Causes and management options for vaginal thrush

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Vagina thrush is generally caused by an overgrowth of the yeast Candida albicans. Sometimes, the reason for candida overgrowth cannot be identified. However, this overgrowth in most cases is as a result of:

Antibiotic use Oral contraceptive use Diabetes
Menstrual cycle changes
General illnesses like diabetes, iron deficiency and immune system disorders Associated vulval skin conditions.


Management options
Topical thrush treatments :These are pessaries and creams which you insert into the vagina with an applicator. They contain anti-yeast medicines such as clotrimazole, econazole or miconazole. Commonly, a single large dose inserted into the vagina is sufficient to clear a bout of thrush. However, you may also want to rub some anti-thrush cream on to the skin around the vagina (the vulva) for a few days, especially if it is itchy. In severe infection, you may be advised to use a second pessary after three days.

Tablets Fluconazole, which is taken as a single dose, or itraconazole which is taken as two doses over the course of one day. Side-effects are uncommon, but always read the information leaflet that comes with the treatment for full information.

Do not take these treatments if you are pregnant or breast-feeding. You may also want to rub some anti-yeast cream on to the skin around the vagina for a few days, especially if it is itchy. Combination packs containing both the tablet and cream are available. In severe infection, a repeat dose of the tablet may be suggested after three days. It is important to note that tablets and topical treatments are thought to be equally effective. Tablets are more convenient, but are more expensive than most topical treatments.

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Non medical options
Do not wear tight-fitting clothing, especially clothing made from synthetic materials. Loosefitting, natural fibre underwear may be better.

Do not washing underwear with biological washing powders or liquids and avoid the use of fabric conditioners.

Avoid using perfumed products around the vaginal area, such as soaps and shower gels, as these may cause further irritation.

Use a simple emollient daily as a moisturiser to protect the skin around the vulva.

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