Thrush in men

See the separate leaflet Vaginal Thrush (Yeast Infection) to read about thrush symptoms in women.

Symptoms of thrush in men

Many people have Candida (the cause of thrush) living in their bodies, without causing any problems. Sometimes, Candida can cause an infection of the penis, causing inflammation of the penis and foreskin. The medical term for this is balanitis - meaning inflammation of the head of the penis - and posthitis - meaning inflammation of the foreskin. These often happen at the same time, called balanoposthitis.

Thrush symptoms in men may include:

• A red rash at the head of the penis. Sometimes, the skin of the head of the penis looks tight or shiny.

• Soreness or itching of the penis.

• Swelling of the tip or head of the penis.

• A discharge from under the foreskin - usually a white or creamy colour, sometimes with a thick 'cottage cheese' type of texture, which sometimes has an unpleasant smell.

• Pain or discomfort when passing urine or having sex.

• Difficulty pulling back the foreskin.

What causes thrush in men?

Candida, a type of fungus, often lives in the skin, gut, mouth, and genitals of healthy people without causing any problems. Thrush happens when Candida grows out of control. This can happen if the conditions are right for it to grow rapidly. For example, it grows well in areas that are warm and damp.

So, although Candida can live on the skin of the penis without causing problems, in hot and sweaty conditions, Candida can grow and cause an infection. Things that can cause this include:

• Hot weather.

• Wearing tight underwear/clothing, especially nylon fabrics, that stop the skin from 'breathing'.

• Not drying after showering or exercising.

• Not cleaning the area under the foreskin (this area should be gently cleaned each day when washing - either with water alone, or water plus a very gentle soap).

  • Some men and boys have a foreskin that doesn't fully pull back (see below) which can make this difficult. Don't try to force back the foreskin if it doesn't pull back easily.

Thrush isn't considered a 'sexually transmitted infection' (STI). This is because Candida organisms are found on the body normally, but sexually transmitted infections, such as Chlamydia and Gonorrhoea, are not part of the normal organisms that live in the body.

Despite this, thrush infections can sometimes be linked to sex. Candida can be passed on during sex (although this is uncommon), and friction during sex can trigger an episode of thrush. Some people find that sex causes thrush to flare up afterwards.

Other situations or conditions make thrush more likely - for example:

• Having diabetes.

  • Having higher blood sugar levels (and sometimes sugar in urine) creates better conditions for Candida to grow.

• A course of antibiotics.

  • Antibiotics, especially 'broad spectrum' antibiotics, which kill off lots of different types of bacteria, can disrupt the balance of good bacteria on the skin. Losing good bacteria can allow Candida to grow.

• Having a weakened immune system which isn't working properly - due to conditions such as AIDS, or medicines such as steroids or chemotherapy.

• A tight foreskin. This can make it difficult to get the penis and under the foreskin clean and dry which makes a build-up of the thrush germ more likely. Men who have had a circumcision are less prone to thrush.

• Skin conditions causing the skin in that area to be cracked or broken.

How to test for thrush in men

If you have never had thrush before, it is best to visit a sexual health clinic or a doctor to check the diagnosis. There are many other causes for balanitis, so it is best to get it checked. A swab can be used to confirm thrush and also exclude other types of infection, such as gonorrhoea.

If you have recurring thrush (ie the infection keeps coming back) you may need urine or blood tests to look for any underlying reason. For example, you may be tested for diabetes or for problems with your immune system. Tests for sexually transmitted infections may also be done.

If you have had thrush before, and you recognise the symptoms, you can buy the treatment (see below) from a pharmacy. However, if it is coming back quickly or regularly, you should see a health professional to check for an underlying problem, and to check that your infection is definitely thrush.

Treatment for thrush in men

Thrush in men is usually easily treated with a course of an antifungal cream. These can be bought at a pharmacy or a large supermarket, or prescribed by a doctor. There are several creams available, including:

• Clotrimazole 1%.

• Miconazole 2%.

• Econazole 1%.

Another option is an antifungal tablet, such as fluconazole. This is a one-off tablet which is swallowed.

Does my partner need treatment too?

If they don't have any symptoms of thrush, they don't need treatment.

Treatment is recommended if they have symptoms of thrush.

Although Candida can be spread during sex, and people can pass it to one another, treating sexual partners for Candida (without symptoms) doesn't seem to affect the chances of thrush infections coming back. This is probably because sexual transmission of Candida isn't the main reason why thrush develops.

Are there any complications from thrush in men?

Usually not. Thrush is, in most people, a mild and easily treated condition. For people whose immune systems are not working properly, it may spread through the body and cause more severe problems.

How to prevent thrush in men

Fungi thrive in hot or wet conditions. So avoid anything which might make your genital area hot or wet for any length of time - for example:

• Shower after exercise and dry yourself thoroughly.

• Avoid synthetic underwear - cotton underwear is best.

• Avoid tight underwear and trousers/shorts.

• Avoid tight Lycra® clothes - wear loose-fitting cotton instead.

• Keep your penis clean - wash regularly, and dry thoroughly. The skin of the penis is very sensitive. Avoid harsh soaps or shower gels. Using water alone may be enough; using a moisturiser like E45 cream instead of soap can also be useful.

Also if you or your partner have thrush, it is best to avoid sex until you have been treated. Using a condom will also help prevent you passing it between you, but remember that condoms may be affected by the creams used to treat thrush - so use another method of contraception if required.