Vulvovaginal candidiasis, more commonly known as vaginal thrush, is quite a common condition which will affect around 75% of women in their life. Thrush is caused by an overgrowth of a fungus candida around the vagina area. Symptoms include a thick white discharge, itchiness, burning and redness.
Any woman can get thrush but some may be more at risk. This includes women who are on certain medications or antibiotics, pregnant women and those with diabetes.
The most common treatment for thrush is an over-the-counter antifungal medication or cream. Some of you may have heard people recommending the topical application of live yoghurt for the treatment of thrush. But is there any evidence for this? Or is it an old wives’ tale?
Yes, there actually is! Live yoghurt contains probiotics which are beneficial bacteria. While our gut microflora is commonly discussed, we also have a vaginal microflora which when disturbed can result in thrush. So in theory, applying live yoghurt which contains beneficial bacteria makes sense!
There’s also evidence to support its use. A 2015 study compared a mixture of yogurt and honey and a standard anti-fungal treatment in reducing the symptoms of thrush in women. This was a double-blind study meaning both the researchers and the participants didn’t know which treatment they received so the chance of bias was greatly reduced. They found that the yogurt was not only as good as the standard treatment in terms of symptom relief but was more effective in relieving some symptoms such as itching, irritation and discharge.
Guidelines from The National Institute for Health and Care Excellence, most commonly known as NICE, also support the topical use of live yoghurt.
If you’re trying this out, make sure to go for live, unflavoured natural yoghurt.
What about oral probiotics?
Probiotic supplementation can also be really helpful for thrush treatment and prevention.
A 2017 Cochrane review (this is a detailed paper which reviews lots of other papers on the area and is one of the highest quality reviews for nutrition) studied the effectiveness of probiotic supplementation on thrush treatment.
The results from this review were promising! They found that when probiotics were used as an adjuvant therapy to antifungal drugs (ie. as an additional or add-on treatment), probiotics could enhance their effect and improve the rate of clinical cure. When probiotics were used as an additional treatment, relapse rates were lower in the following month.
Different trials used different strains of probiotics such as lactobacillus acidophilus, saccharomyces boulardii, streptococcus thermophiles and lactobacillus casei.
Two strains have been particularly well researched. These are lactobacillus rhamnosus and lactobacillus reuteri. They have also been shown to reach the vagina area alive. So if you’re thinking of getting a probiotic for this purpose, make sure to look for these two strains!