Candida – also known as Thrush

Candida (colloquially known in Australia as thrush) is an extremely common and irritating complaint that nearly all women will experience at some point in their lives. There are many different situations that cause thrush to occur, and many women experience it recurrently and require support and an appropriate plan to control the symptoms.

Sometimes thrush is referred to as a yeast or fungal infection: both of which are correct.

So, what is candida?

Candida is a genus of yeasts, and the most common fungal infection worldwide in human beings. The most common species is candida albicans. In recent years the emergence of other species is becoming more common including candida glabrata, candida krusei and candida tropicalis among others. Candida commonly inhabits the vagina in low numbers as part of normal vaginal flora without causing symptoms for long periods of time.

What happens when I get thrush?

Candida can begin to grow rapidly, causing an infection with the usual symptoms of intense vaginal and vulval itch, a white non-offensive discharge, burning externally when passing urine and on occasion anal irritation. Some of the causes of thrush are;

  • being run down with other illnesses
  • following antibiotic treatment
  • having high blood sugars (diabetes)
  • following sexual intercourse on occasion
  • or in women who are on certain medications including steroids and other immunosuppressive therapy.
  • It is quite a common, though not harmful, event during pregnancy.
  • On other occasions there is no obvious reason why thrush occurs.

Generally, there is a reduction in levels of lactobacilli, a healthy resident bacteria in the vagina which helps maintain the normal acidic pH of your vagina, allowing candida to overgrow and causing inflammation and then irritation.

What should I do if I think I have thrush?

If this is the first time you have experienced a vaginal irritation you should see your doctor, have an examination and a vaginal swab taken to send for testing. There are many causes of vaginal itch or soreness, thrush being only one of them. Usually, the doctor can tell from the examination if it is candidiasis and will recommend the appropriate treatment. If you have had the symptoms before and a new attack begins and feels familiar, then it is reasonable to buy over the counter medication from the chemist to begin with. This can include antifungal cream or vaginal tablets (known as pessaries), often taken in combination with a single anti-fungal oral capsule. Restoring lactobacilli, a healthy bacterium important for vaginal health, can help. Natural plain yoghurt is rich in lactobacilli. Applying plain yoghurt generously to a tampon and inserting this into the vagina is an old fashioned, safe and sometimes effective measure for thrush. In this instance it is important if your symptoms do not respond promptly that you seek medical advice and assessment as the cause may be a species of candida resistant to normal over the counter preparations or a bacterial infection, requiring completely different treatment.

What if I keep getting thrush?

If attacks become annoyingly frequent you should see a gynaecologist for assessment. Investigation for possible underlying causes and options for effective ongoing treatment can be discussed. Sometimes dietary modification may help reduce the frequency of episodes. Feel free to make an appointment gynaecologist Dr Peter England and don’t be embarrassed about dealing with this complaint. After all, it’s your health and you have no reason to be uncomfortable.

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Author: Dr Peter England, Obstetrician and Gynaecologist.
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