Vulvovaginal candidiasis

The aim of this leaflet 

This leaflet has been written to help you understand more about vulvovaginal candidiasis (thrush). It will tell you what it is, what causes it, what can be done about it, and where you can find out more about it.  

What is vulvovaginal candidiasis?

Vulvovaginal candidiasis is a yeast infection of the vagina and vulva (inner and outer female genital area).

What causes vulvovaginal candidiasis?

Vulvovaginal candidiasis is usually caused by the yeast Candida albicans.  Other Candida species are becoming more common but Candida albicans is responsible for over 85% of all yeast-induced vulvo-vaginal infections.  

Is vulvovaginal candidiasis hereditary?

No.

What are the symptoms of vulvovaginal candidiasis?

Itch (Pruritus) and increased vaginal discharge are the most typical symptoms. Other symptoms are variable: soreness and burning, painful sexual intercourse (dyspareunia ), or discomfort passing urine (dysuria),. These symptoms may also occur in other vaginal infections.
 
Candida vaginitis is more frequent during pregnancy, especially in the third trimester.
Symptoms of vaginitis are the same during pregnancy, although many women express less severe symptoms.   

What does vulvovaginal candidiasis look like?

Redness (erythema) of the vagina and vulva is common. In severe infections, a typical white, thick, sticky vaginal discharge is seen, but a discoloured discharge may also be seen.
 
Male partners may suffer from itching after sex and may have tiny red spots and pustules (yellow/white spots) on the glans penis.  

How is the diagnosis made?

Examining a swab with a microscope, allows confirmation of around 75% of troublesome yeast infections.
 
If microscopy of fresh vaginal fluid proves negative in a symptomatic patient, laboratory confirmation by culture is indicated.

 Can vulvovaginal candidiasis be cured?

Yes; but in some women it can be a recurrent disease.  

How should it be treated?

During pregnancy, treatment with miconazole or clotrimoxazole cream or suppositories is preferred; and may need to be repeated several times or preventative treatment may be necessary. 
 Anti-yeast treatments by mouth must not be used for vulvo-vaginal yeast infection during pregnancy!
 
Vulvovaginal candidiasis is not a sexually transmitted infection and the male partner does not need to be treated if he has no symptoms.  

What can I do?

Contact your doctor when you experience vulvovaginal itching and/or discharge.  

Where can I find more information about vulvovaginal candidiasis?

Web link to detailed leaflets:
http://www.dermnetnz.org/fungal/vaginal-candidiasis.html
 
Books:
The Sanford Guide to Antimicrobial therapy, 20th edition of the Belgian/Luxembourg version, 2006-2007.
 
While every effort has been made to ensure that the information given in this leaflet is accurate, not every treatment will be suitable or effective for every person. Your own doctor will be able to advice in greater detail. 
 
This leaflet has been prepared by the EADV task force “skin disease in pregnancy”, it does not necessarily reflect the official opinion of the EADV – August 2010 submitted to EADV
 
Updated July 2013