Conversations about intimate health have come a long way, but it’s still one of those subjects many of us shy away from. In fact, according to new research by the insurance provider Vitality, one in five of us are still too embarrassed to seek medical help for female health concerns – with queries involving vaginal discharge and bacterial vaginosis (BV) ranking near the top of the things we’re least willing to discuss.

Also ranking high on the list was thrush, with 46% of women saying they wouldn’t be comfortable discussing it with their friends or family. But while keeping a single infection on the downlow might not be a problem (as long as you seek treatment), dealing with recurrent, chronic thrush can be a draining experience – especially if you’re doing it alone.

A condition that affects 1.2 million women in the UK alone, recurrent thrush is defined as four or more yeast infections in one year or two within six months. At the very least, it can be disruptive – but it can also have a long-term mental health impact, especially for those who struggle to access effective treatment. And with so many of us afraid to discuss what’s going on, it can be hard to know what to do if you’re faced with thrush infections that keep returning.

With this in mind, we asked Dr Sushma Srikrishna, a consultant gynaecologist at HCA Healthcare UK based at London Bridge Hospital, to explain more about the causes of recurrent thrush and the treatment options available. Here’s what she had to say. 

Research into recurrent thrush is still limited, so not much is known about what causes it. However, there are several factors known to increase the risk of recurrent thrush, Dr Srikrishna explains. These are as follows:

• Resistance to thrush treatment
• Use of antibiotics
• Using products that irritate the vaginal area, such as perfumed soaps
• The menstrual cycle – hormonal changes can influence the pH level of the vagina, which can cause thrush to develop
• Tight clothing, including thongs and jeans
• Uncontrolled diabetes – high blood sugars can lead to recurrent thrush
• Immunosuppression – which occurs with certain conditions, cancer treatments, steroid therapies and chronic illnesses
• An increase in oestrogen levels (either naturally as in pregnancy or while taking the combined contraceptive pill) 

There are three main treatments offered for recurrent thrush.

“The most common treatment options include pessaries being inserted into the vagina, a cream used in the affected area or taking anti-fungal capsules orally,” Dr Srikrishna says.

“Sometimes these treatment options need to be used for an extended period of time if the infection is severe or more resistant to the treatments. Always seek specialist referral if thrush or thrush-like symptoms are recurrent.” 

Dr Srikrishna recommends making several simple changes to prevent thrush from returning post-infection. They include:

• Ensuring that you dry yourself properly after washing
• Not wearing tight underwear or clothing (especially thongs) and making sure to wear cotton underwear
• Wiping from front to back after using the toilet
• Not using perfumed soaps in the vaginal area
• Avoiding excessive antibiotic use
• Not using vaginal douches or feminine deodorants
• Using a good probiotic regularly

“Some women may benefit from using pH balancers, especially in the post-menstrual phase,” Dr Srikrishna adds. “If you believe that you are suffering from recurrent thrush, you should speak to your GP or gynaecologist.” 

Want to learn more about looking after your health? Check out our new podcast The Gut Life for helpful tips and tricks to help you look after your gut this summer.

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