Vaginal Thrush
Vaginal thrush is a very common vaginal infection caused by an overgrowth of a type of yeast called candida. This organism lives naturally in the bowel and in small numbers in the vagina. It is mostly harmless, but symptoms can develop if numbers increase in the vagina. Thrush needs the hormone oestrogen to thrive so it very rarely occurs in girls before puberty, or in women after menopause (unless they are on hormone replacement therapy). A vaginal thrush infection can be acute (a single episode) or chronic (recurring or persisting for a long time). Vaginal thrush is not an STI.
What causes a vaginal thrush infection?
A vaginal thrush infection can occur when normal levels of candida in the vagina increase. The vagina is normally mildly acidic and if the acid balance changes, yeasts which naturally occur in the vagina can multiply and cause symptoms. Thrush can occur for no obvious reason, however there are some things that make thrush more likely:
- Taking certain antibiotics.
- Being pregnant.
- Having diabetes.
- Having sweaty and moist skin.
- Having another skin condition (e.g. eczema or psoriasis).
- Immunosuppressive treatment (treatment or medication that reduces your immunity).
How would I know if I have a vaginal thrush infection?
In some instances the vaginal thrush infection can be present and cause no symptoms at all. In most cases however symptoms are experienced and can include any or all of the following:
- Vulval itching that can be mild or severe.
- A white, yeasty smelling discharge (that looks like cottage cheese).
- Redness or swelling of the vulva.
- Vulval soreness.
- Vulval pain during intercourse.
- Stinging when passing urine.
Can I have a test for vaginal thrush?
Yes you can have a test for thrush. If you have symptoms it is recommended that a swab of the vagina be taken for testing, to determine whether it is vaginal thrush or some other cause. It is also possible to have more than one infection at the same time (e.g. thrush and a sexually transmissible infection). If the problem recurs, and the symptoms are exactly the same, it may not always be necessary to repeat the test but if anything is different from a previous episode, a repeat swab may be recommended.
How is it treated?
Sometimes symptoms may only last a short time and treatment may not be needed. If treatment is needed there are the following options:
· Antifungal creams or vaginal pessaries
These treatments are available from the pharmacist without a prescription.
Creams come with applicators, which should be filled and the cream inserted inside the vagina at bedtime. The cream can also be used externally at the same time. Pessaries are tablets or capsules, which can be inserted into the vagina with your finger or with an applicator.
Treatment can vary from a single dose to a 3, 6, or 14 night course.
It is important to use the full course of cream or pessaries, even if you get your period.
· Oral tablets: Single dose
Oral tablets are available as a single dose over the counter in pharmacies and are shown to be as effective as the cream/pessaries. Sometimes your doctor may recommend that you use both the oral tablets and the cream/pessaries.
· Oral tablets: extended treatment
Extended treatment with oral tablets may be prescribed for chronic thrush when the infection is resistant to other treatment or recurring frequently. You will need a prescription for this extended treatment.
Oral treatment for thrush cannot be used during pregnancy and breast feeding. Creams and pessaries are still ok.
How can I prevent thrush?
Thrush is a very common infection and most women will have an episode at least once in their lifetime. While there is no known way that is guaranteed to prevent thrush, good vulval care may be helpful. Good vulval care includes using only water to wash the vulva and vaginal area and avoiding any soaps, body wash, or ‘feminine hygiene’ products such as sprays, wipes or washes; never douching; avoiding wearing tight clothing; and not wearing undies at night.
Pubic lice (Crabs)
Pubic lice are small parasites that infect the pubic hair, armpits, chest hair, and occasionally beards, eyebrows and eyelashes.
How do you get them?
They are passed on by direct person-to-person contact with the area that is infected, or by coming into contact with infected bedding or clothes. This may not necessarily be during sexual contact.
How would I know if I had pubic lice?
Symptoms of pubic lice include lots of itchiness in areas the affected areas where hair is present. This is often worse at night. Very tiny bugs may be present, tiny whitish eggs (nits) may be seen on the hair follicles, and small bluish or red patches on the skin where the hair is.
How are they treated?
Pubic lice can be treated with a pubic lice treatment available over the counter from pharmacies. Clothes and bedding also need to be treated.
How can I prevent them?
Avoid sexual or intimate contact with someone who has been infected until they have been treated. Also avoid using the same bedclothes, clothes, or towels etc. until they have been washed.
Scabies
Scabies is a common skin infection. It is caused by a tiny mite, Sarcoptes scabiei.
How do you get scabies?
Scabies can be spread sexually as well as through non sexual skin to skin contact with someone who has scabies.
How would I know if I had scabies?
The main symptom is intense itching which is worse at night. Sometimes a small rash is visible. It occurs most commonly in the between the fingers, on the wrists, armpits, stomach, and genitals.
Is there a test for scabies?
There is no test for scabies. If you think you have scabies you need to see a doctor for diagnosis.
How are scabies treated?
Scabies is usually treated by applying a topical anti-scabietic cream or lotion to the skin of the entire body. These are available over the counter from pharmacies.
How can I prevent scabies?
The best way to prevent scabies is to avoid any physical contact with someone who is infected until after they have been treated.
Molluscum Contagiosum
This is a common skin infection caused by a virus. It is common in children but also occurs in adults.
How would I know if I had it?
Molluscum contagiosum causes small painless firm lumps with a dimple in the centre. It can appear anywhere on the body but in adults they usually appear on the buttocks, thighs, lower abdomen and genital area.
How do you get it?
It can be spread sexually as well as through non sexual skin to skin contact.
How is it treated?
It will resolve on its own within 12 months but can be treated with freezing or cream.
How can I prevent it?
You cannot really prevent it, it is a common skin infect that is passed between people.
Local services
https://www.health.act.gov.au/hospitals-and-health-centres/canberra-sexual-health-centre
Acknowledgements
Sexual Health Family Planning ACT
Melbourne Sexual Health Centre
Australian STI Management Guidelines
ASHM (Australasian Society of HIV, Viral Hepatitis and Sexual Health Medicine)
STI testing
If you’re sexually active, particularly with multiple partners, you’ve probably heard the following advice many times: Use protection and get tested.
This is important because a person can have a sexually transmitted disease without knowing it. In many cases, there are no signs or symptoms.
It’s a good time to get tested for sexually transmitted infections (STIs) when:
- You have a new sexual partner(s).
- You or your partners have other sexual partners and it’s been more than three to six months since your last test.
- You notice any changes in your body.
- You think you might have an STI.
- You had sex with someone who has an STI.
- You had sex without a condom or the condom broke (also see emergency contraception).
- You have shared injecting equipment.
- You and your partner are planning or having a family, to prevent any infections being passed onto your baby.
Some people have different testing needs so it’s important to talk to your doctor about how regularly you should get tested. In most cases, a simple blood or urine sample is all that’s needed.
The good news is, most STIs are curable and all are treatable. But if left untreated, STIs can have long-term effects on your body. The best way to avoid needing treatment is to take proactive steps to avoid STIs and that means condoms. Condoms are the easiest, and most effective way to protect yourself from STIs no matter your age and type of sexual relationship you are in.
What happens during an STI test?
You will be seen by a qualified health professional, like a doctor or nurse, and they usually begin by asking you about your sexual history. Some of these questions may seem quite personal, such as:
- your sexual orientation (e.g. straight, gay, lesbian, bisexual)
- number of sexual partners
- sexual practices
- whether you have any symptoms
- whether you have injected drugs
- whether you have any tattoos or body piercings.
This information is kept confidential.
This is also a good opportunity for you to ask any questions about sexual health.
After taking a history of your sexual activity the doctor or nurse will perform an examination. This means that the health professional will look at your external genital area and maybe inside your mouth, vagina or anus for any signs of STIs.
Type of test:
- vaginal swabs – a long cotton bud takes a sample of vaginal secretions. If it makes you feel more comfortable, you can do this yourself.
- Sometimes taking a urine sample
- Some STIs, such as hepatitis, syphilis and HIV, require a sample of blood taken from the arm.
- If you have had unprotected oral or anal sex, a throat swab or self-collected anal swab may be required.
Think about the “window period”
The window period is the time between getting an infection and when a positive result will show up on a test.
It is important to know about window periods because tests done too early may not be accurate. In other words, a negative test result may not actually be negative if the test is done too soon after a sexual contact.
Depending on the STI and the type of test used, the window period may be anywhere from a few days to six months. Use the STIs At A Glance chart to find out the window periods for different STIs to help you know when to get tested.
Getting the results
Test results normally take about one week. If your result is positive, sexual partners also need to be tested and treated. This is called contact tracing. Otherwise you could keep re-infecting each other. People with symptoms of an STI may be treated before the test results are back.
Finding out that you have an STI can feel isolating, but remember that it’s not the end of the world, and it’s far better to know. Talking to a parent or trusted friend can help.
You can send free and anonymous SMS at Let Them Know
