Recurring thrush: causes and treatment

For most people, these symptoms go away after treatment. However, for some, symptoms can come and go. Recurring thrush is where you experience these symptoms 4 times or more within 12 months.

You can get recurring thrush across the body, including vaginal thrush, male thrush and oral thrush. Below is a summary of the types of thrush and the symptoms you would expect.

Recurring thrush is quite common, and usually nothing to worry about. That being said, it can be quite uncomfortable.

There could be several potential causes and your doctor will want to ensure which is most likely before prescribing you any treatment.

Your thrush treatment hasn’t worked

One reason you may have recurring thrush is that you haven’t fully treated the original infection. Even if you finish treatment, there is a slight chance that the fungus that caused the original infection has remained. It can cause a new outbreak.

Your partner has thrush

While not an STI, oral and genital thrush can be transmitted from partner to partner via sexual contact.

If you originally had thrush, you may have passed it on to your partner. This can cause a cycle of transmission. Once your partner has it, they can give it back to you. Thrush can often have few or no symptoms, making it even harder to identify the cause of your recurring symptoms.

If you are getting treated for thrush, your partner should also get treatment. Doing so will limit the risk of transmission.

You’re pregnant

Recurring thrush in pregnancy is common. Around 40% of pregnant women struggle with thrush. Thankfully, it is not usually harmful to you or your baby.

40% of pregnant women struggle with recurring thrush.

It is caused by changing hormone levels. High oestrogen levels during pregnancy can cause an overgrowth of the candida fungus.

If you’re pregnant and think you have thrush, consult your doctor so they can find a treatment that’s safe for you and your baby.

You have diabetes

Diabetes can cause many complications, such as foot and heart problems. However, another common problem is thrush. Recurring thrush can be a telltale sign of diabetes.

Uncontrolled high blood sugar levels can elevate your risk of thrush infections. So, ensure you manage your diabetes to avoid developing thrush. However, if you do, most treatments are safe to use.

Numerous changes happen to your body during your menstrual cycle, many of which can cause vaginal thrush.

The first factor is hormonal changes. At the beginning of your period, the production of certain hormones can cause an imbalance in the vaginal flora. This can promote yeast growth.

The menstrual blood itself can also affect the vaginal flora. Particularly, it causes a pH imbalance in the vagina which creates an ideal environment for candida.

Finally, using period products (e.g. tampons) and overcleaning your vagina can affect the pH imbalance. They can also irritate the vagina and make symptoms worse.

Sometimes, recurring thrush can be a symptom of chronic stress. However, it is rarely the sole cause.

Research has shown that stress can have a significant effect on the immune system. It can disturb the delicate balance of good and bad microorganisms in the body which can trigger a surge in yeast growth.

Stress also causes an increase in the hormone cortisol. High levels of cortisol can cause high blood sugar levels which can feed yeast growth and result in an infection.

While stress is linked to recurring thrush, it is less likely to be the sole cause. You may be more susceptible to infection if you have other risk factors.

If you take any repeat medications, there’s a chance that recurring thrush could be a side effect. Here are some of the most common culprits:

• Combined hormonal contraceptives (e.g. the contraceptive pill, patch or ring) contain oestrogen that can promote candida growth.
• Hormone replacement therapy (HRT) also contains oestrogen that can promote candida growth.
• Antibiotics and steroid treatments affect the natural balance of microorganisms, which can allow candida fungus to grow.
• HIV medicines, chemotherapy and other immunosuppressants weaken the immune system. Doing so makes your body less equipped to keep candida fungus at bay and makes you more likely to develop an infection.

You may need preventative treatment if you take any medications and experience recurring thrush as a side effect.

Oral thrush has its own unique causes.

Common causes of oral thrush
Smoking	Asthma inhalers
Dry mouth	Wearing dentures

Keeping good dental hygiene is the best way to prevent oral thrush, especially after inhaler use. You should also quit smoking if you smoke.

If you’re experiencing recurring thrush, you should see your doctor or go to a sexual health clinic as soon as possible. They’ll want to identify the cause as soon as possible. You should especially see your doctor if you’re over 60, pregnant, breastfeeding or have a weakened immune system (e.g. from diabetes or HIV).

You should also see your doctor if thrush treatment hasn’t worked, whether it’s a prescription or over-the-counter medication.

With the occasional bout of thrush, a short course of treatment will successfully clear the infection. However, in the case of recurring thrush, you may need a lower dose for longer.

Your doctor will ask about your symptoms to rule out any other conditions and check what could be causing your symptoms. They may make lifestyle suggestions before prescribing any treatment.

The most commonly prescribed antifungal medication for thrush is fluconazole (Diflucan). The regular dosage for recurrent vaginal thrush is 150mg daily for 3 days, then once weekly for 6 months. For other types of infections, follow the instructions from your doctor. Advice will also be different if you have a weakened immune system.

If you are prone to yeast infections, there are simple measures you can do to reduce your risk:

• avoid washing with scented products
• do not use vaginal deodorants or douches
• wear cotton underwear
• dry yourself properly after washing
• avoid wearing tight underwear or clothing
• avoid sex until your infection has cleared
• keep good oral hygiene and get regular dental checkups

If you’re taking antibiotics, your doctor may also recommend taking probiotics to help maintain the balance of good and bad bacteria in your body.