Recurrent Thrush : Why Does It Keep Coming Back?

Recurrent Thrush : Why Does It Keep Coming Back?

Read about the author MJ Sohal

Have you ever had thrush? I have. And it isn’t pleasant; it’s itchy, uncomfortable and frustrating. It usually means I have to press pause on partnered sex, and often takes multiple doses of treatments to finally shift it.

As someone who has type 1 diabetes, recurrent thrush has been a larger part of my life over the years than I would have liked it to be. The problem is, it’s viewed largely as being “normal”, just something to deal with whenever it happens, which – at times – was every month. The impact of this is huge, both on my mental health and my sex life: no one wants to be continually battling an itchy vulva.

What I didn’t know was that there are things I can be doing to reduce the likelihood of getting thrush. Choices I can make in my everyday life that are really very easy, and that make an actual difference. Here’s what I’ve learned.

What is thrush?

Thrush is a common infection caused by a type of yeast, most often called Candida Albicans. It can affect someone’s mouth, genitals or other areas of their body (such as armpits) and can affect people with a vulva or a penis. It is not a sexually transmitted infection, as it is usually caused by something unrelated to sex, but if someone has it can be passed on.

75% of people with a vagina are thought to experience vaginal thrush at least once in their life and many will experience it recurrently.

The most common symptoms are:

  • itchy, irritated, swollen or sore vulva
  • a thick, white vaginal discharge (that may resemble cottage cheese but doesn’t usually smell)

You may also experience:

  • slight pain when you have sex
  • pain when you go to the toilet (to pee)

However, while thrush is common – and not something to be ashamed of – normalising it is problematic. Here’s why.

What causes thrush?

According to various health and wellness websites (including the NHS and Patient) the most common causes of thrush are the following:
  • skin damage or irritation
  • antibiotics
  • poorly controlled diabetes
  • a weakened immune system (for example, because of HIV, steroids or chemotherapy)
  • hormone replacement therapy (HRT)
  • Pregnancy
  • menopause

However, there are a number of other reasons people can get it, and many reasons for its recurrence.

We asked our community about their experiences. 85% of people said they had had thrush at least once. While a couple said they did not know why, the reasons given by those who did were much more diverse and far-reaching than those commonly given. As well as the list above, our community identified:

  • Other medication, including birth control pills
  • Certain brands of condoms
  • “Double-dipping” (moving between vaginal and anal penetration without taking precautions)
  • A lack of lube and/ or arousal when having sex
  • Mud/ dirt disrupting vaginal pH
  • Poor lubes and other intimate hygiene products
  • Bubble bath/ bombs
  • Stress
  • Poor intimate hygiene
  • Menstruation or menstrual products

Knowledge is power: while thrush may be part and parcel of things like pregnancy, antibiotics, diabetes, HRT and chemotherapy, there are a number of choices we can all make to reduce the chances of getting thrush.

Choose your lube carefully

Some ingredients in popular lubricants are notorious for causing thrush. The main ingredients to look out for are:

  • Glycerin.
    Glycerin is a sugar alcohol that naturally comes from animal fats or plant oils but is made synthetically from petroleum. It is used in lubes due to its moisture retaining properties. As a sugar derivative, it can ferment in the body, which provides a food source for yeast increasing both yeast and urinary tract infections in women.
  • Glycols & Parabens
    Glycols are a type of petrochemical, also derived from petroleum, that are often found in products like antifreeze as well as some flavoured or scented lubes. Parabens are used as a preservative. While many people will find no adverse effects, they are both well known irritants, especially for those who have sensitive skin, so worth avoiding if you can.
Do not use any of the following as sexual lubricants:

Choose a lube that is skin safe and pH balanced, like Yes or SUTIL Luxe

Other intimate products

Many well known feminine hygiene products that you can buy over the counter and are often recommended by GPs actually contain the same ingredients that cause recurrent infections, and therefore exacerbate the problem.

Avoid any intimate washes and wipes, even those that are made and marketed especially for your genitals. This industry is huge, worth billions of pounds and rapidly growing.

Other products to avoid:

  • Scented or coloured shower gels
  • Bath bombs
  • Scented condoms
  • Tampons and scented sanitary pads
  • Any products containing glycerine, glycols or parabens

If you are able to, use a menstrual cup, or invest in period pants as these can be a much more vulva-friendly way to manage your period.

Sexual hygiene

The vulva is self-cleaning, so only needs to be washed with water. However, unperfumed soaps are generally also suitable. For people with a penis is it so important to be washing the penis thoroughly, including under the foreskin. Thrush can be passed back and forth if you are having unprotected sex so intimate hygiene is important but does not mean investing in anything marketed specifically for genitals. Again: warm water is adequate, unperfumed soap is fine.

The vagina is also mostly self-lubricating, but lack of lubrication is absolutely a compounding factor for recurrent thrush and well, wetter is always better. Using skin safe, pH balanced lubes that don’t contain glycerine, glycol or parabens is great and some can double up as a vaginal moisturiser too.

Wearing cotton underwear can also be helpful in managing recurrent thrush.

Rapid treatment

And, if you notice symptoms of thrush, make sure you treat it quickly. If you are having unprotected sex, ensure you communicate with your partner so they can also treat themselves and help to avoid thrush tennis.

It is also a good idea to make sure it is actually thrush. Sexual health clinics and GPs offer testing, so before treating yourself it’s often worth getting checked out. That way, if it is thrush – and it’s recurring – you can speak to someone about it and, whether it is or isn’t, you will be getting the correct treatment. Thrush is one of the most commonly goggled embarrassing health questions yet is one of the most frequently misdiagnosed infection so getting the correct diagnosis and treatment is important.

Recurrent thrush is not only unpleasant and frustrating, it can also lead to treatments being ineffective. If you are getting symptoms of thrush regularly, definitely speak to your GP or sexual health clinic as you may need some more aggressive or longer-term treatments.

To avoid thrush:

  • Choose a skin safe, pH balanced lube
  • Clean your sex toys regularly
  • Avoid bath bombs and scented bath and shower gels
  • Choose period pants or a menstrual cup if you can

If you do find yourself with thrush:

  • use water and emollient (like E45 cream) instead of soap to wash the affected area
  • dry properly after washing
  • wear cotton underwear
  • avoid sex until thrush has cleared up if sex is uncomfortable, and remember that thrush creams can damage condoms
  • if you do have penetrative sex, or use toys, ensure that your partner is also treated and that you clean your toys thoroughly.
Do not:
  • use soaps, shower gels or bath bombs
  • use douches; deodorants; lubes containing glycerine, glycols or parabens on your vagina or penis
  • wear tight underwear or tights