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Thrush: what to do

Tuesday, May 16, 2006
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"Doctor, I've got a discharge!" This is one of the most frequent complaints that leads women to visit their doctors. Vaginal thrush is an extremely common condition. It has been estimated that about 75 percent of adult women will have at least one attack during their lives and 50 percent will have it more than once. Its symptoms include a discharge and an often quite intense itch. But Candida can also live in the vagina without causing any symptoms — it has been found in 15 to 30 percent of women who have no itch or discharge.

What is normal discharge?
Some of us live by the old saying "cleanliness is next to godliness", with the result that we over-clean ourselves. There is absolutely no need to clean inside the vagina; it is a totally self-cleansing organ. Don't bow to advertising hype and think you must douche or cover up your feminine scent; any introduced solutions, soaps and deodorants may upset the balance of the community of micro-organisms that inhabit the vagina. Women have a natural discharge from their vaginas, and it is not a sign that anything is wrong. As part of the body's self-cleaning process, mucus is produced from the glands of the cervix, endometrium, oviducts and vulva. There is also a fluid produced by the vaginal wall itself.

The result is a whitish discharge which may become a yellow or brown stain when it dries on your underwear. You may notice this discharge increase at the time of ovulation, before menstruation and with sexual arousal. A fishy odour may be noticeable, particularly after sexual intercourse; this is also quite normal.

When is a discharge abnormal?
You should be concerned if you notice any of the following symptoms:

  • A significant increase in the amount of vaginal discharge.
  • A change in the colour of the discharge.
  • Change in the odour.
  • Itchiness or soreness of the vulva.
  • Pain with intercourse.
  • Stinging, burning or pain with urination.

Discharge due to thrush
You may just be aware of itchiness and general discomfort when you have vaginal thrush, or you may have a discharge. This discharge is generally described as being thick, cream or white in colour, and looking like cottage cheese. Sometimes the discharge is not obvious — but the intense itching usually gives thrush away! The skin of the vulva and perineum may be involved as well, and you may experience a rash, swelling, soreness or burning and sometimes splitting of the skin.

Talk to a health professional
In the past few years, treatment for thrush has become available 'over the counter' in a pharmacy. This is extremely useful for women who have experienced the condition in the past, and who simply want to get on with treatment. The pharmacist is able to discuss the use of the medication with you and give you advice about the most appropriate treatment. If there is any concern as to the accuracy of the diagnosis or the symptoms do not resolve with a course of treatment — you should consult your doctor.

Consulting your doctor
Vaginal discharge is such a common problem that you should not feel embarrassed about discussing it with your doctor. In most cases, diagnosis is a straightforward affair. The doctor will first ask you some questions and it is important to give honest answers, even if you feel a little embarrassed. There are medical reasons for asking these questions and the doctor needs your answers to make a diagnosis. Remember, medical consultations are confidential and no doctor is going to reveal anything about you to a third person, such as your partner or your mother, unless you give him or her specific permission to do so.


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