Recurring thrush: Causes, treatment, and prevention 

Summary: Thrush, or vaginal yeast infection, is caused by an overgrowth of Candida albicans and can become recurrent due to hormonal changes, antibiotic use, weakened immunity, or imbalances in the vaginal microbiome. While antifungal treatments help, lifestyle adjustments—such as wearing breathable fabrics, maintaining hygiene, managing blood sugar, and avoiding irritants—are key to prevention. Proper diet, hydration, and probiotics can also reduce recurrence. If thrush persists or worsens, seeking medical advice is essential to rule out underlying conditions and find the most effective treatment.

Thrush, also known as a vaginal yeast infection, is a common ailment caused by the overgrowth of the fungus, Candida albicans. About 1 in 20 females gets recurrent thrush.  Although typically mild and fleeting, recurring thrush can be quite annoying for those who deal with it often. Understanding the underlying causes, available treatment options, and preventive strategies is essential for effectively managing the condition and enhancing overall quality of life. 

How do you get vaginal thrush?

The yeast that causes vaginal thrush can exist in the mouth and bowel without causing harm. It can move to the vagina from the anus via the perineum, the area between the anus and vagina. Other yeast species can also inhabit the vagina without causing any problems. 

While Candida albicans is responsible for most severe cases of vaginal thrush, other species such as Candida glabrata can also lead to infections” 

Women are more susceptible to vaginal thrush from puberty until menopause, as the hormone oestrogen stimulates the vaginal cells to produce sugar that yeast can feed on. Therefore, thrush is infrequent before puberty, during breastfeeding (as oestrogen levels are low), and after menopause, unless the woman is undergoing menopausal hormone therapy (MHT) or has diabetes.  

Why do I keep getting thrush? Causes

Repeated or frequent thrush can be distressing and may be caused by several factors. Here are some of the most common causes: 

• Hormonal changes 
• Antibiotic use 
• Treatment resistance 
• Weakened immune system 
•  Disruption of vaginal flora due to over washing or use of irritating products 
• Sexual activity 
• Wearing tight clothes 
• Have difficulty managing diabetes 
• Genetic predispositions, particularly for women (but mechanism not fully understood yet) 
• Use of certain medications 
• Stress 
• Diet and lifestyle 

Also read: Thrush in pregnancy: Causes & home treatments

Why won't thrush go away?

Thrush may persist due to various factors, including an underlying health issue, ineffective treatment methods, or the possibility of reinfection. Frequently encountered causes involve a compromised immune system, diabetes, extended use of antibiotics or steroids, or an imbalance in gut flora in vaginal thrush. In cases of oral thrush, poor oral hygiene, improperly fitting dentures, or ongoing exposure to irritants can also play a role in the continuation of thrush. If symptoms continue despite treatment efforts, it is crucial to see a doctor to determine the root cause and investigate alternative therapies, including antifungal drugs, dietary changes, or enhanced hygiene practices. 

What are the risk factors?

Several factors can increase the risk of developing persistent or recurrent thrush: 

1. A compromised immune system: Individuals with illnesses such as HIV, or cancer, or those receiving chemotherapy have a higher risk of developing thrush due to their diminished capacity to combat infections.  
2. Diabetes: Elevated blood sugar levels create a favourable environment for yeast proliferation, making those with poorly managed diabetes more susceptible to thrush.  
3. Extended antibiotic usage: Antibiotics can disturb the natural microbial balance within the body, facilitating the overgrowth of Candida, the fungus responsible for thrush.  
4. Corticosteroid use: Inhaled steroids (like those prescribed for asthma) or long-term steroid treatments can elevate the risk of oral thrush, particularly if proper oral hygiene practices are neglected.  
5. Inadequate oral hygiene: Neglecting to brush or floss regularly, or having poorly fitting dentures, can cultivate conditions that favor Candida growth.  
6. Hormonal fluctuations: Changes in hormone levels due to pregnancy, contraceptive pills, and hormone replacement therapy can disrupt the body's balance, increasing the chances of thrush development.  
7. Dry mouth (Xerostomia): Insufficient saliva production diminishes the body’s natural defence against yeast growth, elevating the likelihood of thrush.  
8. Tobacco use: Smoking can lead to bacterial imbalances in the mouth, making it easier for Candida to proliferate.  
9. High-sugar diet: While a high-sugar diet does not directly cause thrush, excessive sugar intake can contribute to elevated blood glucose levels, which may promote yeast overgrowth in individuals with diabetes or insulin resistance.

Treating recurring thrush with self-care

Recurring thrush can be frustrating, but simple self-care strategies can help manage and prevent it. Maintaining good hygiene, making dietary adjustments, and supporting your immune system can reduce the risk of recurrence. 

1. Adopt a low-sugar diet: Limit your intake of sugar and refined carbohydrates, as yeast thrives on sugar. Emphasise whole foods, vegetables, and probiotics to maintain a healthy gut flora. 
2. Incorporate probiotics: Consuming probiotics, such as yogurt with live cultures or supplements containing Lactobacillus, can help restore beneficial bacteria and inhibit yeast overgrowth. 
3. Wear breathable fabrics: If you suffer from frequent vaginal thrush, opt for loose-fitting cotton underwear and steer clear of tight, synthetic materials that retain moisture. 
4. Avoid harsh products: Avoid using scented soaps, douches, or feminine hygiene sprays that could upset your natural pH balance and foster fungal growth. Douching is not recommended under any circumstances. 
5. Stay well-hydrated: Staying well-hydrated supports overall health and immune function, which may help the body resist infections.  
6. Manage pre-existing conditions: If you have diabetes, ensure your blood sugar levels are well-regulated, as elevated glucose levels can encourage Candida proliferation. 

Also read: Home Remedies for Thrush (Vaginal Yeast Infections)

Prevention

Thrush can be uncomfortable and persistent, but taking proactive steps can help prevent it from returning: 

1. Maintain proper hygiene: Ensure good oral and personal hygiene practices to minimise the risk of fungal overgrowth. Brush and floss your teeth daily, clean dentures thoroughly, and wash intimate areas using mild, unscented soap.
2. Manage blood sugar levels: For individuals with diabetes, controlling blood sugar is crucial to prevent excessive yeast growth, which lowers the chances of developing thrush.
3. Follow a nutritious diet: Reduce your intake of sugar and refined carbohydrates while adding probiotic-rich foods like yogurt to sustain a healthy bacterial balance in your body.
4. Choose breathable clothing: Select loose-fitting cotton underwear and steer clear of tight, synthetic materials to avoid excess moisture accumulation that can foster fungal growth.
5. Avoid irritants: Refrain from using scented soaps, douches, and feminine hygiene sprays, as these can disrupt the natural pH balance and heighten the risk of thrush.
6. Stay well-hydrated: Consuming sufficient water helps eliminate toxins and boosts immune function, decreasing the likelihood of recurring infections.
7. Utilise antifungal treatments when necessary: If you are susceptible to thrush, consult your doctor about antifungal creams or medications as a preventive strategy, particularly following antibiotic treatment. Long-term antifungal use should only be done under medical assistance to avoid resistance. 

When should you seek medical advice?

If thrush continues despite self-care and over-the-counter remedies, or if it frequently recurs, it is advisable to seek medical advice. A doctor should be consulted if you experience severe symptoms like intense pain, swelling, skin cracks, or difficulty swallowing (in cases of oral thrush). Individuals with compromised immune systems, diabetes, or those on long-term antibiotics or steroids should promptly seek medical assistance, as they face a higher risk of complications. If you're uncertain about your symptoms or if they deteriorate despite treatment, a healthcare professional can identify the underlying issue and suggest the most effective treatment options. They may need to rule out other conditions such as bacterial vaginosis, lichen sclerosus, or sexually transmitted diseases.  

Telehealth with a GP online

Online GP consultations via telehealth provide a convenient method to manage thrush symptoms from home. An online doctor can evaluate your condition, propose treatment alternatives, and prescribe antifungal medications if necessary. They can also help pinpoint underlying factors, such as diabetes or issues with the immune system, and recommend lifestyle adjustments to prevent future occurrences. If your symptoms persist or worsen, you may be referred for further tests or to see a specialist. Online GP chat available 24/7 mostly offers rapid access to medical guidance, sick leave certificate or telehealth medical certificate, making it a practical choice for addressing thrush without requiring an in-person appointment. 

Hola Health offers a fast and convenient way to access healthcare with doctors on demand anytime, anywhere in Australia. Whether you need a night doctor or a quick consult during the day, Hola Health connects you with AHPRA-registered Australian GPs within 15 minutes: 

• Online doctor appointment: Speak to an Australian GP or an after-hours GP for immediate advice and treatment options via telehealth Australia. 
• Multi-Day and same day medical certificate online: Request medical certificates for single or multiple days, perfect for work, school, or carer responsibilities. 
• Prescriptions online: Receive escripts for medications sent directly to your local pharmacy or delivered to your door. 
• Online referrals: Get specialist referrals or referrals for pathology or radiology without the hassle of waiting for a clinic appointment. 

With Hola Health’s web doctor service, you can book telehealth appointments 24/7, ensuring quick and reliable care when it’s needed most by home doctors. Trusted by thousands of Australians, Hola Health makes healthcare accessible and stress-free via 24-hour doctors.  

Frequent thrush infections can significantly affect health and quality of life. Recognising causes like antibiotics, hormonal shifts, and diabetes is essential to manage it effectively. By using antifungal treatments, making lifestyle changes, and implementing preventive strategies, the occurrence of infections can be reduced. Consulting a healthcare professional for accurate diagnosis and treatment is important for lasting relief.