Recurrent Thrush

Thrush is a common yeast infection that affects most women at some point in their life. Whilst most cases can be treated quickly.

Recurrent thrush is typically defined as four or more episodes of vulvovaginal candidiasis (VVC) in a year. It’s caused by the overgrowth of Candida, a yeast that normally lives harmlessly in the vagina. Recurrent thrush needs a different approach where the cause of the thrush is identified and treated.

What are the symptoms of thrush?

Common symptoms include:

  • Itching, irritation or soreness around the vagina

  • Thick white vaginal discharge (often described as ‘cottage cheese-like’)

  • Pain or discomfort during sex or urination

  • Redness or swelling around the vulva

What causes recurrent thrush?

Recurrent thrush can be triggered by:

  • Antibiotic use (which disrupts natural vaginal bacteria)

  • Hormonal changes (e.g. around your period or pregnancy)

  • Diabetes (especially if poorly controlled)

  • Wearing tight or synthetic underwear

  • Sexual activity

  • Using perfumed soaps or vaginal washes

  • A weakened immune system
    Sometimes, there is no obvious cause.

How is recurrent thrush diagnosed?

Diagnosis often includes taking a swab from the vagina to confirm the diagnosis

Is recurrent thrush sexually transmitted?

Thrush is not considered a sexually transmitted infection (STI), but it can sometimes be triggered or passed on through sex. However, many women who are not sexually active also get thrush.

How is it treated?

Treatment options include:

  • Antifungal medications: These may be taken as tablets (e.g. fluconazole) or as vaginal pessaries/creams (e.g. clotrimazole)

  • Maintenance therapy: A longer course of low-dose antifungal treatment may be prescribed (e.g. weekly fluconazole for 6 months)

  • Treating a partner may be considered if they have symptoms

  • Addressing underlying factors such as blood sugar control or changing hygiene products

Should I see a specialist?

Yes, if: 

  • You’ve had multiple recurrences despite treatment 
  • Symptoms are not improving 
  • There's a suspicion of a non-Candida albicans infection (which may be resistant to common treatments) 

Who is treatment for?

Women who have 4 or more episodes of thrush in a year

How often?

As necessary

What does it involve?

  • A consultation with a consultant gynaecologist
  • Blood tests
    • FBC, ferritin, vitamin D, HbA1C, glucose
  • Pelvic examination including high vaginal swab test for microscopic culture and sensitivities for candida
  • Prescription if required
  • Comprehensive report to you and your GP
  • Direct access for any urgent health concerns

The following tests can be added to a recurrent thrush package at an additional cost

  • Nutritional consultation
  • Follow up consultation
  • Examination with vulvoscope

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