Thrush in pregnancy

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What is thrush?

Thrush (vaginal candidiasis) is caused by an overgrowth of yeast (candida) in the vagina. We all have yeasts and bacteria on our skin, and it’s normal for candida it to be present in the vagina. However, if the balance of these is disrupted, then one can overgrow, causing problems such as thrush. This is very common in pregnancy; as our hormones change and oestrogen levels increase, the environment of the vagina changes and this can predispose to thrush.

Thrush in pregnancy is not harmful to the baby. While the baby is in the womb it is not exposed to thrush. During delivery, it is possible for the baby to catch thrush. This is straightforward to treat using antifungal drops.

Thrush symptoms

Thrush symptoms are varied. Thrush commonly causes itching of the vagina or vulva (the skin around the vagina). It can also cause soreness and general irritation, which can lead to pain while passing urine or having sex.

Thrush also causes a characteristic white, cottage cheese-like discharge. This is not normally malodourous.

Thrush treatment

Thrush treatment involves using antifungal medications. During pregnancy, you will need to contact your GP for a prescription (outside of pregnancy they can be purchased over the counter). If you are uncertain about thrush symptoms, then it may be safer to see your GP.

Antifungal pessaries (vaginal tablets) and cream are safe in pregnancy. Clotrimazole or fluconazole pessaries are inserted into the vagina. Additionally, clotrimazole cream can be used 2 to 3 times per day to relieve vulval symptoms. Oral antifungal tablets should not be used in pregnancy.

In addition to this, it is also useful to follow the guidance below on how to prevent thrush.

If your symptoms do not resolve in 7 days, you should see your GP. Treatment failure is common, as is a recurrence of thrush in pregnancy. If this is an issue, you should see your GP. They can then do any further investigations required, such as taking a vaginal swab.

Preventing thrush

There are a number of steps you can take to help prevent thrush. These measures are also useful in thrush treatment:

• You should wash the area around your vagina once a day using a soap substitute, such as aqueous cream. You can then use a simple, perfume-free moisturising cream.
• You should avoid all soaps, shower gels, wipes and feminine hygiene products as these tend to be drying and irritant. Vaginal douching should also be avoided as this can disrupt the balance of the yeasts and bacteria.
• Clothing should be loose-fitting where possible, and you should avoid biological washing powder and fabric conditioner.
• Probiotics such as yoghurts are helpful. These can be eaten or used on the skin in the treatment of thrush.

Main points

• • Thrush (vaginal candidiasis) is caused by an overgrowth of yeast (candida) in the vagina.
  • It’s normal for yeast and other bacteria to be present in the vagina, but when the balance is disrupted, it can lead to thrush.
  • Thrush in pregnancy is not harmful to the baby.
  • If you have thrush at the time of childbirth, it’s possible for your baby to catch thrush during delivery, but this is easily treated with antifungal drops.
  • Thrush usually causes itching of the vagina and vulva, thick white discharge, and pain while passing urine or having sex.
  • Thrush can be treated with over-the-counter antifungal medications, such as creams and pessaries. You will need a prescription from your GP if you’re pregnant.
  • During pregnancy, it is common for thrush treatment to fail and for the condition to recur. If your thrush doesn’t resolve in a week, see your GP for further guidance.
  • There are a number of steps you can take to help prevent thrush, which can be used as effective treatment methods.
  • These include washing your vagina with a soap substitute and using a perfume-free moisturising cream, avoiding shower gels and feminine hygiene products, wearing loose-fitting clothing, and applying probiotics to the area.