Genital thrush

What is thrush (candidiasis/candida)?

Thrush (candidiasis/candida) is a common infection caused by a yeast (a type of fungus). There are small amounts of yeasts that live in warm, moist places on the skin and inside the body. These rarely cause problems. Genital thrush occurs when there is an overgrowth of a yeast (usually candida albicans). Most people with a vagina will be affected by genital thrush at some time in their lives. It can also affect the penis, causing redness and irritation sometimes called balanitis, but this is less common.

Thrush can be passed on during sexual contact and sexual activity may make symptoms worse, however, it is not considered a sexually transmissible infection (STI).

Read about sexually transmissible infections (STIs)

How do you get genital thrush?

The reason people get thrush is not always clear. Thrush can affect anyone, although it is uncommon before puberty and after menopause.

You do not need to be sexually active to get genital thrush.

You may be more likely to get thrush if you:

• are using antibiotics
• are using the oral contraceptive pill
• are pregnant
• have diabetes
• douche or clean inside your vagina
• poor foreskin hygiene
• aren't aware of basic genital skincare
• are immunocompromised
• have other genital skin conditions (e.g. eczema or psoriasis)
• are a smoker.

How do I know if I have genital thrush?

Many people with thrush do not know because they do not have symptoms.

Some people may have symptoms such as:

• itch, irritation or discomfort inside the vagina and/or on the vulva or penis
• white, thick and lumpy (‘curd like’) vaginal discharge, difficulty, pain, discomfort, stinging or burning during urination (peeing)
• a rash, or red and swollen genitals
• cracks or splits in the genital skin
• pain during sex – burning inside the vagina and/or pain at the opening of the vagina or discomfort on the foreskin and shaft of the penis.

What does a test for genital thrush involve?

It is recommended you see a doctor or nurse if you are experiencing any thrush symptoms. Treating these yourself may worsen the condition.

The doctor or nurse will usually take a detailed medical and sexual health history. Any information or details you discuss will be kept private and confidential. This will help them to assess the symptoms and guide any tests and possible treatment options.

It can often be helpful if you have symptoms of thrush, for a doctor or nurse to do a genital examination and use a cotton swab to collect a sample from your vagina, or penis, and/or any cracks or splits in the genital skin. You can also self-collect a sample if you have a vagina.

However, diagnosis of thrush and treatment options can be determined sometimes just from the history you give and the symptoms you describe.

You may choose to test for other STIs or BBVs at the same time as testing for genital thrush. As sometimes thrush can be a symptom caused by an STI.

Sexual Health Victoria (SHV) provides expert, confidential STI and BBV testing to Victorians. We also provide expert information, healthcare and support on a range of reproductive and sexual health matters. For more information on SHV clinical services, see our clinics or you can book an appointment online.

How is genital thrush treated?

Symptoms will sometimes go away without treatment. Treatment is recommended if you have symptoms that are bothering you.

Genital thrush is treated with anti-fungal medications. This may be a cream or pessary (small tablet which is inserted into the vagina) used for 1 – 7 days and/or a single dose oral tablet. Occasionally you may need a longer course of treatment.

If you have symptoms and your doctor or nurse thinks they are most likely to be caused by thrush, you may be offered treatment before your test results come back.

It may be recommended you avoid sexual contact until you have finished treatment and your symptoms have settled as sex may cause discomfort or a burning sensation during or after.

As some creams used to treat genital thrush can affect diaphragms or condoms and cause them to break easily, it is recommended to use the creams after you have had sex, avoid sexual contact, or use an alternative contraception option during genital thrush treatment.

Treatment may also be recommended for your sexual partner/s if your thrush does not resolve (go away) with treatment, or you have recurrent genital thrush.

Where do I get treatment for genital thrush?

You can often buy treatment for thrush over the counter at a pharmacy without a script.

You can buy anti-fungal medications - clotrimazole, miconazole or nystatin as vaginal creams or pessaries (small tablet which is inserted into the vagina). There are also oral fluconazole tablets.

If you are pregnant or breastfeeding, speak to your doctor or nurse before using treatment.

What if I do not get treated?

Genital thrush does not usually cause long term health complications or risks to fertility or pregnancy if not treated.

However, it can trigger ongoing vulval pain if it is recurring and not treated, so getting treatment is strongly recommended.

Will genital thrush come back?

Thrush can resolve (go away) with effective treatment. You do not develop any immunity to thrush once you’ve had it. Many people who are treated for thrush will get another thrush infection at some stage.

Around 5% of people with a vagina will have thrush that comes back more often or is more difficult to clear. If you have four or more episodes of genital thrush symptoms in a year, you may have what is called recurrent thrush.

Symptoms of recurrent thrush may not go away with treatment, and they may differ from typical genital thrush symptoms. Sometimes recurrent thrush may indicate you have an underlying medical condition, or the infection may be resistant to treatment. It is recommended you speak to your doctor or nurse if you have recurrent genital thrush and/or other genital symptoms.

Will genital thrush affect my pregnancy or breastfeeding?

People who are pregnant or breastfeeding can get genital thrush.

During pregnancy, suppression of the immune system and hormonal changes can increase the chance of getting thrush.

If you experience genital thrush during pregnancy, it usually does not cause any health complications for you or the baby. Thrush may be passed to the baby during birth, but this is rare and can be easily treated.

Genital thrush infection during pregnancy is not associated with miscarriage, premature (early) birth, low birth weight or other pregnancy complications.

If you are planning a pregnancy or are already pregnant, testing for thrush is not a routine part of health care. You will only be tested if you have symptoms that are causing you discomfort or concern.

Some treatments for genital thrush are not recommended if you are pregnant or breastfeeding. If you are pregnant or breastfeeding and considering treatment for genital thrush, ask your doctor, nurse, or midwife about the possible effects of the treatment and/or medicine on your baby or breastfeeding.

How can I lower my risk of getting genital thrush?

You may be able to lower your risk of getting genital thrush by the following:

Avoid douching or cleaning inside your vagina as this disrupts the balance of yeasts that live in the vagina.

It is recommended you see a doctor or nurse if you are experiencing any genital thrush symptoms. Treating it yourself may worsen the condition.

Avoid scented soap, bubble baths and products around the vagina. Use only water or soap-free products to wash around your genitals.

Wear cotton or silk underwear rather than synthetics and change underwear daily.

Change out of damp swimming clothes or sports clothes as soon as possible after swimming or exercise.

If using pads or panty liners, change them regularly.

If you have a vagina, wipe from front to back after using the toilet.

Use barrier protection (external condoms, internal condoms or dental dams), correctly during any type of sex (vaginal, anal, oral and sex toys) to minimise friction between barrier protection and genitals

Use lubricant (lube) during sexual activity. Lube is a jelly or liquid-like material that can help to reduce friction and/or dryness during sex and can make sex more comfortable and pleasurable for all partners.

You might think that yeast infections only affect vaginas, but penises can get thrush too. Aside from the discomfort, it’s no big deal. Healthy Male explains:

What causes penis thrush

Many of the same things that increase the risk of vaginal and vulval thrush increase the risk of penis thrush.

• Skin irritation
• Taking antibiotics
• Taking medications that suppress the immune system, such as chemotherapy or corticosteroids
• Having a weakened immune system (e.g. HIV)
• Poorly managed diabetes
• Poor hygiene, especially if you have a foreskin

What are the symptoms of a penis yeast infection?

A yeast infection will mainly affect the head of your penis, especially if you're uncircumcised, as your foreskin keeps the area warm and moist. Symptoms of thrush of the penis include:

• Red rash on your genitals, mainly under the foreskin, which may be itchy
• Small red spots on the head of your penis
• Discharge from your penis
• Pain when you urinate
• Difficulty pulling back your foreskin
• A smelly, 'cheese-like' substance under your foreskin

You might also have no symptoms at all.

How do you treat yeast infections of the penis?

The good news is that penis thrush is often simple to treat.

Sometimes good hygiene can be enough to clear things up. Make sure you always gently wash your genitals — avoiding soaps and shower gels, which can make irritation worse — pulling the foreskin back and cleaning the head of your penis. When you're drying yourself, make sure to be gentle and thoroughly pat dry.

If this does not help the symptoms, then treatment with antifungal cream might be helpful.

This information has been produced in consultation with and approved by: Healthy Male

Where to get more information and support

• Sexual Health Victoria
• A doctor or nurse
• Your local community health service
• An obstetrician or gynaecologist
• Better Health Channel
• Melbourne Sexual Health Centre – a specialist sexual health clinic
• Jean Hailes
• Multicultural Centre for Women’s Health – for culturally and linguistically diverse women.
• Healthy male: Yeast infection in men
• The Labia Library
• What’s Going on Down There - an interactive website that can help self-assess vaginal discharge changes
• The Women’s (The Royal Women’s Hospital)
• Equinox – for transgender services
• The Centre Clinic – a safe and friendly general practice, providing care for LGBTI community members as well as specialist medical care for people living with HIV, and expert sexual health screening and treatment.

If you are using the internet for information, only use reliable and reputable websites, such as the ones provided above.