Itching to hush irritating thrush?

Posted 9 February 2018 in Men's Health, Sexual Health, Womens health

A man and woman itching with thrushOne of the numerous infections that can be caused by a type of yeast known as Candida, thrush affects around 75% of women at some point in their life, and can affect men too. It can be a nuisance, causing discharge, discomfort and irritation, but if you find it’s a common occurrence it may be a sign of an underlying problem. (1)

What is thrush?

Thrush, also known as candidiasis, is the name given to a number of skin and mucous membrane infections involving Candida, which is a group of several species of yeast (fungus). In society, ‘thrush’ is generally defined as vaginal or penile candidiasis, so the same definition applies to the term ‘thrush’ in this blog hereafter. (2)

Symptoms of thrush in women include an odourless vaginal discharge with the appearance of cottage cheese, irritation and itching of the vagina and vulva, and pain or stinging on urination or during sex. For men, thrush can cause irritation and burning of the head of the penis and beneath the foreskin, pain on retraction of the foreskin, a cottage cheese-like discharge and odour. But not everyone with thrush will have all of the according symptoms listed - in fact, it is possible to have thrush without any symptoms. (2)

What causes thrush?

Candida and certain species of bacteria, known collectively as flora, live naturally in the vagina and are beneficial in that they keep the acidity of the vagina at a healthy level. However, particular factors can upset the balance of the flora and allow Candida to proliferate, leading to thrush. Such factors include antibiotics, pregnancy, being post-menopausal, poorly controlled diabetes, a compromised immune system or broken or irritated skin in the vagina. Sometimes, having sex or even periods can bring on an episode of thrush. (2)

Men may develop penile thrush through sex with a female partner who has vaginal thrush. (2)

How is thrush treated?

If you think you’ve got thrush for the first time, you’ll need to visit your GP for a diagnosis and to rule out anything else. Treatment comes in various forms, namely external and vaginal creams, pessaries and oral capsules. (2, 3)

The mainstay of treatment of thrush in women is a pessary or vaginal cream containing clotrimazole, an antifungal. The pessary or cream usually only needs to be inserted into the vagina once, as long as the high strength is used. Lower strengths are available, but they will need to be used more than once. Other, less common antifungals used in this way include econazole and miconazole. (3)

If the vaginal forms of treatment are unsuitable, fluconazole and itraconazole antifungal capsules are available. Again, fluconazole can be taken as a single dose. (3)

To ease itching and irritation of the vulva while the above treatment takes effect, creams containing antifungals such as clotrimazole can be applied to the area several times a day. (3)

To treat thrush in men, a cream containing an antifungal such as clotrimazole may be applied to the penis, or oral fluconazole can be taken as a single dose. As for women, the cream can be used alongside the capsule to ease symptoms while the capsule works. (3, 4)

If you’ve already had a diagnosis of thrush in the past, you can visit a pharmacy instead of the GP where you can buy clotrimazole-containing external and vaginal creams, clotrimazole pessaries and fluconazole capsules over the counter.

When else will I need to see the GP?

As well as experiencing symptoms for the first time, there are several other instances when you will need to see your GP or visit a sexual health clinic when you develop thrush:

If you fall into one or more of these groups, the healthcare professional you see may need to look at the area to gauge whether it’s thrush or a different infection. If they’re unsure, they may take a sample of the discharge using a cotton swab to send off for testing. If you get recurrent thrush, your GP may run tests to check if there is an underlying problem with your immune system. (2)

In men, thrush can develop into a condition called balanitis. The head of the penis and the foreskin can become red, painful and inflamed, with associated foul-smelling discharge and painful urination. If you think you have balanitis you should visit your GP. (5)

Can I prevent thrush?

There are certain steps you can take to try to prevent bouts of thrush in the future. Opt for showers as opposed to baths, use non-perfumed intimate washes or emollients rather than soap on the groin area, and dry thoroughly afterwards. Wear loose-fitting cotton underwear where possible and don’t douche or use deodorants on your intimate area. (2)

References

  1. raTrust. Vaginal Thrush Overview [cited 7 February 2018]. Available at: https://ratrust.org.uk/sexual-health/stis/vaginal-thrush/overview
  2. NHS Choices. Thrush in men and women [cited 7 February 2018]. Available at: https://www.nhs.uk/conditions/thrush-in-men-and-women/
  3. British National Formulary (version 1.3.4) [Mobile application software]. Retrieved from: www.bnf.org
  4. Canesten. Thrush in Men [cited 7 February 2018]. Available at: https://www.canesten.co.uk/en/female/female-knowledge/thrush-in-men/
  5. NHS Choices. Balanitis [cited 7 February 2018]. Available at: https://www.nhs.uk/conditions/balanitis/

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