Simple vaginal candidiasis: what are the options? 3 But keep in mind that they only provide temporary symptomatic relief and do not cure the infection, so they should only be used as adjuncts, and not as substitutes for proper treatment of thrush. In addition, simple emollients (moisturising treatments) can be applied onto the skin surrounding the vaginal opening, for relief of symptoms such as itching or redness. Duration of treatment depends on how severe the disease is. Some of these medications need to be prescribed by a doctor and some may even be available to purchase over the counter. It’s advised to inserted them at night as the lying down position will minimise the leakage of drug through the vagina. These pessaries or creams can be inserted either using an applicator or with fingers. Vaginal pessaries are pills which needs to be inserted directly into the vagina. Oral tablets when swallowed are absorbed into the bloodstream through the gut and can affect the whole body, whereas intravaginal preparations act mainly in the vaginal wall and surrounding area hence, systemic effects are minimal. 2 Both these mechanisms result in disruption of the cell membrane of the Candida fungi, causing cell death and thereby reducing the number of fungi in the vagina.ĭuration of treatment depends on how severe the disease isĪntifungals are available in various formulations such as oral tablets and vaginal pessaries or creams. Azoles inhibit the synthesis of ergosterol (the main fungal sterol) and polyenes bind to and interact with sterols present in fungal cell membrane. Azoles like fluconazole and miconazole, and polyenes like nystatin are some of the commonly used antifungals for thrush.Īzoles and polyenes are two types of antifungals which differ in their mechanism of action. Thrush, being a fungal infection, is treated with antifungals either orally or topically (intra vaginally). Your GP may just examine you and come to a clinical diagnosis or will take a swab from your vaginal wall to test for a specific diagnosis. It may be some other infection, especially when the discharge is yellowish or malodorous (with a bad smell). Whichever of these symptoms you experience, unless you have already been diagnosed before, it’s always better to visit your GP and get yourself checked rather than self-diagnosing and treating yourself with over-the-counter medications, because even though thrush is common, your symptoms may not always be thrush. Sex may be painful or vulva may look red and swollen. While some people with thrush may not have any symptoms, and do not need any treatment at all, some may find their genital area or vulva is itchy or sore, or some may notice a thick, cottage cheese-like vaginal discharge. However, it usually does not require any special investigation and is often a clinical diagnosis - where a diagnosis is given without needing lab tests or medical imaging. There is no single symptom or sign specific to thrush. Despite the many types of Candida species, 80-89% of the time thrush is caused by the bacteria Candida albicans. Vaginal thrush or candidiasis occurs when the composition of the normal flora is disrupted, resulting in an overgrowth of yeasts. The normal vaginal mucosa (the inner lining of the vaginal wall) harbours a range of microbes known as vaginal flora.
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