With recurrent thrush on the increase, we asked **Tania Adib to clear up common myths about this condition and advise on how best to help prevent and treat it
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Three out of four women will suffer from an episode of thrush at some point, and while it can be easily treated, the symptoms can make our lives uncomfortable.
What’s more, recurrent thrush is on the rise. Recent figures published in The Lancet Infectious Diseases revealed that recurrent thrush - four or more episodes a year - is set to 'increase from 138 million women a year in 2018 to almost 158 million by 2030'. The 25 to 34-year age group is most affected, according to the research.
Despite the fact that thrush is a common infection, it’s still somewhat shrouded in embarrassment and taboo. Unsurprisingly there are many misconceptions about the infection. Thankfully there are expert voices opening up the conversation about thrush and women’s intimate health. There is a wealth of information and online resources ranging from information on what is thrush to facts about symptoms of thrush and available treatments.
One leading doctor who is no stranger to the issue is Consultant Gynaecologist and Gynaecological Oncologist, **Miss Tania Adib. We put your most frequently asked questions to her, from how can you ‘catch’ thrush to whether it is harmful in pregnancy and how to prevent it from coming back. Here’s what she told us.
Get The Gloss: What exactly is thrush?
Tania Adib: “It's a fungal yeast infection caused by an overgrowth of candida albicans. Candida is a normally occurring organism in the vagina and most of the time it doesn’t lead to an infection. When the vaginal microbiome isn't functioning as well as it could be, candida can overgrow. And this is what we know as thrush, or to give it its medical name, vulvovaginal candidiasis.”
How can I tell if I have thrush?
“You would have a thick, white vaginal discharge, which is often likened to cottage cheese. You will often experience significant itching, which can be really uncomfortable. The combination of a white discharge and itching are the most common symptoms of thrush. It does not really have a smell.”
What are some of the common myths and misconceptions about thrush?
“The most common misconception is that thrush is a sexually transmitted infection. Also, that it's linked to cleanliness - that it means that you're not clean. Neither of those is true.”
How do you ‘catch’ thrush?
“Thrush can be linked to hormones, particularly oestrogen, as well as to the immune system. If any of those is not functioning as well as they could be, then you could be more prone to thrush. You may be more at risk of developing thrush if you are exposed to potential triggers, for example: using perfumed products in your intimate area or if you have been prescribed a course of antibiotics."
How common is thrush?
“It’s common, so women shouldn't feel stigmatised by having it. In fact, three out of four women will get it at least once in their lifetime. Recurrent thrush is also not uncommon. You can get thrush in the mouth, armpits and between the fingers as well as in the vagina (vaginal thrush). It doesn’t just affect women, occasionally men and babies can experience different types of thrush too.”
Who is most likely to suffer from thrush?
“Anyone who has an immune condition can be more susceptible to thrush. For example, women with HIV can be more susceptible and women who have diabetes experience more thrush. And if you take a course of antibiotics, then you might also be more susceptible to experiencing a thrush episode. Thrush can be related to hormones, so women taking the oral contraceptive pill or HRT are more at risk of suffering from thrush.”
Is it common to get thrush while pregnant?
“Yes. Women who are pregnant have slightly lower immune systems. Whenever your immune system is not working as well as it could be, you will be more prone to thrush. Pregnant women often have more episodes than non-pregnant women, but there’s no evidence that thrush harms the unborn baby.”
Why do you get thrush while on antibiotics?
“Antibiotics kill a lot of the good bacteria in the gut and this can cause an overgrowth of candida albicans both in the gut and on the vagina, which can lead to thrush.”
Is thrush linked to periods?
“Women can find that they are more prone to thrush at particular points in their cycle, particularly just before their period. Once women go through menopause, some find that their thrush settles, and they have far fewer episodes because their oestrogen levels are dropping. If the thrush is linked to hormones, those who experience thrush on a monthly basis related to periods are likely to have far fewer episodes after the menopause, if they don’t take HRT.”
Should we be careful with tampons, pads and even underwear if we’re prone to thrush?
“Thrush (candida albicans) likes warm damp conditions. I would advise changing tampons and pads regularly - certainly every three or four hours. It’s important to make sure that the area is aerated. It's difficult to get air to the vulva and vagina - and if you have thrush, you really want to help the area to breathe. Wearing cotton underwear and avoiding tight clothing, such as tights or skinny jeans, can all be beneficial.”
Do I need a special soap or wash if I have thrush?
“The skin on the vulva is really sensitive and delicate and so it’s best to keep things as simple and natural as possible. Avoid harsh or highly scented soaps as they may aggravate your already sensitive skin."
Can I have sex if I have thrush?
“Thrush is not a sexually transmitted infection, so there’s nothing to stop you, but if you have active thrush and you have intercourse, it will rub against the walls of the vagina and make it more irritated."
How do you deal with treating the symptoms of thrush?
“It slightly depends on the symptoms and where I think the thrush is affecting the patient mainly. I would normally treat it with an antifungal oral tablet containing fluconazole* or itraconazole in combination with an anti-thrush cream. This is applied to the vulva.
“You can also use a pessary that you put into the vagina. This is also a good option if you don't want to take anything by mouth or if you are pregnant. Normally again I would use that with a cream that you put on the vulva as well to treat the fungal infection thoroughly as well as for comfort to stop the itching."
If you are at all unsure of your symptoms or condition, please consult your healthcare practitioner. If you are pregnant or breastfeeding, please always speak to your healthcare practitioner.
* Fluconazole is not suitable if you are pregnant, trying for a baby or breastfeeding.
How long does it take for thrush to clear up with treatment?
“It’s normally quite quick - within 48 hours. If you take an oral tablet or a pessary, it's normally just a one-off treatment with the cream that you use for three or four days. Normally one course of treatment is enough. In a small minority, it can become recurrent, in which case we need to continue the treatment for a little bit longer until it clears. If there is no improvement in your symptoms within three days, or if they've not disappeared within seven days, please consult a healthcare professional.”
Do I need to see a doctor if I have thrush?
“You can get the thrush treatments I mentioned on prescription, but they are also available over the counter at pharmacies and in the Women’s Intimate Health aisle at your nearest store. Your pharmacist may be able to advise, but if you are unsure or if you are a first-time thrush sufferer, visit your GP.”
How do you help stop thrush from coming back?
“Recurrence is common and sometimes medication is the only effective treatment, but there are other things you can do that might keep it at bay. I would advise absolutely to take a probiotic regularly either by mouth or vaginally, whatever you feel more comfortable using. You should reduce sugar in your diet as much as possible. And you should employ the good vulval care that I mentioned earlier: avoidance of any harsh soaps, use water to wash the vulva and wear cotton underwear and loose clothing.”
How does sugar make thrush worse?
“Candida feeds on sugar and thrives in conditions where there is a lot of sugar, so reducing it in your diet can help to reduce episodes of thrush.”
What happens if thrush is left untreated?
“It can become a real nuisance with continued itching and discharge, which are really uncomfortable. Long-term it can lead to more inflammation and redness of the tissues.”
And lastly, any words of wisdom about thrush?
“Eat a healthy, balanced diet, moderate your sugar intake, take an oral probiotic and don't use harsh soaps."
**Miss Tania Adib does not endorse any medicinal product or treatment.
**Miss Tania Adib does not endorse any Canesten products.
For more information about thrush visit canesten.co.uk
Canesten Thrush Combi Pessary & External Cream 500mg pessary & 2% w/w cream contain clotrimazole. Always read the label.