Thrush in Men
Thrush is the common word for a yeast (fungal) infection from a germ called candida. This germ is often present harmlessly on our skin, but sometimes causes a problem when it multiplies. Candidal infections can affect many body systems, but most commonly cause problems in the genital area, in the mouth (oral thrush) or on the skin.
Thrush in men is a common problem, although it occurs less often in men than it does in women. It is usually a mild infection caused by a yeast, and in most cases quickly clears up with treatment.
See the separate leaflet Vaginal Thrush (Yeast Infection) to read about thrush in women.
Thrush symptoms in men
It is reasonably common to have the thrush called candida albicans, but not have any symptoms at all. When thrush causes a problem, it is due to inflammation of the penis and foreskin (balanitis). The symptoms may include:
- A red rash at the head of the penis.
- Soreness or itching of the penis.
- The tip of the penis may be swollen.
- A discharge from the end of the penis - usually a white or creamy colour, sometimes with a thick 'cottage cheese' type of texture, which may or may not be smelly.
- Pain or discomfort when passing urine or having sex.
- It may be difficult to pull the foreskin back (retract the foreskin).
Thrush causes in men
As with many thrush infections, the most common reason is that the germs that normally live harmlessly on or in our body multiply to a level where they cause symptoms. Thrush is a common fungus, and like other fungi, it thrives in situations which are hot and damp. So in some cases, the thrush germ lives harmlessly on the skin around the penis, but if there are hot and sweaty conditions, it multiplies and causes symptoms. For example, if the weather is hot, or you wear tight nylon clothes that don't allow the skin to 'breathe', or if you don't dry yourself carefully after showering or exercising. Thrush is not officially classed as a 'sexually transmitted infection' (STI), but sometimes it can be passed on during sex or triggered by sex. Most women will have thrush at some point in their lives, but they rarely pass it on to their male partners. However, sometimes this does happen. Sometimes men or women can carry the thrush germ without having any symptoms, and then pass it on through having sex.
Some situations or conditions make thrush more likely - for example:
- Having diabetes.
- A course of antibiotics.
- Having an 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 area 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.
What should I do if I think I have thrush?
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 check there is no reason for this. For example, you may be tested for diabetes or for problems with your immune system. Tests for sexually transmitted infections may also be done. Your partner should also be tested for thrush and sexually transmitted infections if the problem keeps coming back.
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.
Thrush treatment for 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:
Note that these creams may affect latex condoms and contraceptive diaphragms/caps, making them less effective.
Another option is an antifungal tablet, such as fluconazole. This is a one-off tablet which is swallowed.
Does my partner need treatment too?
No - not unless your partner has symptoms or signs of thrush.
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
As mentioned above, 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. Perfumed soaps or shower gels may cause an irritation - it may help to wash with an emollient such as E45® or aqueous cream instead.
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.
Further reading and references
Balanitis; NICE CKS, October 2018 (UK access only)
Arendrup MC; Candida and candidaemia. Susceptibility and epidemiology. Dan Med J. 2013 Nov60(11):B4698.