Vaginal yeast infections and thrush

Yeasts can go from being a normal part of your flora to an uncomfortable vaginal overgrowth known as a yeast infection (or thrush, depending on where you live).

Yeast overgrowth is very common, particularly after antibiotics, when your healthy flora may be having a rough time keeping colonies in check.

Symptoms of a yeast infection

  • Vulvovaginal itching
  • Burning
  • Stinging
  • Rawness
  • Redness
  • Discharge – thick, white, sometimes cottage cheese-like
  • Yeast infections usually do not smell bad, but may smell yeasty, like bread
  • Yeast infections often occur after taking antibiotics

Cyclic vulvovaginitis

You may find that symptoms appear at about the same time in your cycle, repeatedly. This pattern indicates hormones are playing a role.

Often, symptoms will appear when oestrogen levels are higher since oestrogen increases your vaginal glycogen levels. Glycogen is a sugar, which may also feed yeast.

Cyclic vulvovaginitis is the name given to any vaginal or vulvar symptoms (inflammation, itching, infection) that occurs in a pattern related to the menstrual cycle.

If you have a vaginal yeast infection, your digestive tract may also have an overgrowth of yeast. This matters when it comes to treatment.

Intestinal yeast blooms can be silent, with the only sign being uncomfortable, sometimes painful, vulvovaginal symptoms, but you can also get digestive symptoms such as bloating, gas, constipation, and diarrhoea, and so on.

You may notice that if you eat a lot of carbs or sugar (bread, pizza, burgers, beer or sweets) your vaginal symptoms get worse. A big night out or a lazy weekend in can go bad, and quickly – you’ll notice that the correlation between food or drinks and your vaginal symptoms becomes apparent reasonably fast, sometimes within hours or overnight.

Why do some people call a yeast infection ‘thrush’? The UK, Australia and New Zealand all call a yeast infection ‘thrush’, while North Americans will call it a ‘yeast infection’. They both mean the same thing.

Treating a yeast infection/thrush

There are two ways to approach yeast. The first is the top-down approach, while the second is the bottom-up approach. Or, you can do both.

The top-down approach uses your diet and perhaps a few choice supplements to manage the yeast bloom.

The bottom-up approach treats only your vagina and vulva. If you do both, you will be covering all bases. Doing both is smart if you have chronic yeast problems and notice a connection between what you eat and drink and symptoms.

If your yeast infection or thrush is a rare event, you may be able to quickly resolve a yeast bloom with some targeted vaginal treatments.

Effective vaginal yeast infection/thrush treatments

Getting tested for vaginal yeast species

  • Comprehensive vaginal microbiome test to see what’s happening in your vaginal microbiome
  • If you have recurrent vaginal thrush or yeast infections (vulvovaginal candidiasis), a comprehensive microbial DNA test is recommended

Other vaginal yeast infection treatment options

Digestive tract yeast treatment overview

Yeast biofilms

Yeasts make biofilms, like most microbes. A biofilm is a protective matrix that effectively hides the colony from treatments and helps it take over/protect its patch.

If for some reason the healthy biofilms in your vagina or intestines are disrupted, yeasts can move in and take over more than their allotted share of space.

Too many yeasts and a solid yeasty biofilm mean more infections and frequent recurrences at the slightest provocation.

Learn more about rare yeasts – Cryptococcal infections.

When yeast grows legs

Some yeast infections can become invasive, working themselves deeply into vaginal tissue. In these cases, often a test result for yeast will come back negative, but symptoms all point to yeast.

Talk to your healthcare provider about invasive yeast if you suspect you have a deeper problem.

More information on treating yeast infections

Test before treating – always

You should be sure it is a yeast infection or thrush by getting a test from your doctor. Each strain of yeast is a little bit different, with previously minor, harmless strains, now becoming drug-resistant emerging pathogens.

Comprehensive vaginal microbiome testing is available.

Antifungals can be just as bad as antibiotics when it comes to drug resistance. Using non-resistance-forming treatments (often non-drug treatments) is preferable. If you aren’t sure if you have yeast or something else, do our yeast and BV symptom checker to point you in the right direction.

If you’ve tried lots of yeast treatments and nothing works, look into cytolytic vaginosis – it looks just like a yeast infection, but yeast treatments won’t work.

Types of yeast

There are several types of yeast, with the most common cause of yeast infections and thrush being Candida albicans.

Candida albicans tends to result in the cottage-cheesy discharge – it can be copious and chunky, though it doesn’t smell bad. (If your discharge smells bad, you may have bacterial vaginosis or another bacterial infection. See your doctor for a test.)

An up and coming pathogen is Candida glabrata. Less common yeasts that can cause vulvovaginal symptoms include Candida tropicalis, Candida parapsilosis, and Candida krusei.

There are some even less common yeasts that can cause yeast infections and thrush, including Saccharomyces cerevisiae, despite some strains being commonly used as a probiotic.

References​1–4​

  1. 1.
    Dermendzhiev T, Pehlivanov B, Petrova A, Stanev S, Murdjeva M. Quantitative system for diagnosis of vulvovaginal candidiasis. Journal of Medical Mycology. Published online November 2022:101302. doi:10.1016/j.mycmed.2022.101302
  2. 2.
    Nyirjesy P, Brookhart C, Lazenby G, Schwebke J, Sobel JD. Vulvovaginal Candidiasis: A Review of the Evidence for the 2021 Centers for Disease Control and Prevention of Sexually Transmitted Infections Treatment Guidelines. Clinical Infectious Diseases. Published online April 13, 2022:S162-S168. doi:10.1093/cid/ciab1057
  3. 3.
    Sun Z, Ge X, Qiu B, et al. Vulvovaginal candidiasis and vaginal microflora interaction: Microflora changes and probiotic therapy. Front Cell Infect Microbiol. Published online February 3, 2023. doi:10.3389/fcimb.2023.1123026
  4. 4.
    Zhang L, De Salvo R, Ehret A, Young K, Trapp S. Vulvovaginal candidiasis: A real-world evidence study of the perceived benefits of Canesten®. SAGE Open Medicine. Published online January 2022:205031212210854. doi:10.1177/20503121221085437


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