Their use is based on common practice rather than research studies:
- Hygiene. Thrush is not due to poor hygiene. However, the normal conditions of the vagina may be altered by excess washing and rinsing out (douching) of the vagina, bubble baths, scented soaps, spermicides, etc. The normal mucus and germs (bacteria) in the vagina may be upset by these things and allow Candida spp. to infect. Therefore, it may be best to wash just with water and unscented soap and not to douche the vagina.
- Clothes. Don't wear nylon underwear or tight-fitting jeans too often. Loose cotton pants are best. Stockings rather than tights are preferable. The aim is to prevent the vaginal area from being constantly warm, moist and airless. Avoid washing underwear in biological washing powder and using fabric conditioners.
- Antibiotic medicines. Be aware that thrush is more likely if you take antibiotics for other conditions. Antibiotics may kill the normal harmless bacteria in the vagina which help to defend against Candida spp. As Candida spp. are yeasts and not bacteria, they will not be killed by antibiotics. This is not to say that every course of antibiotics will lead to thrush. But, if you are prone to this problem and you are prescribed antibiotics then have some anti-thrush treatment ready to use at the first sign of thrush.
- Sex. Thrush is not a sexually transmitted infection. However, friction when you have sex may cause minor damage to the vagina which may make Candida spp. more likely to thrive. So, make sure your vagina is well lubricated when having sex. If natural secretions are not sufficient then use a lubricant when you have sex. After sex, wipe yourself so you are clean and dry.
It may also be worth reviewing any medication you are taking, as some medicines can make you more prone to thrush. You should discuss this with your doctor.
Further reading and references
Sexually Transmitted Infections in Primary Care; Royal College of General Practitioners and British Association for Sexual Health and HIV (Apr 2013)
Candida - female genital; NICE CKS, November 2016 (UK access only)
Martin Lopez JE; Candidiasis (vulvovaginal). BMJ Clin Evid. 2015 Mar 162015. pii: 0815.
British National Formulary; NICE Evidence Services (UK access only)
Abad CL, Safdar N; The role of lactobacillus probiotics in the treatment or prevention of urogenital infections - a systematic review. J Chemother. 2009 Jun21(3):243-52.
Fischer G, Bradford J; Vulvovaginal candidiasis in postmenopausal women: the role of hormone replacement therapy. J Low Genit Tract Dis. 2011 Oct15(4):263-7. doi: 10.1097/LGT.0b013e3182241f1a.
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