For mild vaginal thrush, a short course of anti-thrush medicine may be recommended. It is usually taken for one to three days.
If your thrush symptoms are more severe, you’ll need to take the treatment for longer.
Anti-thrush medicines are available as:
an anti-thrush pessary – to deal with Candida in the vagina. A pessary is a specially shaped pill that you insert into your vagina using an applicator
an anti-thrush cream – to deal with Candida on the skin around the vagina’s entrance
anti-thrush tablets – which can be used instead of creams and pessaries; these are swallowed and are called oral treatments
Pessaries and oral treatments have been found to be equally effective in treating thrush. Around 80% of women are successfully treated regardless of the type of medication they use.
Deciding on the type of treatment
Many women use anti-thrush pessaries and creams to treat a straightforward bout of thrush. Pessaries and creams are recommended if you’re pregnant or breastfeeding.
Oral treatments are simpler and more convenient than pessaries and creams, but they can have side effects. Both are equally effective.
The two main types of anti-thrush tablets that are prescribed by doctors to treat vaginal thrush contain the antifungal medicines fluconazole or itraconazole. If you prefer to use a cream, you can use an emollient moisturiser rather than an antifungal cream.
Anti-thrush tablets can cause side effects, including:
an upset stomach
Pessaries that are often prescribed for thrush include the anti-fungal medicines:
Vaginal pessaries are not absorbed into the body, but they can:
be awkward to use
cause a mild burning sensation, slight redness or itching
leave a white or creamy stain on your underwear (it washes out)
damage latex condoms and diaphragms, so you will have to use another form of contraception while using them
You shouldn’t use vaginal pessaries without seeing a doctor.
Pharmacy anti-thrush treatments
Some tablets, creams and pessaries to treat vaginal thrush are available over the counter from your pharmacist, and a prescription is not needed.
Anti-thrush pessaries and creams containing clotrimazole are widely sold from pharmacies.
Fluconazole is also available over the counter from pharmacies as a single-dose tablet for treating thrush.
These treatments can be effective if you’ve had thrush before. However, don’t buy medication directly from a pharmacy if it’s your first bout of thrush. Visit a doctor first.
You shouldn’t use over-the-counter thrush treatments for a long period of time without talking to a doctor.
Advice if you’re pregnant or breastfeeding
If you have thrush and you’re pregnant or breastfeeding, you should always consult your doctor rather than buying anti-thrush medication directly from a pharmacy.
You won’t be prescribed oral treatment because it may affect your baby. An anti-thrush pessary – such as clotrimazole, econazole or miconazole – will usually be prescribed.
If you’re pregnant, take care when inserting a pessary as there’s a small risk of injuring your cervix (neck of the womb). To reduce the risk, insert the pessaries using your finger instead of using the applicator.
If you have symptoms around your vulva, such as itching and soreness, you may also be prescribed an anti-thrush cream. Between attacks you may also want to use a regular moisturiser around the vagina. For example, E45 cream can be used as a soap substitute. After applying, wash it off then apply a greasier moisturiser to protect the skin. However, be aware that moisturisers can weaken condoms.