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Innermost Secrets / Innermost Living / Body Clock
Skip Navigation LinksCandidiasis (Thrush)
Page modified at: 21/02/2010

Candidiasis (Thrush)Candidiasis is a common genitourinary infection caused by a fungal / yeast infection.
Although it is usually due to Candida Albicans it can be due to other Candida species or yeasts. Vulvovaginal Candidaiasis (VVC)  an Candida infection of the vulva and vagina in women is extremely common with an estimated 75% of women having  at least one episode of and 40%–45% having  two or more episodes.

 

 

About 10-20% of women will have complicated VVC requiring alternative or further treatment.  It is often silent and about 10-20% of women have Candida in their vaginas which would show up on a swab culture. In the absence of any signs or symptoms of infection then treatment for assymptomatic Candida infection is not required.
 
How is Candidiasis spread?
Vulvovaginal Candidaiasis is not usually acquired through sexual intercourse; treatment of sex partners is not recommended but may be considered in women who have recurrent infection.
 
How do I reduce the risk of catching Candidiasis?

  • Male and female condoms, when used correctly, can help protect against STIs
  • Before you have sex, talk to your partner about using condoms
  • Use condoms every time you have vaginal or anal sex
  • If you have oral sex, use a dam

How do I reduce the risk of passing Candidiasis on to others?
Testing and treating (if appropriate) all sexual contacts helps to prevent the infection being passed on to other but treatment of male sex partners has not been beneficial in preventing the recurrence of Vulvovaginal Candidaiasis.  The surest way to avoid transmission of sexually transmitted diseases, including Vulvovaginal Candidaiasis, is to abstain from sexual contact or to be in a long-term mutually monogamous relationship with a partner who has been tested and is known to be uninfected.  
Avoiding alcohol and drug use may also help prevent transmission of Vulvovaginal Candidaiasis because these activities may lead to risky sexual behavior. It is important that sex partners talk to each other about their HIV status and history of other STDs so that preventive action can be taken.
Transmission of an STD, including Vulvovaginal Candidaiasis cannot be prevented by washing the genitals, urinating, and/or douching after sex. Any unusual discharge, sore, or rash, particularly in the groin area, should be a signal to refrain from having sex and to see a doctor immediately.
 
What are the symptoms of Candidiasis?
Candidiasis  is predominantly identified in women. Male partners are usually asymptomatic  but can develop ballanitis.
Women might notice:

    * Nothing – some are silent
    * Pruritus (itching)
    * vaginal soreness, and redness or swelling
    * pain during sex (dyspareunia),
    * pain passing urine (dysuria)
    * abnormal vaginal discharge (usually curdy thick and white)

Men might notice:

    * Nothing – usually assymptomatic
    * Rarely - ballanitis, which is characterized by red areas on the top (glans) of the penis in conjunction with pruritus or irritation.

What happens if Candidiasis isn't treated?
Without treatment, the infection can cause persistent soreness and discharge but rarely causes major health issues in healthy men and women.
 
How can I reduce the risk of catching Candidiasis?
There are no specific measures to reduce the risk of Candidiasis in otherwise healthy women. Recurrent Vulvovaginal Candidiasis is usually defined as four or more episodes of symptomatic in 1 year, affects a small percentage of women (<5%). The casue is poorly understood, and the majority of women have no apparent predisposing or underlying conditions. Vaginal cultures should be obtained from patients to confirm the clinical diagnosis and to identify unusual species, including nonalbicans species, particularly Candida glabrata. C. glabrata and other nonalbicans Candidia species are observed in 10%–20% of patients with recurrent Vulvovaginal Candidiasis . Conventional antifungal drugs are not as effective against these species as against C. albicans.
 
How do I reduce the risk of passing Candidiasis on to others?
Testing and treating (if appropriate) all sexual contacts helps to prevent the infection being passed on to others.
 
How can I get tested for Candidiasis?
If you think you might have Candidiasis it's important to be tested .
 
NHS:Testing is free on the NHS from genitourinary medicine clinics, sexual health clinics, many contraception clinics, your GP and pharmacies. You can find a clinic to help with Candidiasis by phoning directory enquiries and asking for genitourinary medicine, sexually transmitted disease or venereal disease or locate one using our NHS Genitourinary Medicine Clinic page in the Sexual Health Section of our website.
 
PRIVATE:Alternatively you can have confidential private testing. Telephone               0345 2303386         0345 2303386 or use the Confidential Text Service 07786202070
 
 
How is Candidiasis treated?
Uncomplicated  Vulvovaginal Candidiasis is easy to treat with short courses (single dose and regimens of 1-3 days) of topical antifungal agents with about an 80-90% success rate.
 
Recommended Regimens
Intravaginal Agents: Clotrimazole 1% cream 5 g intravaginally for 7–14 days*  OR Clotrimazole 100 mg vaginal tablet for 7 days  OR Clotrimazole 100 mg vaginal tablet, two tablets for 3 days  OR Miconazole2% cream 5 g intravaginally for 7 days*  OR Miconazole 100 mg vaginal suppository, one suppository for 7 days* OR  Miconazole 200 mg vaginal suppository, one suppository for 3 days* OR Miconazole 1,200 mg vaginal suppository, one suppository for 1 day*
Oral Agent: Fluconazole 150 mg oral tablet, one tablet in single dose
 
The creams and suppositories in this regimen are oil-based and might weaken latex condoms and diaphragms. Refer to condom product labeling for further information.
 
Intravaginal preparations of butaconazole, clotrimazole, miconazole, and tioconazole are available over-the-counter (OTC). Women whose condition has previously been diagnosed with VVC are not necessarily more likely to be able to diagnose themselves; therefore, any woman whose symptoms persist after using an OTC preparation, or who has a recurrence of symptoms within 2 months, should consult their GP.  Unnecessary or inappropriate use of OTC preparations is common and can lead to a delay in the treatment of other vulvovaginitis etiologies, which can result in adverse clinical outcomes.

Complicated  Vulvovaginal Candidiasis
Women with underlying debilitating medical conditions (e.g., those with uncontrolled diabetes or those receiving cor-ticosteroid treatmen and pregnant woment) do not respond as well to short-term therapies. Efforts to correct modifiable conditions should be made, and more prolonged (i.e., 7–14 days) conventional antimycotic treatment is necessary.
Non Candida Vulvovaginal Candidiasis
The optimal treatment of nonalbicans VVC remains unknown. Options include longer duration of therapy (7–14 days) with a nonfluconazole azole drug (oral or topical) as first-line therapy. If recurrence occurs referral to a specialist is advised.

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