Vaginal Thrush: Symptoms, Causes & Treatment

16 min read
Vaginal Thrush: Symptoms, Causes & Treatment

Vaginal thrush is extremely common. It can cause intense itching, burning, soreness and a thick white discharge, although symptoms can vary and discharge isn’t always present.

Thrush is caused by an overgrowth of Candida, a type of yeast that can normally live in the vagina without causing any problems.

That last part is important. Candida itself isn’t always abnormal. Thrush develops when Candida multiplies enough to cause inflammation and symptoms.

Many people recognise the familiar itch of thrush and successfully treat an occasional episode with an antifungal from the pharmacy. But if it’s your first episode, treatment isn’t working or symptoms keep returning, it’s worth getting checked rather than assuming every vaginal itch is thrush.

Key takeaways

  • Vaginal thrush is caused by an overgrowth of Candida yeast, most commonly Candida albicans.
  • Candida can normally be present in the vagina without causing symptoms and doesn’t need treatment simply because it is detected.
  • Common symptoms include vulval itching, burning, soreness, redness and sometimes thick white discharge.
  • Thrush usually doesn’t cause the strong fishy smell commonly associated with bacterial vaginosis.
  • Vaginal antifungal creams and pessaries are common treatments and oral fluconazole is another option for some people.
  • Oral fluconazole and boric acid shouldn’t be used to treat vaginal thrush during pregnancy.
  • Recurrent thrush is generally defined in Australian guidance as four or more episodes within 12 months and deserves proper investigation.
  • Sexual partners don’t usually need treatment unless they develop symptoms.
  • Menstrual cups haven’t been shown to increase the risk of vaginal infections when used appropriately.

On this page

What is vaginal thrush?

Vaginal thrush, also called vulvovaginal candidiasis or a vaginal yeast infection, is caused by an overgrowth of Candida yeast.

Candida albicans causes most cases, although other Candida species can sometimes be involved, particularly when thrush keeps returning or doesn’t respond to standard treatment.

Candida can normally live on the skin and in areas including the mouth, bowel and vagina without causing disease.

So having Candida present doesn’t necessarily mean you have thrush.

It becomes a problem when the yeast overgrows and triggers inflammation, producing symptoms such as itching, burning or soreness.

What are the symptoms of vaginal thrush?

Typical symptoms include:

  • intense vulval itching
  • burning or soreness around the vulva and vaginal opening
  • redness or swelling
  • small cracks or splits in irritated vulval skin
  • stinging when urine touches irritated skin
  • pain or discomfort during sex
  • thick white or clumpy vaginal discharge

The discharge is often described as cottage-cheese-like, but not everyone with thrush develops this appearance. Discharge may look relatively normal or be absent.

A strong unpleasant or fishy smell is less typical of thrush.

Because several vaginal and vulval conditions can cause itching, soreness or discharge, symptoms alone aren’t always enough to confirm the diagnosis.

For a broader look at discharge changes, read our guide to vaginal discharge and what’s normal.

Thrush vs bacterial vaginosis: what’s the difference?

Thrush and bacterial vaginosis are two common causes of vaginal symptoms, but they involve different changes and require different treatments.

Thrush Bacterial vaginosis
Cause Overgrowth of Candida yeast Change in the vaginal bacterial community
Discharge Often thick, white or clumpy, but may be normal or absent Often thin, watery, white or grey
Smell Usually no strong fishy smell A fishy smell is common
Itching Often prominent Usually less prominent
Vulval redness or soreness Common Less typical
Treatment Antifungal treatment Antibiotic treatment

 

If you aren’t sure which condition you have, particularly if symptoms are new, recurrent or different from previous episodes, getting tested is more useful than trying several treatments and hoping one works.

Read our complete guide to bacterial vaginosis (BV).

What causes vaginal thrush?

Thrush develops when Candida that is already present, or has colonised the area, multiplies enough to cause symptoms.

Sometimes there is no obvious reason why this happens.

Factors associated with thrush can include:

Antibiotics

Antibiotics can alter the normal bacterial community of the vagina, making Candida overgrowth more likely in some people.

This is why some people regularly notice thrush after a course of antibiotics.

Pregnancy and higher oestrogen levels

Thrush is more common during pregnancy.

Higher oestrogen levels can create conditions that favour Candida growth, which may also help explain why some people notice thrush with particular hormonal treatments.

Diabetes

Poorly controlled diabetes can increase the likelihood of Candida infections.

Repeated thrush can occasionally be one reason a doctor considers checking blood glucose levels.

A weakened immune system

Conditions or medicines that suppress immune function can increase susceptibility to Candida infections.

Vulval irritation

Fragranced washes, soaps, douching and other irritating products can cause burning and itching in their own right.

They don’t necessarily cause Candida overgrowth, but irritated tissue can make symptoms harder to interpret and may make an existing episode feel worse.

Read our guides to vulvitis and vaginal douching for more.

What about sugar?

You may have heard that eating sugar causes vaginal thrush or that eliminating sugar will cure it.

The relationship isn’t that straightforward.

Persistently high blood glucose associated with poorly controlled diabetes can increase susceptibility to Candida infections, but that isn’t the same as saying eating a dessert causes thrush.

There isn’t good evidence that everyone with vaginal thrush needs to follow a restrictive or sugar-free diet.

Is vaginal thrush sexually transmitted?

Thrush isn’t considered a sexually transmitted infection.

It can occur without any sexual activity at all.

Candida can sometimes be exchanged between sexual partners, but routine partner treatment isn’t recommended.

If your partner develops symptoms such as penile redness, itching, soreness or inflammation, they should seek treatment for their own symptoms.

Sex itself can also make an active episode of thrush feel more painful because inflamed vulval or vaginal tissue is easily irritated by friction.

There’s no rule that you must avoid sex entirely, but it makes sense to wait if sex is uncomfortable.

Some vaginal antifungal creams can also weaken latex condoms or diaphragms. Check the product instructions or ask your pharmacist about compatibility during treatment.

How is vaginal thrush diagnosed?

If you’ve had medically confirmed thrush before and the symptoms feel identical, your pharmacist may be able to recommend an over-the-counter treatment.

But not every episode of vaginal itching is thrush.

A doctor may diagnose thrush by asking about your symptoms and examining the vulva and vagina.

A vaginal swab may also be taken to look for Candida.

Testing becomes particularly useful when:

  • this is your first suspected episode
  • symptoms are unusual
  • treatment hasn’t worked
  • symptoms quickly return
  • you have recurrent episodes
  • another diagnosis is possible

Importantly, Candida found on a swab doesn’t always need treatment if you have no symptoms because Candida can be part of the normal vaginal flora.

How is vaginal thrush treated?

Uncomplicated vaginal thrush is usually treated with an antifungal medicine.

Vaginal creams and pessaries

Azole antifungal medicines such as clotrimazole can be used as:

  • vaginal creams
  • pessaries or vaginal tablets

Depending on the product, treatment may involve a single dose or a course over several days.

External antifungal cream may also be recommended when there is significant vulval itching or irritation.

Follow the instructions for the particular product rather than stopping as soon as symptoms begin to improve.

Oral fluconazole

Fluconazole is an oral antifungal medicine that can be used for uncomplicated vaginal thrush in some non-pregnant people.

It isn’t suitable for everybody and can interact with other medicines, so ask your pharmacist or doctor whether it is appropriate for you.

Oral fluconazole shouldn’t be used to treat vaginal thrush during pregnancy.

How quickly should thrush improve?

Symptoms should generally improve after appropriate antifungal treatment, although irritated tissue can take a little longer to settle completely.

If symptoms don’t improve, don’t just keep repeating antifungal treatments.

It may not be Candida, the Candida species may be less responsive to standard treatment or another vulval or vaginal condition may be contributing.

What is recurrent vaginal thrush?

Australian STI guidance defines recurrent vulvovaginal candidiasis as four or more episodes in a 12-month period.

If this is happening, it’s worth moving beyond repeated pharmacy treatment and getting the diagnosis confirmed.

Your doctor may:

  • examine the vulva and vagina
  • take a vaginal culture or other laboratory test
  • identify whether Candida albicans or another Candida species is involved
  • consider diabetes, immune problems, recent antibiotics or other contributing factors
  • consider whether another vulval or vaginal condition could be causing the symptoms

Recurrent Candida albicans may be treated with a longer initial course of antifungal treatment followed by maintenance treatment.

Australian STI Guidelines include a regimen using oral fluconazole during an initial treatment phase followed by weekly fluconazole for six months, where appropriate.

Vaginal treatment can be used as an alternative in some circumstances.

This sort of long-term treatment should be managed with a healthcare professional rather than self-prescribed.

What if ordinary thrush treatment keeps failing?

Repeated symptoms despite antifungal treatment deserve a closer look.

Possibilities include:

  • a non-albicans Candida species
  • antifungal resistance or reduced susceptibility
  • bacterial vaginosis
  • vulval dermatitis or another skin condition
  • vaginitis from another cause
  • genitourinary syndrome of menopause
  • vulvodynia or another pain condition
  • a sexually transmitted infection

This is why years of treating every itch as “another bout of thrush” can sometimes delay the right diagnosis.

Thrush during pregnancy

Thrush is common during pregnancy because hormonal changes can make Candida overgrowth more likely.

Topical vaginal antifungal treatments are generally used during pregnancy, often for a longer course than would be needed for uncomplicated thrush outside pregnancy.

Australian STI Guidelines recommend at least seven days of topical treatment where treatment is needed during pregnancy.

Oral fluconazole and boric acid shouldn’t be used to treat vaginal thrush during pregnancy.

If you’re pregnant and think you have thrush, speak with your GP, midwife, pharmacist or maternity healthcare provider before starting treatment.

Thrush, perimenopause and menopause

Thrush can occur around perimenopause and after menopause, but not every episode of vaginal burning, dryness or irritation during this stage of life is Candida.

Falling oestrogen can cause changes to vaginal and vulval tissue known as genitourinary syndrome of menopause (GSM).

GSM can cause:

  • dryness
  • burning
  • irritation
  • pain during sex
  • urinary symptoms

Those symptoms can easily be mistaken for recurrent thrush.

Thrush also tends to become less common after menopause in people who aren’t using oestrogen therapy, although it can still occur.

If you’re repeatedly treating “thrush” during perimenopause or after menopause without much improvement, ask your doctor whether GSM, a vulval skin condition or another cause could be contributing.

Read more about vaginal health in perimenopause and vaginal dryness.

Can menstrual cups or discs cause thrush?

Current evidence doesn’t show that appropriately used menstrual cups increase the overall risk of reproductive tract or vaginal infections.

A 2026 systematic review of menstrual cup use and vaginal health found no increased infection risk across the infections evaluated, although research into individual infections remains limited.

There isn’t good evidence that menstrual cups or reusable menstrual discs specifically cause vaginal thrush.

Good hygiene still matters:

  • wash your hands before inserting or removing a cup or disc
  • clean the product according to the manufacturer’s instructions
  • avoid leaving cleanser residue on the product
  • follow recommended wear times

If your vulva or vagina is very sore during an active episode of thrush, inserting and removing an internal product may simply be uncomfortable.

There’s nothing wrong with switching temporarily to an external product such as a cloth pad if that feels better.

If you continue using a reusable cup or disc, clean it carefully according to the manufacturer’s instructions before using it again.

What about probiotics and natural remedies for thrush?

There is plenty of interest in supporting the vaginal microbiome through probiotics and other complementary approaches.

Some research is exploring particular probiotic strains, but evidence isn’t strong enough to replace established antifungal treatment for symptomatic vaginal candidiasis.

Boric acid

Boric acid vaginal capsules are sometimes discussed online as a treatment for recurrent thrush.

They may have a role in selected cases of difficult-to-treat or non-albicans Candida under medical supervision, but they aren’t an everyday home remedy.

Boric acid is toxic if swallowed and must never be taken orally.

It should also not be used during pregnancy.

Yoghurt

Eating yoghurt as part of your usual diet is fine, but inserting yoghurt into the vagina isn’t an established treatment for thrush.

Food yoghurt isn’t manufactured or tested as a vaginal medicine and doesn’t provide a controlled dose of an antifungal treatment.

Tea tree oil and essential oils

Essential oils can irritate vulval and vaginal tissue and aren’t recommended as a substitute for antifungal treatment.

Natural doesn’t automatically mean gentle enough for genital tissue.

Vaginal steaming

There is no evidence that vaginal steaming treats Candida infections, and hot steam can burn sensitive vulval tissue.

Can you prevent vaginal thrush?

There isn’t a guaranteed way to prevent thrush and having an episode doesn’t mean you’ve done something wrong.

A few practical habits may help reduce irritation and unnecessary disruption to the vaginal environment:

  • avoid douching or washing inside the vagina
  • avoid fragranced intimate products if they irritate you
  • wash the external vulva gently rather than scrubbing it
  • change out of wet swimwear or sweaty clothes when practical
  • manage diabetes carefully if this applies to you
  • use antibiotics only when medically indicated

You don’t need to keep the vagina “extra clean” to prevent thrush.

In fact, repeated washing and fragranced products can cause irritation that feels very similar to infection.

When should you see a doctor about thrush?

See your GP, sexual health clinician or other qualified healthcare professional if:

  • this is the first time you’ve had these symptoms and you aren’t sure it is thrush
  • antifungal treatment doesn’t work
  • symptoms return shortly after treatment
  • you have four or more episodes in a year
  • you’re pregnant
  • you have diabetes or a condition affecting your immune system
  • your discharge has a strong or unusual smell
  • you have pelvic or lower abdominal pain
  • you have bleeding between periods or after sex
  • you develop sores, blisters or ulcers
  • you have fever or feel generally unwell
  • you have a new sexual partner and STI testing may be appropriate

It’s also worth getting checked if you’ve been treating yourself for “thrush” repeatedly for months or years without a laboratory-confirmed diagnosis.

If appointments about vaginal symptoms feel awkward, our guide to talking to a doctor about vaginal concerns explains how to prepare and what you can ask.

Frequently asked questions

Is vaginal thrush an STI?

No. Vaginal thrush isn’t considered a sexually transmitted infection and can develop without sexual activity. Candida may occasionally be exchanged between partners, but routine partner testing or treatment isn’t recommended unless the partner develops symptoms.

What does thrush discharge look like?

Thrush may cause thick, white or clumpy discharge that is sometimes described as cottage-cheese-like. However, discharge can also look normal or be absent, so appearance alone can’t confirm thrush.

Does thrush smell?

Thrush usually doesn’t cause the strong fishy smell associated with bacterial vaginosis. If odour is the main symptom, particularly with thin greyish discharge, BV or another cause may be more likely and testing can help.

Can you have thrush without discharge?

Yes. Some people mainly experience vulval itching, burning, redness or soreness without an obvious change in discharge.

Can thrush go away on its own?

Mild Candida overgrowth may sometimes settle, but symptomatic thrush is commonly treated with antifungal medicine because symptoms can be very uncomfortable. If you aren’t sure whether the symptoms are actually thrush, getting a diagnosis before repeatedly self-treating is sensible.

Why do I keep getting thrush?

Recurrent thrush can occur without an obvious cause, but factors such as antibiotics, diabetes, increased oestrogen levels, immune suppression or a non-albicans Candida species may contribute. Repeated symptoms can also turn out to be another vulval or vaginal condition, which is why recurrent cases should be properly assessed.

How many times a year counts as recurrent thrush?

Australian STI Guidelines define recurrent vulvovaginal candidiasis as four or more episodes within a 12-month period.

Do I need to treat my partner for thrush?

Usually not. Routine treatment of asymptomatic sexual partners isn’t recommended. A partner who develops symptoms such as genital redness, irritation or itching should seek treatment for their own symptoms.

Can antibiotics cause thrush?

Yes. Antibiotics can alter the bacterial environment of the vagina and make Candida overgrowth more likely in some people.

Can my period cause thrush?

Your menstrual cycle can change the vaginal environment and some people notice symptoms at particular times of the month, but menstruation itself isn’t considered a direct cause of thrush. Repeated cyclical symptoms are worth tracking because irritation or other conditions can sometimes mimic Candida infection.

Can menstrual cups cause thrush?

There isn’t good evidence that appropriately used menstrual cups cause vaginal thrush. Clean your cup according to its instructions and wash your hands before insertion and removal. If internal products feel uncomfortable while you have thrush, use another period product until the irritation settles.

Can probiotics cure vaginal thrush?

Research into probiotics and the vaginal microbiome is ongoing, but probiotics shouldn’t be relied on instead of antifungal treatment for symptomatic candidiasis. Different probiotic products also contain very different organisms and doses, so they can’t be considered interchangeable.

Can thrush be mistaken for something else?

Absolutely. BV, sexually transmitted infections, vulval dermatitis, vulvitis, genital herpes, GSM and other conditions can all cause itching, burning, irritation or changes in discharge. If treatment isn’t working or symptoms keep returning, getting the diagnosis checked is more useful than continuing to assume it is thrush.

Not every itch is thrush

Thrush is common, uncomfortable and usually straightforward to treat.

But its familiarity can also be a trap.

Vulval itching and vaginal irritation have many possible causes, and repeatedly using antifungal treatment when Candida isn’t responsible can delay the treatment you actually need.

If you recognise an occasional, familiar episode and pharmacy treatment works, that may be all that is needed.

If symptoms keep returning, look different from usual or refuse to settle, that is the point to stop guessing and get them properly assessed.

Related reading

Sources and further reading

This article provides general educational information and isn’t a substitute for individual medical advice.