Thrush (Vaginal Candidiasis): Causes, Symptoms and Which Tests

Itching, burning and white "curd-like" discharge — and almost every woman recognises thrush. It is one of the most common reasons to see a gynaecologist. The good news: thrush (vaginal candidiasis) is NOT a venereal disease and usually responds well to treatment. Let us go through it calmly: why it happens, what the symptoms are, which tests are really needed, and when frequent recurrences call for a more serious work-up.

What Thrush Is and Why It Happens

Thrush is an overgrowth of a yeast fungus of the genus Candida (most often Candida albicans). An important point: Candida is normally present in small amounts in many healthy women and is part of the microflora. The disease starts when the balance is disturbed and the fungus begins to multiply actively. So candidiasis is not an "infection from outside" but a disruption of one's own balance, and it deserves to be treated without shame or panic.

Symptoms of Thrush

Typical signs: itching and burning in the genital area, thick white discharge without a strong odour (often compared to cottage cheese), discomfort on urination and during intimacy, redness and swelling. Similar symptoms are caused by other conditions (bacterial vaginosis, sexually transmitted infections), so a diagnosis should not be made on sensations alone — especially with a first episode.

Why Thrush Appears (Causes and Triggers)

Candida overgrowth is most often triggered by: antibiotics (which kill "good" bacteria), high blood sugar and diabetes, hormonal changes (pregnancy, the pill), reduced immunity, stress, tight synthetic underwear and excessive hygiene. The link with sugar is a reason to check glucose with frequent thrush: poorly controlled diabetes is a known driver of recurrences.

Which Tests Are Needed (and When)

With a typical first episode, a doctor often makes the diagnosis clinically and by microscopy of a swab (showing fungal threads). Tests matter when symptoms are atypical, it is not the first episode, treatment fails, or other infections need to be ruled out — then an STI test is also appropriate. Microscopy of a swab is the basic method, while in complicated cases a culture is considered the gold standard.

Frequent Recurrences: When a Culture Is Needed

If there are 4 or more episodes a year, this is recurrent candidiasis. Here microscopy alone is not enough: a culture (or PCR) with identification of the Candida species is needed, because some species (for example Candida glabrata) are poorly seen under the microscope and respond worse to standard drugs. Recurrences are a reason not to cycle through creams but to be assessed by a doctor and look for an underlying cause.

Treatment and When to See a Doctor

Uncomplicated thrush is treated with antifungals (topical or in tablets) — the specific regimen and dose are prescribed by a doctor, and self-treatment by advertising often fails with recurrences. See a doctor with a first episode (to confirm the diagnosis), with frequent recurrences, in pregnancy, and also if symptoms are unusual or there is discharge with an odour — that is already a reason to rule out other causes.

This article is for informational purposes only and does not replace a doctor's consultation.