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NHS Choices Condition

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If your symptoms of vaginal thrush are mild, your GP may recommend a short course of antifungal medicine, which will usually need to be taken for 1-3 days. If your symptoms are more severe, you will need to take the treatment for longer.

Antifungal treatments for thrush can be taken by mouth (orally), or by inserting them into your vagina (intravaginal pessaries). Oral and intravaginal treatments have been found to be equally effective in treating thrush, with around 80% of women being successfully treated. 

Topical creams are also available to treat sore parts of the vulva (the external sexual organs).

In all cases of thrush, you should go back to your GP if, following treatment, your symptoms have not cleared up.

Oral antifungal treatment

Oral antifungal treatment is usually recommended for girls who have vaginal thrush and are between 12-16 years of age. They are not suitable if you are pregnant or breastfeeding (see below). The two oral antifungal treatments that are usually prescribed are fluconazole or itraconazole.

Oral antifungal treatments can cause side effects including:

  • nausea (feeling sick),
  • vomiting,
  • headache,
  • diarrhoea,
  • flatulence (wind),
  • constipation (being unable to empty your bowels),
  • bloating, and
  • an upset stomach.

Intravaginal pessaries

Intravaginal pessaries that are often prescribed for thrush include:

  • clotrimazole,
  • econazole, and
  • miconazole.

Intravaginal pessaries do not cause as many side effects as oral antifungal treatments, but they can:

  • be awkward to use,
  • cause a mild burning sensation, slight redness, or itching, and
  • damage latex condoms and diaphragms. You should therefore use another form of contraception while using intravaginal pessaries.

Pregnant and breastfeeding women

If you are pregnant or breastfeeding, you should not use any medication that is available over-the-counter (OTC) in a pharmacy. Instead, you should visit your GP.

You will not be prescribed oral antifungal treatment because these may affect your baby. However, you may be prescribed an intravaginal pessary, such as clotrimazole, econazole, or miconazole, to be used for at least seven days.

If you are pregnant, you should take care when inserting a pessary, because there is a risk of causing injury to your cervix (the neck of the womb). To reduce the risk, you may prefer to insert the pessaries by hand, instead of using the applicator.

If you have vulval symptoms, such as vulval soreness, you may also be prescribed a topical imidazole cream.

Self help

Some oral and topical medications that can be used to treat vaginal thrush are available over-the-counter (OTC) from your pharmacist, without a prescription. For example, flucanozole is available OTC as a single-dose tablet for treating thrush. These can be useful for treating thrush if you have had the condition before and it has returned.

However, if you have developed the symptoms of thrush for the first time, you should visit your GP in order to confirm the diagnosis. OTC treatments should also not be used long-term without first seeking medical advice and, if your symptoms have not improved within 7-14 days, you should visit your GP.

If you have thrush, as well as using OTC treatments, there are a number of other self-help techniques you can try. These include:

  • washing your vaginal area using water - avoid using perfumed soaps, shower gels, vaginal deodorants, or douches,
  • not using latex condoms, spermicidal creams, and lubricants, if they cause irritation to your genital area,
  • not wearing tight-fitting, synthetic (man-made) clothes, and
  • wearing cotton underwear and loose-fitting clothes, whenever possible.

Treating recurrent thrush

If you have recurrent episodes of thrush, your GP may run some further tests to confirm the diagnosis and rule out any other possible conditions (see diagnosis). Your GP may suggest a longer course of antifungal treatment, or may give you a prescription that you can use whenever the symptoms return. 

Some research has also suggested that using a treatment strategy known as 'maintenance therapy' can help to reduce the reoccurrence of thrush. Maintenance therapy involves taking an oral, or intravaginal, antifungal on a weekly or monthly basis for up to six months.

This has been found to reduce the reoccurrence of thrush during treatment, and may also help to protect against thrush even after the treatment has stopped. 

view information about Thrush on www.nhs.co.uk »

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