Candidiasis (thrush) - Treating vaginal thrush

For mild vaginal thrush, a short course of anti-thrush medicine may be recommended. It is usually taken for one to three days.

If your thrush symptoms are more severe, you'll need to take the treatment for longer.

Anti-thrush medicines are available as:

• an anti-thrush pessary – to deal with Candida in the vagina. A pessary is a specially shaped pill that you insert into your vagina using an applicator, similar to how a tampon is inserted
• an anti-thrush cream – to deal with Candida on the skin around the vagina's entrance
• anti-thrush tablets – which can be used instead of creams and pessaries; these are swallowed and are called oral treatments

Pessaries and oral treatments have been found to be equally effective in treating thrush. Around 80% of women are successfully treated regardless of the type of medication they use. 

Deciding on the type of treatment

Many women use anti-thrush pessaries and creams to treat a straightforward bout of thrush. Pessaries and creams are recommended if you're pregnant or breastfeeding.

Oral treatments are simpler and more convenient than pessaries and creams, but they can have side effects. Both are equally effective.

Anti-thrush tablets

The two main types of anti-thrush tablets that are prescribed by doctors to treat vaginal thrush contain the antifungal medicines or itraconazole. If you prefer to use a cream, you can use an emollient moisturiser rather than an antifungal cream.

Anti-thrush tablets can cause side effects, including:

• nausea
• vomiting
• headache 
• diarrhoea 
• wind
• constipation 
• bloating
• an upset stomach

Anti-thrush pessaries

Pessaries that are often prescribed for thrush include the anti-fungal medicines:

• clotrimazole
• econazole
• miconazole

Vaginal pessaries are not absorbed into the body, but they can:

• be awkward to use
• cause a mild burning sensation, slight redness or itching
• leave a white or creamy stain on your underwear (it washes out)
• damage latex condoms and diaphragms, so you will have to use another form of contraception while using them

You shouldn't use vaginal pessaries without seeing a doctor. Read more about why vaginal pessaries should not be used frequently.

Pharmacy anti-thrush treatments

Some tablets, creams and pessaries to treat vaginal thrush are available over the counter from your pharmacist, and a prescription is not needed.

Anti-thrush pessaries and creams containing clotrimazole are widely sold from pharmacies under the brand name Canesten.

Fluconazole is also available over the counter from pharmacies as a single-dose tablet for treating thrush, under the brand names Diflucan and Canesten Oral.

These treatments can be effective if you've had thrush before. However, don't buy medication directly from a pharmacy if it's your first bout of thrush. Visit your GP first.

You shouldn't use over-the-counter thrush treatments for a long period of time without talking to your GP.

Advice if you're pregnant or breastfeeding 

If you have thrush and you're pregnant or breastfeeding, you should always visit your GP rather than buying anti-thrush medication directly from a pharmacy.

You won't be prescribed oral treatment because it may affect your baby. An anti-thrush pessary – such as clotrimazole, econazole or miconazole – will usually be prescribed.

If you're pregnant, take care when inserting a pessary as there's a small risk of injuring your cervix (neck of the womb). To reduce the risk, insert the pessaries using your finger instead of using the applicator.

If you have symptoms around your vulva, such as itching and soreness, you may also be prescribed an anti-thrush cream. Between attacks you may also want to use a regular moisturiser around the vagina. For example, E45 cream can be used as a soap substitute. After applying, wash it off then apply a greasier moisturiser to protect the skin. However, be aware that moisturisers can weaken condoms.

Complementary therapies

Some women find that complementary therapies, such as bathing the genital area with diluted tea tree oil gel or plain bio-live yoghurt, ease the symptoms of thrush.

However, tea tree essential oil can sometimes irritate the skin. You should not use more than one or two drops in the bath, and if there is any irritation, stop using the oil and wash the area with clean, warm water.

Although using yoghurt won't do you any harm, there's no evidence to suggest that it will relieve the symptoms of thrush or help treat it. It should not be considered as the main treatment method.

If you want to try using plain live yoghurt, one method is to smear it directly over the vulva to ease any soreness or irritation, and then insert it directly into the vagina.

The easiest way to do this is to use a tampon with an applicator. Push the tampon back inside the applicator, add about one teaspoon of plain live yoghurt to the space and insert the tampon in the usual way. Remove the tampon an hour later.