vaginal thrush

Question 1

what are the symptoms of vaginal thrush?

Answer 1

• Vulval itching (often the defining symptom)
• Vulval soreness and irritation
• Vaginal discharge (usually white, ‘cheese-like’, and non-malodorous)
• Superficial dyspareunia
• Dysuria (pain or discomfort during urination)

Question 2

what are the red flags of vaginal thrush?

Answer 2

• Recurrent infection — defined as four or more episodes in 1 year, with at least partial resolution of symptoms between episodes
• Severe infection as defined by symptom severity
• Infection during pregnancy
• Infection in women with uncontrolled diabetes, women with immunocompromising
conditions (such as HIV infection), and women taking immunosuppressive drugs (such as
systemic corticosteroids)
• Treatment failure
• Age under 16 or over 60

Question 3

what is the lifestyle advice for vaginal thrush?

Answer 3

• Avoid the following potential predisposing factors:
o Washing and cleaning the vulval area with soap or shower gels (including those
containing perfume and antiseptics)
o Cleaning the vulval area more than once a day
o Washing underwear in biological washing powder and using fabric conditioners. o Wearing tight-fitting and/or non-absorbent clothing
• Use a simple emollient to moisturise the vulval area

Question 4

what are the drug treatment options for vaginal thrush?

Answer 4

• Topical antifungal creams e.g. clotrimazole 1% or 2% cream
• Oral antifungals e.g. fluconazole 150mg capsule
• Intravaginal creams e.g. clotrimazole 10%
• Combinations preparations can also be bought OTC which contain a combination of either
two creams or a pessary and a cream

Question 5

what are other things to be cautious of when patient presents with thrush?

Answer 5

• Foul smelling or purulent discharge could indicate a bacterial infection
• Urinary frequency and urgency could indicate a urinary tract infection (UTI)
• Abnormal vaginal bleeding could indicate an STI or cancer

all of these would need referring to a doctor