Vulvovaginal thrush commonly causes itching and irritation around the vulva or inside the vagina, which can range from mild to severe. The area may feel sore, tender or swollen, and the skin can appear red or inflamed. Many people notice a thick, white vaginal discharge, often described as looking like cottage cheese. This discharge does not usually have a strong or unpleasant smell.
Other symptoms can include a burning or stinging sensation when passing urine, discomfort or pain during sex, and soreness or small cracks in the skin around the vulva. Some people may notice increased discomfort just before their period. Symptoms can vary from person to person and may be more noticeable at night or after exercise.
Treatment depends on age and symptoms. Under the Common Conditions Service, our pharmacists can assess and treat females aged 16 to 60 years, where symptoms are consistent with uncomplicated vulvovaginal thrush.
Treatment for vulvovaginal thrush usually involves a short course antifungal medicine, and both vaginal and external treatments are effective. Most people are treated with a vaginal pessary, inserted at night for one, three or six days depending on the product used. An antifungal cream may also be recommended for use on the outside of the vulva to help relieve itching, redness and soreness.
In many cases, a cream alone is not enough to fully treat thrush and is best used alonside a vaginal pessary. The choice of treatment depends on where the symptoms are located, personal preference and product availability. If symptoms include significant inflammation or irritation of the vulva, a combination cream contraining an antifungal and a mild steroid my be advised for short-term use.
It is important to complete the full course of treatment. Menstrual bleeding can reduce the effectiveness of vaginal treatments, so treatment is best completed before a period starts or restarted once bleeding has eased.
Some people will need referral to a GP for assessment, including those who are pregnant, have recurrent thrush, diabetes, symptoms that do not improve, or symptoms that suggest another cause such as bacterial vaginosis or a sexually transmitted infection.
Alongside treatment, good skincare can help symptoms settle and reduce the risk of thrush coming back:
Thrush can sometimes be passed to sexual partners. A partner does not usually need treatment unless they have symptoms. Vaginal treatments may reduce the effectiveness of condoms, so extra contraception may be needed during treatment.
