Note- Vaginal infections are not caused by the menstrual cycle, but can be triggered or worsened by it e.g. some forms of recurrent thrush or BV. 

The two most common forms of recurrent vaginal infection are Thrush and Bacterial Vaginosis (BV).

1. Thrush

Thrush is an infection caused by a yeast fungus called candida that is normally harmless. Thrush tends to grow in warm, moist conditions and develops if the balance of bacteria changes. It’s not a sexually transmitted infection but can sometimes develop after you’ve had sex. It can develop in the vagina and on the genitals [1].

It’s a very common cause of unusual vaginal discharge – 3 out of 4 women will have thrush at some point in their lives [2].

Main symptoms [1]:

• white/ yellow discharge (like cottage cheese), which doesn’t usually smell
• itching and irritation around the vagina
• soreness and stinging during sex or when you urinate (pee)

2. Bacterial Vaginosis

Bacterial Vaginosis (BV) is a common infection of the vagina. It’s harmless and easily treated. Bacterial vaginosis occurs when there’s a change in the natural balance of bacteria in your vagina. BV is not classed as an STI, even though it can be triggered by sex. People who haven’t had sex can also get BV [3].

Main symptoms [3]:

• Vaginal discharge has a strong fishy smell
• Vaginal discharge is white or grey
• Vaginal discharge is thin and watery
• BV doesn’t usually cause any soreness or itching

Visit your doctor if you are experiencing these symptoms, in order to rule out other types of infection.

TOP TIPS! These are some things you can do to prevent recurrent infections of either thrush, or Bacterial Vaginosis (BV):

1. Thrush

Your GP or sexual health clinic will want to confirm it’s thrush and rule out other infections [1].

You’ll be asked about your symptoms. If it’s not clear it’s thrush:

• a doctor or nurse may look at your vagina
• a cotton bud may be wiped over the discharge to test for other infections

Treatment

You’ll often need antifungal medicine to get rid of thrush. This can be a tablet you take, a tablet you insert into your vagina (pessary) or a cream to relieve the irritation. Thrush should clear up within a week, after 1 dose of medicine or using the cream daily [1].

Recurring thrush

You might need to take treatment for longer (for up to 6 months) if you keep getting thrush (you get it more than twice in 6 months). Your GP or sexual health clinic can help identify if something is causing your thrush, such as your period or sex. They’ll recommend how often you should use treatment.

A pharmacist can help with thrush

You can buy antifungal medicine from pharmacies if you’ve had thrush diagnosed in the past and you know the symptoms. A pharmacist can recommend the best treatment for you. Ask if they have a private area to talk if you’re embarrassed. You shouldn’t use antifungal medicine more than twice in 6 months without speaking to a pharmacist or doctor.

2. Bacterial Vaginosis (BV)

Your GP or sexual health clinic will want to confirm it’s BV and rule out a sexually transmitted infection (STI) [3]. You’ll be asked about your symptoms [3]. If it’s not clear it’s BV:

• a doctor or nurse may look at your vagina
• a cotton bud may be wiped over the discharge inside your vagina to test for other infections

This won’t hurt but it may feel uncomfortable.

Treatment

Bacterial vaginosis is usually treated with antibiotic tablets or gel. These are prescribed by your GP or sexual health clinic. If you’re pregnant, it’s often safe to use treatment. Partners don’t need treatment, unless female partners have symptoms.

Recurring bacterial vaginosis

It’s common for BV to come back, usually within 3 months. You’ll need to take treatment for longer (up to 6 months) if you keep getting BV (you get it more than twice in 6 months). Your GP or sexual health clinic will recommend how long you need to treat it. They can also help identify if something is triggering your BV, such as sex or your period.

A pharmacist can help with bacterial vaginosis

A pharmacist can recommend the most effective treatment for your symptoms. You can buy ph-balancing treatments for BV without a prescription, but they have not been clinically tested to a high enough standard for doctors to be allowed to recommend them.

However, many people have tried and tested ph-balancing products such as ‘Balance Activ‘ for themselves and highly recommend it, especially if you would rather not have to take recurrent courses of antibiotics.

Further information:

• NHS information on vaginal thrush: http://www.nhs.uk/conditions/Thrush/Pages/Introduction.aspx
• NHS information on Bacterial Vaginosis: http://www.nhs.uk/conditions/bacterialvaginosis/Pages/Introduction.aspx
• NHS information on sexually transmitted infections: http://www.nhs.uk/Conditions/Sexually-transmitted-infections/Pages/Introduction.aspx

Page last reviewed and updated: June 2018

References:

1. NHS. (2017) Thrush in men and women. [ONLINE] Available at: https://www.nhs.uk/conditions/thrush-in-men-and-women/. [Accessed 27 February 2018
2. Sexwise. (2017) Thrush. [ONLINE] Available at: https://sexwise.fpa.org.uk/stis/thrush. [Accessed 27 February 2018].
3. NHS. (2018) Bacterial vaginosis. [ONLINE] Available at: https://www.nhs.uk/conditions/bacterial-vaginosis/. [Accessed 27 February 2018].