How to treat thrush in pregnancy, according to doctors

Thrush in pregnancy is very common - especially during the third trimester - and as many as a fifth of people who are pregnant can find themselves dealing with a yeast infection at some stage.

If you think you might have developed thrush during your pregnancy, it’s usually nothing to worry about and won't pose a serious risk to either you or your unborn child. However, it’s still important to make an appointment to see your doctor or antenatal team to get a correct diagnosis and find out if further tests are needed. They will also be able to provide individualised advice on safe treatment options.

We consulted Dr Ashfaq Khan, a consultant gynaecologist and obstetrician, and Dr Babak Ashrafi, a GP, for this article and they shared their expert advice with us on how to treat thrush in pregnancy and how to get quick relief from thrush symptoms.

Although thrush in pregnancy is common and generally not something to worry about, you should still make an appointment to see your GP straight away if you think you have thrush whilst pregnant, or if you are pregnant and experience any symptoms that concern you. 

What causes thrush in pregnancy?

"Thrush in pregnancy is usually caused by the overgrowth of a fungus called Candida albicans, which is naturally present in the vagina," explains Dr Khan. 

According to the NHS, it usually exists without causing any harm or symptoms, because its growth is kept under control by normal bacteria. However, if the balance of bacteria changes then the fungus can grow. This imbalance can be more common in pregnancy because of hormonal changes. Hormonal changes can cause a number of different symptoms during your pregnancy, including hot flashes, pregnancy migraines and even pregnancy cravings.

"Hormonal changes during pregnancy - particularly the increase in oestrogen levels - can create an environment conducive to the overgrowth of this fungus," notes Dr Khan. "Additionally, changes in pH levels and weakened immune responses during pregnancy can also contribute." This is why thrush can keep recurring in women during this time. 

"The symptoms of thrush are the same for pregnant and non-pregnant women," notes Dr Ashrafi. "These include itchiness and soreness of the vagina and vulva, vaginal discharge that is white and thicker than usual, pain during sex, stinging when urinating and red, cracked and inflamed skin around your vagina and vulva."

How common is thrush in pregnancy?

"It's relatively common to experience thrush during pregnancy due to hormonal changes and immune system fluctuations that mean symptoms can be exacerbated," explains Dr Khan. Indeed, research shows that it will affect three out of four women in their lifetimes, occurring more frequently during pregnancy. 

What’s more, it may be more prevalent during certain stages of pregnancy. “It is normal to experience thrush especially during the third trimester, when the body goes through the most changes,” reveals Dr Ashrafi. "While there is no evidence to suggest thrush will harm your baby, it’s important to get thrush treated as soon as possible."

How doctors recommend treating thrush in pregnancy

If you're pregnant, the NHS recommends seeing a doctor or midwife for personalised advice before using any treatments for thrush. They explain that symptoms can usually be soothed with a topical cream or tablet inserted into the vagina - called a pessary. But this needs to be discussed with your GP or antenatal team first. 

"Over the counter medicines are considered to be the most effective treatment option available," notes Dr Ashrafi. "The thrush should clear up within seven to 14 days of starting treatment." However, you should feel relief from the uncomfortable symptoms of thrush sooner.

"The best treatments for thrush in pregnancy typically involve antifungal medications such as clotrimazole or miconazole, which are generally considered safe for use during pregnancy when used as directed," explains Dr Khan. Importantly, according to the NHS, if you're pregnant you should not take anti-thrush tablets. All treatments for thrush in pregnancy should be discussed with your antenatal team prior to using them. 

"Always seek the advice of a medical professional who will be able to advise on the best treatment available," says Dr Ashrafi. "For example, while Canestan cream - a common antifungal medication - can be used during pregnancy, this should be checked with your doctor midwife first."

"Symptoms of thrush may begin to ease within a few days of starting treatment, but it may take up to a week," adds Dr Khan. "In the meantime, wear loose-fitting clothing, keep the area clean and dry and avoid irritants such as scented products."

Can you avoid thrush in pregnancy?

Although you can’t guarantee you will completely avoid thrush during pregnancy, there are some measures you can take to help reduce your risk of developing thrush in general. 

"To reduce the risk during pregnancy, women should wipe from front to back to avoid bacteria spreading and they should wear breathable cotton underwear that isn’t too tight," suggests Dr Ashrafi. In fact, trying to limit tight-fitting clothing in general is preferable.

Dr Khan adds: "Women should keep the genital area clean and dry, and avoid using harsh soaps or douches. Additionally, steer clear of scented hygiene products, since they can disrupt the natural balance of bacteria and yeast in the vagina."

What should you do about thrush in pregnancy that won't go away?

While one bout of thrush is usually nothing to worry about, you should speak to your doctor or midwife if it’s a frequent problem. Dr Khan explains: "This is because persistent thrush during pregnancy may indicate an underlying issue that requires further evaluation and management."

Dr Ashrafi adds, "You should always see a doctor if your symptoms haven’t resolved by the time your course of treatment has come to an end, or if [your symptoms] change or get worse. It’s important for other causes to be ruled out by a healthcare professional."

Is thrush in pregnancy anything to worry about?

In general, if you think you might have thrush in pregnancy, it’s best to speak to your GP or antenatal team to get advice on the best course of treatment for your personal situation. 

"There’s no reason to worry as long as the diagnosis of thrush is correct and you’re being treated appropriately," says Dr Ashrafi. "This is why it’s important to see a doctor for a full examination and any tests you might need to make sure there’s nothing else causing your symptoms."

According to the NHS, there's no evidence that thrush can harm an unborn baby. Dr Khan adds: "While it's not usually dangerous, recurrent thrush during pregnancy can affect quality of life - due to discomfort and disruption to daily activities - and can potentially lead to complications if left untreated." This is why pregnant women always should consult their doctor or midwife for appropriate advice and support.

Our experts

Dr Babak Ashrafi

Dr Babak Ashrafi is a GP at Superdrug Online Doctor. He studied at King’s College London and qualified as a general practitioner in 2007 after training in East London. He was a partner for six years at Lower Clapton Group Practice, followed by roles at Nuffield Health and then Wandsworth Medical Centre before moving into digital healthcare. His special interests include sexual health, men's health, diabetes and women's health. 

Dr Ashfaq Khan

Dr Ashfaq Khan has been practicing obstetrics and gynaecology in London for the last 20 years, having completed his clinical training in women’s health at Barts London, The Royal London Hospital, The Whittington Hospital and King George Hospital. He is the founder of Harley Street Gynaecology private practice and is also consultant obstetrician and gynaecologist at Whittington NHS Hospital.