About three-quarters of women will have vaginal thrush during their lifetime – but some have persistent symptoms
About three-quarters of women will have vaginal thrush during their lifetime – but some women have persistent symptoms.
Vaginal thrush is caused by the Candida albicans yeast, which lives in the vagina (usually without causing symptoms).
Not all women with itchy vaginas had thrush, but acute thrush was often over-diagnosed, said Associate Professor Gayle Fischer, gynecological and pediatric dermatologist at the University of Sydney.
“Patients usually assume that anything that itches on the vulva is thrush,” she said.
“So do pharmacists. And actually, so do a lot of general practitioners.
“It is only after the topical antifungal medications have been used numerous times and failed to improve the patient’s symptoms that people start to ask questions about what else could possibly be going on.”
On the other hand, chronic thrush is something that is “terribly under-diagnosed”, she said.
Patients with chronic thrush are symptomatic all of the time. “They are terribly distressed because they are always itchy and always sore,” said Associate Professor Fischer.
Symptoms include dyspareunia, painful splitting and swelling after intercourse and stinging during urination.
“It is ruining their life,” said Associate Professor Fischer. “They can’t have sex. They can’t wear fashionable clothes because anything tight will feel more itchy. They can’t do things like sport, ride a bike, go to the gym. They can’t last a day at the office without having to rush to the toilet to have a scratch. If you look at quality of life in these patients, they are pretty much off the scale.”
In the following 15-minute video, Associate Professor Fischer answers the following questions:
- Is an itchy vulva always thrush?
- What is a typical presentation of chronic thrush?
- What should you look for when examining a patient that may have chronic thrush?
- Are there many investigations that should be done for chronic thrush?
- Is the pathophysiology of chronic thrush the same as acute thrush?
- What is the best way to treat chronic thrush?
- What is the DLQI?
- How do you advise patients who are using alternative therapies for their chronic thrush?
- Is chronic thrush different to recurrent thrush?
- Any take home messages?
