Vaginal Thrush

• Vaginal Thrush

  Overgrowth of candida in/around the vaginal area due to a change in the pH
• Vaginal thrush symptoms

  Itching/soreness outside the vaginal area

  white/curd like discharge, odourless

  dysuria (painful when passing urine)

  can experience pain during intercourse
• Causes of Vaginal thrush

  Antibiotics: alter the levels of bacteria in the vagina, allowing candida to overdevelop

  Hormonal changes: contraceptive pill etc

  Wearing tight/synthetic clothing which promotes moisture build up> candida overdevelop

  Damage to the vagina tissue during intercourse
• Vaginal thrush REFER

  > under 16yrs or 60+

  >first time symptoms of thrush

  >recurrent bouts of thrush (more than 2 attacks in 6 months)

  >treatment failure

  >pregnant/breastfeeding

  > weak immune system: diabetes/chemo

  >vulva sore/blisters

  >blood in the urine/discharge, yellow/green discharge (suspect bacterial)

  > Fish smell to the discharge

  > no improvement after 7 days
• Vaginal thrush treatment 


  Fluconazole oral 150mg capsule

  > 12-24 hours to work

  > use external cream concurrently to provide immediate relief from itch.

  >Single dose treatment

  advised to treat partner at the same time

  >side effects: headahce, nausea, flatulence, abdominal pain, diarrhoea
• fluconazole is a CYP450 enzyme inhibitor - interacts with warfarin
• vaginal thrush treatment

  clotrimazole 2%cream

  > external cream

  > provides immediate relief from itching, can be used by males as well on the tip of the penis for 2 weeks
• clotrimazole pessary/internal cream counselling

  canesten 10% cream

  >provides immediate relief

  > insert at night a can fall out during the day
• Vaginal thrush counselling

  avoid tight/ synthetic underwear (promotes moisture build up= candida overdevelopment)

  
  

  avoid deodorants and perfumes

  
  

  canestest available, diagnostic test kit over the counter which tests differentiates thrush from bacterial vaginosis