vaginal thrush

Last edited 06/2021 and last reviewed 06/2021

Yeasts may be present in a woman's vagina or vulva with no symptoms present.

  • common among women of reproductive age

  • caused by overgrowth of yeasts; C. albicans, in 70-90% of cases, with non-albicans species such as C. glabrata in the remainder

  • presence of candida in the vulvovaginal area does not necessarily require treatment, unless symptomatic, as between 10% and 20% of women will have vulvovaginal colonisation

  • candidiasis occurs most commonly when the vagina is exposed to estrogen, therefore it is more common during the reproductive years and during pregnancy
    • an episode of vulvovaginal candidiasis (VVC) is often precipitated by use of antibiotics
    • immunocompromised women and women with diabetes are predisposed to candidiasis

  • VVC does not appear to be associated with tampons, sanitary towels or panty liners when they are used appropriately

  • as VVC can be found in non-sexually active individuals, it is not classed as an STI

Key points (2):

  • all topical and oral azoles give over 80% cure
  • pregnant: avoid oral azoles, the 7 day courses are more effective than shorter ones
  • recurrent (>4 episodes per year): 150mg oral fluconazole every 72 hours for 3 doses induction, followed by 1 dose once a week for 6 months maintenance