Thrush is the most common reason for contacting a gynecologist. But we can not say that this problem concerns only the fair sex. Thrush in men, although it happens much less often, but it causes a lot of trouble. The first question is what to do, treat or not treat? And if treated, how? Women’s forums are full of a lot of questions about thrush, but always these questions are the right answers and give the right recommendations. It should be understood that only a doctor can diagnose and prescribe effective treatment for thrush. Uncontrolled advertising of drugs has already borne fruit. As a result, the causative agent of the disease has become resistant to most antifungal drugs only through their free sale and self-treatment. In this article, we will analyze what thrush is, and also learn how to properly treat it
What is a yeast infection?
Thrush (or candidiasis) is an inflammation of the mucous membrane of the vagina and other external genitalia, which is caused by yeast-like fungi of the genus Candida.
Most often, the pathogen is fungi of the subspecies Candida albicans – 85-90% of cases, but recently, other fungi – the so-called group of Candida non-albicans-often provoke thrush.
It should be noted that fungi of the genus Candida are normal for absolutely everyone. Their growth is controlled by the acidic environment and other representatives of the normal flora of the vagina. The amount of candide increases dramatically when the acidity changes in the direction of alkalinization. This suppresses the growth of other microorganisms, and the free niche is quickly occupied by fungi. Under normal conditions, the pH of the vagina of a woman of reproductive age has an acidic environment, which is supported by lactobacilli.
Causes of thrush
A reasonable question arises – if the fungi Candida are normal flora, some of which then there is a yeast infection?
The reasons for the increase in the number of Candida fungi can be:
- Hormonal changes. Pregnancy, the use of hormonal contraceptives. Thrush can develop during ovulation and before menstruation.
- Treatment with antibiotics, corticosteroids, immunosuppressants;
- Metabolic disorders, for example, in diabetes mellitus. Candida fungi actively multiply with an increase in blood sugar and an abundance of glycogen;
- Obesity-the causes of thrush are the same as in diabetes mellitus. Obesity is often accompanied by an increase in blood sugar levels with all the ensuing consequences;
- Staying in the genital area in a wet state for a long time (for example, wearing a wet swimsuit for a whole day), or living in a warm and humid climate;
- Douching, excessive hygiene of the genitals, especially with alkaline means (soap, shower gel) – these actions lead to a change in the PH of the environment;
- Unprotected sexual acts. Thrush can be transmitted sexually.
Signs of thrush in women
The first sign of a vaginal yeast infection are a white discharge, sometimes they acquire a yellow tint. They are quickly joined by signs of inflammation – itching, burning, swelling, redness and pain.
Classic symptoms of thrush:
- curd-like white discharge, accompanied by a sour smell;
- inflammation and redness of the external genitals;
- itching in the perineum, increasing in the evening;
- painful sensations when urinating;
- unpleasant sensations during sexual intercourse.
What is the danger of thrush?
MYTH # 1
Thrush is not dangerous, and therefore it is not necessary to treat it.
Yes, indeed, the disease is not fatal. But the acute form without adequate treatment can turn into a chronic one, which is a prerequisite for the development of candida cystitis, cervicitis or salpingitis (fungal damage to the fallopian tubes and uterus).
Thrush during pregnancy can lead to complications, including the development of secondary infections, as well as infection of the child during childbirth. Therefore, doctors try to cure thrush in pregnant women as quickly as possible.
In addition, often recurrent thrush can be a marker of diabetes mellitus and serious immunosuppressive conditions that are a consequence of HIV infection.
Thrush in men
Thrush is traditionally considered a female problem. However, representatives of the stronger sex can also suffer from this disease. Although of course thrush in men is not so often. This is due to the peculiarities of the anatomical structure of the genitals. “Male thrush” often has an asymptomatic course, but sometimes manifests itself with characteristic symptoms.
Signs of thrush in men
- Redness and swelling of the glans penis
- Itching during urination and after sexual intercourse
- White plaque in the area of the urethra
If a man has these symptoms, he needs to see a urologist. In the medical world, there is a debate about whether to treat thrush in men. If the disease bothers, then of course you need to take action. In the event that the thrush does not manifest itself in any way – you can refrain.
MYTH # 2
For the prevention of thrush in women, it is necessary to treat a sexual partner.
There is no scientific evidence for this fact. Men are usually asymptomatic carriers of the Candida fungus. Treatment of thrush in men does not in any way reduce the risk of relapse in women. Treatment is recommended only in the case of an obvious manifestation of symptoms in a man for his comfort.
Treatment of thrush in men has its own characteristics, again associated with the anatomical structure of the genitals. It is obvious that local forms-candles and vaginal tablets in this case can not be applied. Therefore, men are prescribed antifungal drugs in the form of tablets. Treatment regimens for thrush in men are the same as for women.
Diagnosis of thrush
1. Inspection. The doctor diagnoses the presence of redness on the skin of the external genitals, swelling and redness of the urethra mucosa, swelling of the vulva, gray-white plaque on the mucous membrane, under which areas of bright hyperemia are found. Thrush is characterized by abundant or moderate discharge from the genital tract – white, thick or flaky, curd – like, filmy, sometimes watery.
2. Laboratory diagnostics:
- Bacteriological research is the sowing of material on a nutrient medium, thanks to which it is possible to determine the number, genus and species of fungi, their sensitivity to antifungal drugs, as well as the accompanying bacterial flora. This method greatly facilitates the selection of treatment. The material for the study is a smear on the flora from the vagina or cervix.
- Measuring the PH of the vagina is not a specific marker, since changes in acidity occur not only in thrush, but also in other infections.
- Colposcopyis a method that allows you to identify epithelial changes typical of the inflammatory process. In addition, the method allows you to diagnose asymptomatic forms of the disease. At the same time, the colposcopic method of diagnosis is not specific and does not allow to determine the causative agent of the disease.
- PCR method-polymerase chain reaction. The study is necessary to determine the specific type of fungus. For the diagnosis of thrush, it is rarely used, if there are difficulties in diagnosis, for example, with a combined infection.
We will list all the options for diagnosing thrush that a doctor can recommend to you, but most often the bacteriological method is quite enough to determine both the diagnosis and treatment.
Ways to treat thrush
We remind you that at the first sign of thrush, it is better to consult a doctor. Do not self-medicate, especially with “folk methods”.
MYTH # 3
Treatment of thrush with folk remedies is a worthy alternative to classical therapy.
All these douches with soda for thrush, as well as the use of a solution of apple cider vinegar and garlic candles can lead to vaginal dysbiosis, and to an even greater exacerbation of candidiasis. In the worst case, a secondary infection can join and you will also get gardnerellosis or mycoplasmosis as a bonus to thrush. Washing with a solution of chamomile in thrush can temporarily smooth out the symptoms-relieve itching. At the same time, the fungus will continue to multiply, that is, in the near future you will have a relapse, and most likely with more vivid symptoms.
For effective treatment of thrush, it is necessary, first of all, to adjust your diet – to minimize carbohydrates, products containing a large amount of sugar, yeast. Milk intake is also better to reduce-leave only fermented milk products of low fat content. It is advisable to reduce the consumption of products containing gluten (wheat, rye, barley, semolina, pasta and oats).
Preparations for thrush
1. Imidazole derivatives-clotrimazole, ketaconazole, fluconazole.
MYTH # 4
One tablet of fluconazole in a dosage of 150 mg will help to get rid of thrush.
This is not true, unfortunately. It would certainly be very good if 1 tablet from thrush led to a cure. Unfortunately, this does not happen in practice. Not only is fluconazole used only for the treatment of Candida albicans, and thrush is not always caused by a fungus of this species, but also resistance to fluconazole is increasingly determined even with a course of treatment of 7-14 days. That is, the maximum that 1 tablet from thrush can do is to smooth out the symptoms for a while, which will definitely return again.
It is important to note that only local antifungal drugs are not enough for successful treatment. Therefore, the treatment regimen for thrush should include both local and oral forms.
Local antifungal drugs:
- clotrimazole 1% cream 5.0 in the vagina-7-14 days;
- clotrimazole-vaginal tablets 100 mg once a day — 7 days;
- clotrimazole in vaginal tablets 100 mg 2 times a day — 3 days;
- miconazole 2% cream 5.0 in the vagina, for 7 days;
- itraconazole 1 table (200 mg) per day. — 7 days;
- fluconazole 1 tab (50 mg) per day– 7 – 14 days.
2. Antibiotics with antifungal effect against thrush – nystatin, natamycin.
- Nystatin 1 table-3-4 times a day, 14 days;
- Natamycin candles – 1 candle for 3-6 days;
Prevention of thrush in women consists in the periodic use of antifungal drugs in a short course, for example, 3 days 1 time a month. This is the so-called suppressive treatment. The decision on the need for such treatment should be made by the doctor.
That’s all that can be said about thrush, although unofficial medicine can offer a lot of useless, and sometimes even harmful methods of treatment. In any disease, it is necessary first of all to analyze the cause – why did this happen? Especially if in 1-2 months after treatment, the yeast infection is back again. This means that either the drugs were chosen incorrectly, and you only temporarily smoothed out the symptoms, or you need to reconsider your lifestyle. It’s about hygiene and nutrition. Also, frequent relapses of thrush can indicate the presence of concomitant diseases, so do not delay a visit to the doctor.
Treat thrush correctly and take care of your health!
Read the answers to questions about thrush here