discomfort in the vagina such as itching or burning, a thick, white discharge that can resemble cottage cheese, stinging or burning while urinating or during sex, redness or swelling of the vagina or vulva and splits in the genital skin.

That sounds like me. How can I treat it?

The recommended treatment for vaginal thrush is usually topical or oral anti-fungal agents including clotrimazole, miconazole, fluconazole and nystatin which come in the form of vaginal creams or pessaries (vaginal tablets) and capsules that are taken orally.

All these treatments are available from your local pharmacy without a prescription.

"Treatment for vaginal thrush is usually topical or oral anti-fungal agents." Image: iStock.

Do I need to see a doctor or can I just go to the pharmacy?

If it’s the first time you’re experiencing any of these symptoms or you’ve had thrush multiple times in the space of 12 months, or you’re worried that you may have something else, you should make an appointment with your GP first.

If you experience pain around the pelvis or abdomen and/or are younger than 18 years of age you should also see a doctor, even if you’ve had thrush before.

While a pharmacist will ask questions to determine if the treatment is right for you, it is necessary to get a diagnosis from the doctor especially if you’ve never had thrush before or if you have a recurrent or persistent infection.

Doctors can confirm the infection and differentiate from other conditions that may share similar symptoms such as bacterial vaginosis, sexually transmitted infections like genital herpes or a urinary tract infection.

A doctor’s visit will usually include a vaginal examination.

What if I’m getting it frequently?

While those who experience thrush on a regular basis due to an identifiable cause (such as recent antibiotics) may be able to self-manage with over-the-counter treatments from the pharmacy, it’s important to see a doctor if you’re experiencing symptoms of recurrent vaginal thrush, defined as four or more episodes within a 12-month period.

If recommended treatment isn’t making the infection go away, doctors need to rule out other potential conditions that are causing the symptoms, usually with an internal examination and a swab from the vagina.

Your doctor can help. Image: iStock

It might be that a resistant yeast is causing the thrush infection which requires an alternative treatment. Very occasionally it can be one of the first indicators of diabetes and in post-menopausal women, symptoms similar to thrush may be due to low oestrogen levels. This check is important to ensure that you don’t have a different infection or condition that is going untreated.

Don’t go in blindly though.

Whether for thrush or any problem or condition, there are certain questions you should always ask your doctor to ensure that a) you’re getting adequate but not unnecessary treatment and b) you know exactly what is going on.

These are:

• Do I really need this test or procedure?
• What are the risks and side effects?
• Are there simpler, safer options?
• What happens if I don’t do anything?
• What are the costs?

Thrush is an extremely common condition that is usually easily treated with over-the-counter topical and/or oral anti-fungal agents. If it’s your first time or you’ve had it four or more times in a year, make an appointment with your doctor first to ensure that it’s actually vaginal thrush you’re dealing with even if the symptoms match up.

The more you know, the less embarrassed or nervous you need to be. Trust us, your vagina will thank you for it.

How have you treated thrush in the past?