Thrush is a common fungal infection that occurs in both women and men; it is usually harmless but can be uncomfortable and tends to come back. Thrush is not a sexually transmitted infection. Below is what it looks like in both partners, what triggers it, and how testing is done.
What candidiasis is
The cause is fungi of the genus Candida. About 200 species are known in nature, and only 15 cause candidiasis; most often it is Candida albicans, which accounts for up to 60% of cases. These fungi normally live on the skin and mucous membranes without causing harm and begin to multiply uncontrollably when the bacterial balance changes or the skin barrier is damaged. Candida likes warm, moist areas, so thrush can appear not only on the genitals but also in the armpits, groin folds, or between the fingers. Vulvovaginal candidiasis in women and balanitis in men are distinguished separately. Candidiasis also occurs in the oropharynx, on the skin, on mucous membranes, and in the genitourinary tract.
Symptoms in women and men
In women, these are white vaginal discharge resembling cottage cheese, which usually has no odor, itching and irritation around the vulva and vagina, and pain and burning during sex or urination. In men, there is irritation, burning, and redness of the glans penis and the area under the foreskin, white discharge of the same appearance, an unpleasant odor, and difficulty retracting the foreskin. On the skin of other areas, a red itchy or painful rash more often appears, which flakes with white or yellow discharge; on darker skin it is harder to notice. Sometimes there are no symptoms at all, and a person learns about candidiasis only during testing for another reason.
Risk factors
Triggers can include the following conditions and circumstances, and either partner may have them:
- irritated or damaged skin;
- taking antibiotics;
- poorly controlled diabetes;
- weakened immunity, including due to HIV or chemotherapy;
- hormone therapy during menopause and pregnancy.
Sex can also be a trigger.
Why it comes back
First, Candida fungi are not uniform: some species have varying degrees of resistance to antifungal agents, so the usual approach may not work. Second, mucosal immunity plays a key role in keeping Candida in check, and with T-cell deficiency the tendency to relapse increases. Third, the trigger may remain unchanged — poorly controlled diabetes, constant skin irritation from tight underwear, or cyclical changes related to menstruation. When discussing recurrent episodes, the doctor looks for exactly this kind of cause before choosing an approach.
How diagnosis is done
At the appointment, the doctor first wants to confirm that it really is thrush and to rule out other infections. First, they ask about symptoms, their course, and previous episodes. Then they may examine the vagina, penis, or affected skin. If the picture is unclear or thrush recurs, a sample of discharge is taken with a cotton swab to identify the causative agent and check for other infections. Partners are not treated if they have no symptoms.
When to see a doctor
A routine visit to a family doctor is appropriate if symptoms appear for the first time, if you are under 16 or over 60, if episodes recur more than four times in 12 months, if previous treatment did not work, and also during pregnancy, breastfeeding, or with weakened immunity.
Call 103 or 112 immediately if the condition is life-threatening: suspected stroke or heart attack, a serious road traffic accident.
This material is for reference: it does not replace a consultation with a doctor, who will assess your specific situation.
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This content is for reference and does not replace a doctor's consultation. Medical disclaimer