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Thrush is a type of fungal infection caused by the overgrowth of the Candida albicans yeast (fungus) in the genital area. Candida is normally present in the genital area alongside numerous other microorganisms as part of a healthy microbial balance. However, certain factors can cause Candida albicans to grow at an abnormally rapid rate, disrupting the microbial balance and subsequently causing a thrush infection.

Thrush can be caused by numerous factors pertaining to an individual’s lifestyle, hygiene and medication usage:

• The overuse of antibiotics - antibiotics are designed to eliminate all types of bacteria from the body. Unfortunately, the overuse of antibiotics may result in the elimination of beneficial bacteria which compete with the Candida fungus for space and nutrients, helping to maintain a healthy microbial balance in the genital area. The resulting disruption to the microbial balance can cause the Candida fungus to overgrow, resulting in a thrush infection.
• Hormone changes - hormonal fluctuations can affect the probability of experiencing a thrush infection in women. Changes in the body’s levels of the female hormone oestrogen can affect the functioning of vaginal epithelial cells which help maintain the natural pH level and microbial balance of the vaginal environment. The higher glycogen levels in these cells can provide more nutrients for the Candida fungus, triggering Candida overgrowth and increasing the risk of experiencing a thrush infection.
• Perfumed bathing products - the chemicals in certain perfumed bathing products can disrupt the natural pH balance of the genital region, disrupting the balance of microbes that prevent the overgrowth of Candida and causing thrush.
• The build-up of moisture in the genital area - it is advisable to dry the genital area properly after taking a bath or shower to avoid creating a damp environment which creates ideal conditions for Candida overgrowth. Additionally, moisture can contribute to skin irritation and inflammation, which further compromises the natural barrier of the skin surrounding the genital area and can exacerbate thrush symptoms.

The primary symptoms of genital thrush in women are:

• A white and often odourless vaginal discharge resembling cottage cheese
• Irritation and itching around the vagina
• Stinging or soreness during sex or while urinating

The primary symptoms of genital thrush in men are:

• A white discharge from the penis resembling cottage cheese
• Irritation or redness on the head of the penis or under the foreskin
• Difficulty pulling back the foreskin

Individuals affected by the above-mentioned symptoms should consult a pharmacist or doctor immediately to discuss treatment options. For more information, watch our Video Guide On Fluconazole (Thrush Treatment).

The most common types of thrush are genital thrush and oral thrush, both of which are caused by an overgrowth of the Candida yeast due to factors pertaining to an individual’s hygiene, sexual activity, antibiotic usage and/or lifestyle choices. However, genital thrush affects the genital area, while oral thrush can affect the mouth, tongue, gums, throat or inner cheeks. Moreover, genital thrush symptoms differ from those of oral thrush.

Additionally, genital thrush causes a discharge, irritation, itchiness and a stinging sensation while urinating. In contrast, oral thrush causes white patches in the mouth that can be wiped off to leave red patches, a loss of taste or an unpleasant taste in the mouth, and a painful and/or burning sensation in the mouth.

Recurrent thrush is diagnosed if an individual experiences three or more thrush outbreaks within a year. Recurrent thrush can also refer to four or more thrush outbreaks occurring within a year in individuals who are taking antibiotics.

It is important to note that recurring thrush can cause the individual to be asymptomatic for certain periods in between thrush infections. This means the affected individual will not experience persistent symptoms unless they are exposed to a trigger that results in a thrush infection.

The exact cause of recurrent thrush is not always clear, but several risk factors and common triggers can increase the likelihood of experiencing repeated infections. If you have had two or fewer thrush infections in the past six months, it is recommended to consult our pharmacy team about managing the condition with over-the-counter or prescription medications.

Conversely, if you have had three or more infections in the last six months, it is advisable to consult your doctor to discuss the most appropriate treatment options.

Recommended reading: Why Do I Keep Getting Thrush? Recurring Thrush, Explained

The gut contains numerous types of microorganisms, including the Candida fungus, which is usually harmless and part of a healthy gut microbiome, but may cause thrush if the gut microbiome becomes imbalanced.

For instance, the use of antibiotics can eliminate beneficial bacteria, causing an imbalance in the gut microbiome. This can provide Candida with more space and nutrients to grow excessively, subsequently causing thrush.

Taking a probiotic supplement, such as OneVit Probiotics Complex, can help restore a healthy balance by reintroducing beneficial bacteria such as Lactobacillus rhamnosus and Lactobacillus reuteri into the gut, thereby preventing Candida overgrowth and reducing the risk of recurrent thrush infections.

Thrush can be prevented by avoiding some of the common triggers that result in recurrent infections. This includes:

• Changing out of undergarments at the end of the day and/or after engaging in physical activity
• Wearing loose undergarments to facilitate ventilation in the genital area and prevent the build-up of moisture that can cause Candida overgrowth
• Avoiding long, hot baths and douching to maintain the natural balance of yeast and beneficial bacteria in the genital area
• Moderating the intake of sugary foods as a high blood glucose level can provide the Candida yeast with the nutrients required to grow at an excessive rate and cause a thrush infection
• Using barrier contraceptives, such as condoms, when having sex

Thrush infections cause similar symptoms in men and women. This includes itching/irritation in the genital area and a discharge resembling cottage cheese. However, certain factors which trigger thrush in women do not affect women, such as:

• Pregnancy - during the third trimester of pregnancy, rising oestrogen levels and increased blood flow to the vaginal area can create an environment that is conducive to Candida overgrowth. This can subsequently increase the risk of experiencing a thrush infection.
• Menstruation - changes in pH levels around the vagina before and during a period can disrupt the natural microbiota of the vagina, increasing the probability of Candida overgrowth which can subsequently increase the risk of experiencing a thrush infection.

The best treatments for thrush include:

• Fluconazole - a tablet-based, internal thrush treatment containing 150 mg of the active ingredient ‘fluconazole’ which stops an enzyme known as lanosterol 14-ɑ-demethylase from increasing the body’s levels of ergosterol, disrupting the cell membrane structure of the Candida yeast to limit its growth and alleviate thrush symptoms.
• Clotrimazole External 1% Cream - a topical thrush treatment containing a 1% concentration of the active ingredient ‘clotrimazole’, which blocks the lanosterol 14-ɑ-demethylase enzyme to weaken the fungal cell membrane of the Candida yeast and alleviate thrush symptoms.
• Canesten External 1% Cream - the branded version of Clotrimazole External 1% Cream. Canesten External 1% Cream is medically identical to Clotrimazole External 1% Cream, which means both treatments are equally effective at treating thrush. However, Clotrimazole External 1% Cream is a generic treatment and is therefore cheaper.
• Canesten External 2% Cream - a topical thrush treatment containing a 2% concentration of the active ingredient ‘clotrimazole’. Canesten External 2% Cream works in the same way as the 1% variant, with the only difference being the higher concentration of the active ingredient to treat more severe symptoms.
• Canesten Pessary - an internal treatment for female thrush consisting of a small device known as a ‘pessary’ which is inserted into the vagina to deliver clotrimazole directly to the site of the thrush infection.
• Canesten Duo - a treatment pack consisting of one Fluconazole 150 mg capsule to treat thrush infections internally and one tube of Canesten External 2% Cream for topical application to relieve irritation and itchiness.
• Canesten Thrush Internal Cream - an internal cream for women to treat thrush at the source of the infection. Canesten Thrush Internal Cream is a suitable alternative for women who prefer not to use a Canesten Pessary.
• Diflucan (Fluconazole) 150 mg - the branded version of Fluconazole 150 mg. Diflucan (Fluconazole) 150 mg is medically identical to Fluconazole 150 mg, which means both treatments are equally effective at treating thrush. However, Fluconazole 150 mg is a generic treatment and is therefore cheaper.

For detailed information on the best thrush treatment options, refer to our Complete Guide to Treating a Thrush Infection.

Thrush infections typically last for two days if the affected individual takes a Fluconazole 150 mg tablet, either by itself or alongside the topical application of Canesten External 2% Cream as part of Canesten Duo. In contrast, thrush can last for 1-2 weeks if it is treated solely using Clotrimazole (Canesten) 1% or 2% Cream.

It is important to note that the exact time thrush symptoms last depends on the individual. Therefore, it is advisable to consult a pharmacist or doctor for more accurate treatment times.

Thrush symptoms eventually subside on their own - but this can take several weeks, during which time the affected person is likely to experience discomfort and/or pain due to symptoms such as itching or burning in the affected area. This may be prevented by consulting a pharmacist or doctor about suitable treatment options as soon as possible.