Introduction
What is vaginal thrush?
Vaginal thrush, also known as candida, vulvovaginal candidiasis, or vaginal candidosis, is a yeast infection caused by the candida species of fungus, usually Candida albicans.
Thrush most commonly affects women in their thirties and forties, and those who are pregnant. Many women are affected by vaginal thrush at some point in their lives and, in some women, it recurs regularly.
Candida albicans is often found in the vaginas of women who do not have thrush, but the infection commonly causes irritation and swelling of the vagina and vulva. However, in the majority of cases, thrush can be treated effectively.
It is not known what makes some women more prone to thrush than others, but women with poorly controlled dia
Causes
Thrush is caused by a naturally occurring fungus, usually Candida albicans. The fungus is often present in the mouth and vagina and, sometimes, it does not cause any symptoms.
There are a number of factors that have been associated with triggering episodes of thrush. However, with the exception of pregnancy, antibiotics , and poorly controlled diabetes, evidence for individual risk factors has been found to be inconclusive. Accepted risk factors and possible risk factors for thrush are outlined below.
Accepted risk factors
Antibiotics - thrush occurs in about 30% of women who are taking a course of systemic, or intravaginal antibiotics . Although using any type of antibiotics can increase your risk of getting thrush, to develop the condition, the Candida fungus must already be present.
Pregnancy - if you are pregnant, changes in the levels of female sex hormones, such as estrogen, make you more likely to develop thrush. During pregnancy, the Candida fungus is more prevalent (common), and recurrent infection is also more likely.
Diabetes mellitus (poorly controlled) - if you have diabetes mellitus which is not effectively controlled, you are more likely to develop thrush.
Immunodeficiency - if your immune system is weakened by an immunosuppressive condition, such as HIV, or AIDS, your risk of developing thrush is increased. This is because your immune system , which usually fights off infection, is unable to effectively control the spread of the Candida fungus.
Possible risk factors
Contraceptives - it is thought that contraceptives, particularly combined oral contraceptives, increase the risk of thrush. However, the results of studies that have been carried out in this area have been inconclusive.
Sexual behavior - although thrush is more common during the peak years of sexual activity (during the thirties and forties), there is little evidence to support that the condition is spread during sex, or that there is any benefit in treating sexual partners. However, women who have oral sex may be at greater risk of developing thrush.
Tight-fitting clothing - wearing tight-fitting clothing, such as tights, or using panty liners, may increase your chances of developing thrush.
Female hygiene - there is little evidence to suggest that sanitary towels are a risk factor for thrush. There is also no evidence that tampons, or vaginal douching, are risk factors for developing the condition.
Complications
Treatment for thrush using antifungal medication is ineffective in up to 20% of cases. Treatment for thrush is considered to have failed if the symptoms do not clear up within 7-14 days.
Depression and psychosexual problems ( anxiety about having sex) can sometimes occur in women who have recurrent thrush. Your doctor will be able to advise you about specialist treatments, such as counseling , if you have either of these conditions.
In rare cases, candidal balanitis ( inflammation of the head of the penis) can occur in male partners of women who have thrush. Your doctor will usually recommend a course of antifungal medication if you have this condition.
Diagnosis
See your doctor
See your doctor if you have the symptoms of thrush. Your doctor will ask you about your symptoms, and whether or not you have had thrush in the past.
A diagnosis of thrush is usually based on the presence of the symptoms of the condition, such as vaginal itch, discomfort, pain during sexual intercourse, and a thick, creamy, odorless discharge .
Testing
If the recommended treatment fails to relieve your symptoms, if thrush regularly recurs (keeps coming back) or, if your symptoms are particularly severe, you may need to have some tests in order to confirm a diagnosis.
Testing will usually involve a sample of your vaginal secretion being taken for analysis in a laboratory. The test will show whether or not there is yeast in the secretion, and will determine if your symptoms are being caused by other common conditions, such as bacterial vaginosis (another type of vaginal infection), or trichomoniasis, infection with a bacteria call Trichomonas vaginalis (TV).
It is important to remember that vaginal thrush is not a sexually transmitted infection (STD). Your partner will not need to be tested, or treated, for the condition unless they also have symptoms. However, if you are at all concerned about STDs, you should talk to your doctor about being tested.
Prevention
Some women, who have vaginal thrush, use probiotics, such as live yogurts, to help treat and prevent the condition. There is no medical evidence that probiotics are effective but, equally, there is no reason to think that they could be unsafe.
Symptoms
The symptoms of vaginal thrush include:
vulval itching,
vulval soreness and irritation,
vaginal discharge ,
pain , or discomfort, during sexual intercourse (superficial dyspareunia), and
pain , or discomfort, during urination (dysuria) may sometimes be present.
Vulvovaginal inflammation
As well as the above symptoms of thrush, you may also have vulvovaginal inflammation . The signs of vulvovaginal inflammation include:
erythema (redness) - of the vagina and vulva,
vaginal fissuring (cracked skin) - in severe cases of inflammation ,
edema (swelling from a build up of fluid) - also in severe cases of inflammation , and
satellite lesions (sores in the surrounding area) - this is rare, but may indicate the presence of other fungal conditions, or the herpes simplex virus.
Vaginal discharge
A vaginal discharge is a common symptom of vaginal thrush. It is often white and 'cheese-like', but may also be watery or purulent (contain pus). The discharge is usually odorless.
Treatment
If your symptoms of vaginal thrush are mild, your doctor may recommend a short course of antifungal medicine, which will usually need to be taken for between 1-3 days. If your symptoms are more severe, you will need to take the treatment for longer.
Antifungal treatments for thrush can be taken either by mouth (orally), or by inserting them into your vagina (known as intravaginal pessaries). Topical creams are also available to treat sore parts of the vulva.
In all cases of thrush, you should always go back to see your doctor if, following treatment, your symptoms have not cleared up.
Oral antifungal treatment
Oral antifungal treatment is usually recommended for girls who have vaginal thrush and are between 12-16 years of age. Fluconazole, or itraconazole, are two oral antifungal treatments that are usually prescribed. However, oral antifungal treatments can cause side effects that include:
nausea ,
vomiting,
diarrhea ,
constipation
bloating, and
an upset stomach .
Intravaginal pessaries
Intravaginal pessaries that are often recommended include clotrimazole, econazole, or miconazole. They do not cause as many side effects as oral antifungal treatments, but they can:
be awkward to use,
cause mild irritation, and stinging, when they are inserted, and
can damage latex condoms and diaphragms. Therefore, you should use another form of contraception while you are using intravaginal pessaries.
Pregnant and breastfeeding women
If you are pregnant, or breastfeeding, you will not be prescribed oral antifungal treatment because it may affect your baby. Your doctor will probably prescribe an intravaginal pessary, such as clotrimazole, econazole, or miconazole, to be used for at least seven days.
If you are pregnant, you should take care when inserting a pessary, particularly if it has an applicator because there is a risk of causing injury to the cervix . To reduce this risk, you may prefer to insert pessaries by hand.
If you have vulval symptoms, an imidazole cream, such as clotrimazole or econazole, may be recommended in addition to an intravaginal pessary.
Self help
Some oral and topical (creams) medications that can be used to treat vaginal thrush are available from your pharmacist, over-the-counter (OTC), without a prescription. For example, flucanozole is available OTC as a single dose tablet for treating thrush. They can be useful for treating thrush if you have had the condition before and it has returned.
However, if you have developed the symptoms of thrush for the first time, you should visit your doctor in order to confirm a diagnosis because self-diagnosing can be unreliable. Also, OTC treatments should not be used long term without first seeking medical advice and, if your symptoms have not improved within 7-14 days, you should visit your doctor.
If you have thrush, as well as using OTC treatments, there are also a number of other things that you can do to help ease the problem. These include:
washing your vaginal area using water - avoid using perfumed soaps, shower gels, vaginal deodorants, or douches,
avoiding using latex condoms, spermicidal creams, and lubricants, if they cause irritation,
avoiding wearing tight-fitting, synthetic clothes, and
wearing cotton underwear and loose-fitting clothes, where possible.
You should always go back to see your doctor if the symptoms of thrush recur and:
you are under 16 or over the 60 years age,
you are pregnant,
you have abnormal menstrual bleeding, or lower abdominal ( stomach ) pain ,
your symptoms are different from a previous episode of thrush - for example, if the discharge is a different color, or if you have ulcers , or blisters,
you have had two cases of thrush within six months, and you have not consulted a healthcare professional for more than a year,
you, or your partner, have previously had a sexually transmitted infection (STD), or
you have reacted badly to an antifungal treatment in the past, or if they were ineffective.
Treating recurrent thrush
Recent studies have shown using a treatment strategy known as 'maintenance therapy' can significantly reduce the recurrence of thrush.
The studies found that using oral fluconazole on a weekly basis, or using either oral itraconzole, or intravaginal clotrimazole, on a monthly basis, were effective in preventing thrush from recurring.
The studies also found that the level of protection against thrush was reduced when these treatments were stopped.
http://www.wellsphere.com/wellguide.s?articleId=87§ionId=146&searchString=Fishy+Smell+Vaginal+Discharge
What is vaginal thrush?
Vaginal thrush, also known as candida, vulvovaginal candidiasis, or vaginal candidosis, is a yeast infection caused by the candida species of fungus, usually Candida albicans.
Thrush most commonly affects women in their thirties and forties, and those who are pregnant. Many women are affected by vaginal thrush at some point in their lives and, in some women, it recurs regularly.
Candida albicans is often found in the vaginas of women who do not have thrush, but the infection commonly causes irritation and swelling of the vagina and vulva. However, in the majority of cases, thrush can be treated effectively.
It is not known what makes some women more prone to thrush than others, but women with poorly controlled dia
Causes
Thrush is caused by a naturally occurring fungus, usually Candida albicans. The fungus is often present in the mouth and vagina and, sometimes, it does not cause any symptoms.
There are a number of factors that have been associated with triggering episodes of thrush. However, with the exception of pregnancy, antibiotics , and poorly controlled diabetes, evidence for individual risk factors has been found to be inconclusive. Accepted risk factors and possible risk factors for thrush are outlined below.
Accepted risk factors
Antibiotics - thrush occurs in about 30% of women who are taking a course of systemic, or intravaginal antibiotics . Although using any type of antibiotics can increase your risk of getting thrush, to develop the condition, the Candida fungus must already be present.
Pregnancy - if you are pregnant, changes in the levels of female sex hormones, such as estrogen, make you more likely to develop thrush. During pregnancy, the Candida fungus is more prevalent (common), and recurrent infection is also more likely.
Diabetes mellitus (poorly controlled) - if you have diabetes mellitus which is not effectively controlled, you are more likely to develop thrush.
Immunodeficiency - if your immune system is weakened by an immunosuppressive condition, such as HIV, or AIDS, your risk of developing thrush is increased. This is because your immune system , which usually fights off infection, is unable to effectively control the spread of the Candida fungus.
Possible risk factors
Contraceptives - it is thought that contraceptives, particularly combined oral contraceptives, increase the risk of thrush. However, the results of studies that have been carried out in this area have been inconclusive.
Sexual behavior - although thrush is more common during the peak years of sexual activity (during the thirties and forties), there is little evidence to support that the condition is spread during sex, or that there is any benefit in treating sexual partners. However, women who have oral sex may be at greater risk of developing thrush.
Tight-fitting clothing - wearing tight-fitting clothing, such as tights, or using panty liners, may increase your chances of developing thrush.
Female hygiene - there is little evidence to suggest that sanitary towels are a risk factor for thrush. There is also no evidence that tampons, or vaginal douching, are risk factors for developing the condition.
Complications
Treatment for thrush using antifungal medication is ineffective in up to 20% of cases. Treatment for thrush is considered to have failed if the symptoms do not clear up within 7-14 days.
Depression and psychosexual problems ( anxiety about having sex) can sometimes occur in women who have recurrent thrush. Your doctor will be able to advise you about specialist treatments, such as counseling , if you have either of these conditions.
In rare cases, candidal balanitis ( inflammation of the head of the penis) can occur in male partners of women who have thrush. Your doctor will usually recommend a course of antifungal medication if you have this condition.
Diagnosis
See your doctor
See your doctor if you have the symptoms of thrush. Your doctor will ask you about your symptoms, and whether or not you have had thrush in the past.
A diagnosis of thrush is usually based on the presence of the symptoms of the condition, such as vaginal itch, discomfort, pain during sexual intercourse, and a thick, creamy, odorless discharge .
Testing
If the recommended treatment fails to relieve your symptoms, if thrush regularly recurs (keeps coming back) or, if your symptoms are particularly severe, you may need to have some tests in order to confirm a diagnosis.
Testing will usually involve a sample of your vaginal secretion being taken for analysis in a laboratory. The test will show whether or not there is yeast in the secretion, and will determine if your symptoms are being caused by other common conditions, such as bacterial vaginosis (another type of vaginal infection), or trichomoniasis, infection with a bacteria call Trichomonas vaginalis (TV).
It is important to remember that vaginal thrush is not a sexually transmitted infection (STD). Your partner will not need to be tested, or treated, for the condition unless they also have symptoms. However, if you are at all concerned about STDs, you should talk to your doctor about being tested.
Prevention
Some women, who have vaginal thrush, use probiotics, such as live yogurts, to help treat and prevent the condition. There is no medical evidence that probiotics are effective but, equally, there is no reason to think that they could be unsafe.
Symptoms
The symptoms of vaginal thrush include:
vulval itching,
vulval soreness and irritation,
vaginal discharge ,
pain , or discomfort, during sexual intercourse (superficial dyspareunia), and
pain , or discomfort, during urination (dysuria) may sometimes be present.
Vulvovaginal inflammation
As well as the above symptoms of thrush, you may also have vulvovaginal inflammation . The signs of vulvovaginal inflammation include:
erythema (redness) - of the vagina and vulva,
vaginal fissuring (cracked skin) - in severe cases of inflammation ,
edema (swelling from a build up of fluid) - also in severe cases of inflammation , and
satellite lesions (sores in the surrounding area) - this is rare, but may indicate the presence of other fungal conditions, or the herpes simplex virus.
Vaginal discharge
A vaginal discharge is a common symptom of vaginal thrush. It is often white and 'cheese-like', but may also be watery or purulent (contain pus). The discharge is usually odorless.
Treatment
If your symptoms of vaginal thrush are mild, your doctor may recommend a short course of antifungal medicine, which will usually need to be taken for between 1-3 days. If your symptoms are more severe, you will need to take the treatment for longer.
Antifungal treatments for thrush can be taken either by mouth (orally), or by inserting them into your vagina (known as intravaginal pessaries). Topical creams are also available to treat sore parts of the vulva.
In all cases of thrush, you should always go back to see your doctor if, following treatment, your symptoms have not cleared up.
Oral antifungal treatment
Oral antifungal treatment is usually recommended for girls who have vaginal thrush and are between 12-16 years of age. Fluconazole, or itraconazole, are two oral antifungal treatments that are usually prescribed. However, oral antifungal treatments can cause side effects that include:
nausea ,
vomiting,
diarrhea ,
constipation
bloating, and
an upset stomach .
Intravaginal pessaries
Intravaginal pessaries that are often recommended include clotrimazole, econazole, or miconazole. They do not cause as many side effects as oral antifungal treatments, but they can:
be awkward to use,
cause mild irritation, and stinging, when they are inserted, and
can damage latex condoms and diaphragms. Therefore, you should use another form of contraception while you are using intravaginal pessaries.
Pregnant and breastfeeding women
If you are pregnant, or breastfeeding, you will not be prescribed oral antifungal treatment because it may affect your baby. Your doctor will probably prescribe an intravaginal pessary, such as clotrimazole, econazole, or miconazole, to be used for at least seven days.
If you are pregnant, you should take care when inserting a pessary, particularly if it has an applicator because there is a risk of causing injury to the cervix . To reduce this risk, you may prefer to insert pessaries by hand.
If you have vulval symptoms, an imidazole cream, such as clotrimazole or econazole, may be recommended in addition to an intravaginal pessary.
Self help
Some oral and topical (creams) medications that can be used to treat vaginal thrush are available from your pharmacist, over-the-counter (OTC), without a prescription. For example, flucanozole is available OTC as a single dose tablet for treating thrush. They can be useful for treating thrush if you have had the condition before and it has returned.
However, if you have developed the symptoms of thrush for the first time, you should visit your doctor in order to confirm a diagnosis because self-diagnosing can be unreliable. Also, OTC treatments should not be used long term without first seeking medical advice and, if your symptoms have not improved within 7-14 days, you should visit your doctor.
If you have thrush, as well as using OTC treatments, there are also a number of other things that you can do to help ease the problem. These include:
washing your vaginal area using water - avoid using perfumed soaps, shower gels, vaginal deodorants, or douches,
avoiding using latex condoms, spermicidal creams, and lubricants, if they cause irritation,
avoiding wearing tight-fitting, synthetic clothes, and
wearing cotton underwear and loose-fitting clothes, where possible.
You should always go back to see your doctor if the symptoms of thrush recur and:
you are under 16 or over the 60 years age,
you are pregnant,
you have abnormal menstrual bleeding, or lower abdominal ( stomach ) pain ,
your symptoms are different from a previous episode of thrush - for example, if the discharge is a different color, or if you have ulcers , or blisters,
you have had two cases of thrush within six months, and you have not consulted a healthcare professional for more than a year,
you, or your partner, have previously had a sexually transmitted infection (STD), or
you have reacted badly to an antifungal treatment in the past, or if they were ineffective.
Treating recurrent thrush
Recent studies have shown using a treatment strategy known as 'maintenance therapy' can significantly reduce the recurrence of thrush.
The studies found that using oral fluconazole on a weekly basis, or using either oral itraconzole, or intravaginal clotrimazole, on a monthly basis, were effective in preventing thrush from recurring.
The studies also found that the level of protection against thrush was reduced when these treatments were stopped.
http://www.wellsphere.com/wellguide.s?articleId=87§ionId=146&searchString=Fishy+Smell+Vaginal+Discharge
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