Assessing and managing thrush

It is common for women of child-bearing age to present in general practice with vaginal discharge.

The second most common cause of infective vaginal discharge is Candida albicans, a commensal organism that may be found in up to 20 per cent of women. In the majority of cases, acute vulvovaginal candidiasis, or thrush, is caused by an overgrowth of C albicans, although non-albicans species such as C glabrata could be the cause. Thrush may present with a non-offensive white discharge with itching. Vaginal pH is typically less than 4.5.¹

Clinical assessment

It is important to consider whether an STI may be responsible in a woman presenting with vaginal discharge. When taking a history, it is helpful to evaluate whether any treatments have already been tried and their effect.