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Candidiasis (thrush) - Treating vaginal thrush

NHS Choices Medical Reference

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For mild vaginal thrush,

a short course of

anti-thrush medicine 

may be recommended. It

is usually taken for between one and three days.

If your thrush symptoms are more severe, you'll need to take the treatment for longer.

Anti-thrush medicines are available as:

  • an anti-thrush pessary to deal with Candida in the vagina. A pessary is a specially shaped lump of medication that you insert into your vagina using an applicator, in a similar way to how a tampon is inserted 
  • an anti-thrush cream to deal with Candida on the skin around the entrance to the vagina
  • anti-thrush tablets, which can be used instead of creams and pessaries; these are taken by mouth and are called oral treatments

Pessaries and oral treatments have been found to be equally effective in treating thrush. Around 80% of women are successfully treated regardless of the type of medication they use. 

Deciding on the type of treatment

Many women use anti-thrush pessaries and creams to treat a straightforward bout of thrush. Pessaries and creams are recommended if you're pregnant or breastfeeding.

Oral treatments are simpler and more convenient than pessaries and creams, but they can have side effects. They tend to only be used for troublesome thrush that keeps coming back.

Anti-thrush tablets

The two main types of anti-thrush tablets that are prescribed by doctors to treat vaginal thrush contain the antifungal medicines fluconazole or itraconazole.

Anti-thrush tablets can cause side effects including:

Anti-thrush pessaries

Pessaries that are often prescribed for thrush include the anti-fungal medicines:

Vaginal pessaries don't cause as many side effects as anti-thrush tablets but they can:

  • be awkward to use
  • cause a mild burning sensation, slight redness or itching
  • leave a whiteish creamy stain on your underwear (it washes out)
  • damage latex condoms and diaphragms, so you will have to use another form of contraception while using them

You shouldn't use vaginal pessaries too often. Read more about why vaginal pessaries should not be used frequently.

Pharmacy anti-thrush treatments

Some tablets, creams and pessaries to treat vaginal thrush are available over the counter from your pharmacist without a prescription.

Anti-thrush pessaries and creams containing clotrimazole are widely sold from pharmacies under the brand name Canesten.

Flucanozole is also available over the counter from pharmacies as a single-dose tablet for treating thrush under the brand name Diflucan.

These treatments can be useful for treating thrush if you've had it before and it's returned. However, avoid buying thrush medication direct from a pharmacy if it's your first bout of thrush. Visit your GP first.

Also, you shouldn't continue to use over-the-counter thrush treatments over a long period of time without consulting your GP.

Advice if you're pregnant or breastfeeding

If you have thrush and you're pregnant or breastfeeding, you should always visit your GP rather than buying anti-thrush medication over the counter from a pharmacy.

You won't be prescribed oral treatment because it may affect your baby. An anti-thrush pessary, such as clotrimazole, econazole or miconazole will probably be prescribed to be used for at least seven days.

If you're pregnant, take care when inserting a pessary because there's a risk of injuring your cervix (neck of the womb). To reduce the risk, it may be better to insert the pessaries by hand instead of using the applicator.

If you have symptoms around your vulva, such as itching and soreness, you may also be prescribed an anti-thrush cream.

Complementary therapies

Some women find that complementary therapies, such as bathing the genital area with diluted tea tree oil gel or plain bio-live yoghurt helps to ease their thrush symptoms.

However, tea tree essential oil can sometimes cause skin irritation. You should not use more than one or two drops in the bath and if there is any irritation stop using the oil and wash the area with clean, warm water.

Although using yoghurt won't do you any harm, there's no evidence to suggest that it will relieve the symptoms of thrush or help treat it and it should not be considered a main treatment.

If you want to try using plain live yoghurt, one method is to smear it directly over the vulva to ease any soreness or irritation and then insert it directly into the vagina.

The easiest way to do this is to use a tampon with an applicator. Push the tampon back inside the applicator, add about one teaspoon of plain live yoghurt to the space and insert the tampon in the usual way. Remove the tampon an hour later. 

Medical Review: February 17, 2012
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