Vaginal thrush, also known as vulvovaginal candidiasis, is a common fungal infection caused by an overgrowth of the yeast Candida albicans. This organism naturally lives in the vagina and gut, but an imbalance allows it to multiply uncontrollably. Thrush is particularly common during pregnancy and is usually managed easily with safe treatments, posing no typical threat to the unborn baby.
Recognizing the Symptoms
The typical symptoms of vaginal thrush involve noticeable irritation and discomfort in the genital area. Individuals often experience intense itching, soreness, and a burning sensation around the vulva and vagina. This irritation may also lead to pain during sexual intercourse or a stinging sensation when passing urine.
A characteristic sign of thrush is a thick, white vaginal discharge, frequently described as looking like cottage cheese. Unlike other vaginal infections, this discharge usually does not have a strong or unpleasant odor. It is important to consult a healthcare provider for a confirmed diagnosis, as other conditions, such as bacterial vaginosis (BV), can present with similar symptoms. BV typically involves a thin, watery, grey discharge with a strong, fishy smell.
Why Pregnancy Increases Susceptibility
Pregnant individuals are at a significantly higher risk of developing vaginal thrush compared to those who are not pregnant. This increased susceptibility is largely due to the profound hormonal changes that occur during gestation. Elevated levels of the hormone estrogen are a primary factor, as estrogen encourages the growth of Candida.
Higher estrogen levels also lead to an increased accumulation of glycogen within the vaginal cells. Glycogen acts as a food source for the Candida yeast, providing a favorable environment for multiplication. Furthermore, pregnancy can alter the delicate balance of the vaginal microbiome, allowing the yeast to outgrow the protective bacteria that normally keep it in check.
Treatment Options Safe During Pregnancy
The primary approach for treating vaginal thrush during pregnancy focuses on topical antifungal medications. These treatments (creams and pessaries inserted into the vagina) are generally considered safe because very little medication is absorbed into the mother’s bloodstream. Common medications include clotrimazole and nystatin.
A longer course of treatment is often recommended for pregnant individuals to ensure the infection is fully cleared. Healthcare providers typically prescribe a course lasting six or seven days, which is more effective than shorter regimens. Even for over-the-counter products, it is important to speak with an obstetrician or midwife before beginning treatment to confirm the diagnosis and safety.
The use of oral antifungal tablets, such as fluconazole, is generally avoided during pregnancy. High doses of oral fluconazole have been associated with potential birth defects, making it a second-line option reserved only for cases where topical treatments have failed and are specifically prescribed by a specialist. When inserting a pessary, women are often advised to avoid using the applicator to prevent potential physical damage to the cervix.
Potential Effects on Mother and Baby
A reassuring fact for pregnant people is that a vaginal thrush infection does not typically harm the developing fetus. The infection remains localized to the vagina and vulva, posing no direct risk. The discomfort caused by the infection, such as itching and soreness, is primarily a maternal issue.
There is a possibility of passing the Candida organism to the baby during a vaginal delivery. If this transmission occurs, the newborn may develop oral thrush, which presents as white, velvety patches inside the mouth and on the tongue. This neonatal infection is common, generally harmless, and easily treated with antifungal medication applied directly to the baby’s mouth.
To minimize recurrence, simple hygiene and lifestyle modifications can be helpful. Wearing loose-fitting clothing and breathable cotton underwear helps to keep the genital area dry, as the yeast thrives in warm, moist conditions. Avoiding perfumed soaps, bubble baths, and douching also helps maintain the natural balance of the vaginal environment.