Vaginal thrush during pregnancy

Most women experience occasional bouts of a common yeast infection known as vaginal thrush. It causes itching, irritation and swelling of the vagina and surrounding area, sometimes with a creamy white cottage cheese-like discharge.

Vaginal thrush is fairly harmless but it can be uncomfortable and it can keep coming back, which is known as recurrent thrush.

Thrush is a yeast infection, usually caused by a yeast-like fungus called ‘Candida albicans’.

Many women have Candida in their vagina without it causing any symptoms. Hormones in vaginal secretions and ‘friendly’ vaginal bacteria keep the fungus under control. Problems arise when the natural balance in the vagina is upset and Candida multiplies.

Vaginal thrush can sometimes be passed on during sex but is not considered a more serious sexually transmitted infection or STI. So, if you have thrush it’s best to avoid having sex until you’ve completed a course of treatment and the infection has cleared up.

During pregnancy
You are more at risk of getting thrush while you’re pregnant. Changes in the levels of female hormones, such as oestrogen, increase your chances of developing thrush and make it more likely to keep coming back.

There is no evidence that thrush affects your chances of getting pregnant. And, if you have thrush while you are pregnant, it won’t harm your unborn baby.

However, if you’re pregnant or breastfeeding and you have thrush, you should avoid taking oral anti-thrush treatments. Instead, use vaginal pessaries, plus an anti-thrush cream if necessary.

Treatment
If you have thrush and you’re pregnant or breastfeeding, you should always visit your doctor rather than buying anti-thrush medication over the counter from a pharmacy.

You won’t be prescribed oral treatment because it may affect your baby. An anti-thrush pessary; a small soluble block that is inserted into the vagina to treat the infection will most likely be prescribed to be used for about 3 to 7 days.

If you’re pregnant, take care when inserting a pessary because there’s a risk of injuring your cervix (neck of the womb). To reduce the risk, it may be better to insert the pessaries by hand instead of using the applicator.

If you have symptoms around your vulva, such as itching and soreness, you may also be prescribed an anti-thrush cream.

Not all of these products are safe to use at different stages of pregnancy, so it’s important to talk to your doctor and pharmacist before using any products.

What can I do to prevent vaginal thrush?
There are a number of simple things you can do:

  • Wear cotton or silk underwear rather than synthetics and change daily. Wear tights or stockings for as short a time as possible.
  • Wash underwear in hot water and pure soap and double rinse to make sure any irritants are removed before you wear them.
  • Change out of damp swimming costumes or sports clothes as soon as possible after swimming or exercise.
  • If using pads, change them regularly and avoid perfumed or deodorised pads.
  • Avoid tight fitting clothes such as jeans as this creates a moist, warm environment that encourages the overgrowth of bacteria and yeasts
  • Never douche — except if it is specifically prescribed by a doctor to treat an infection.
  • Douching increases your risk of vaginal irritation and is not recommended during pregnancy. A healthy vagina does not need a vaginal deodorant.
  • Avoid using soaps, bubble baths, bath salts, perfumes and perfumed powders (talcs) around the vaginal area.
  • Never ever use anything harsh such as disinfectants — even diluted, near your vagina.
  • A gentle moisturizer like aqueous cream may be advised. Use water or soap substitutes to wash the area.
  • Always wipe from the front to the back after going to the toilet since this stops bowel organisms being swept into the vagina. Don’t use perfumed toilet paper because it can cause irritation.