The Basics of Vulvovaginal Candidiasis

It is probable that all of you have heard of it and most of you have been visited by it at some point of your life, maybe in the summer. So let’s learn some things about Vulvovaginal Candidiasis.

This is the second article on Ask Your Gyno with Dr Amalia

The basics

This article is part of the VSV ( vaginas who have sex with vaginas) and STIs series and because in the first article we discussed the most common Vaginitis – Bacterial Vaginosis-, in this article we will discuss the second most common which is Vulvovaginal Candidiasis (also known as thrush, yeast or fungal infection). 75% of us will have Vulvovaginal Candidiasis at least once in our lives. It could be asymptomatic (no symptoms), or it can cause symptoms like white discharge that looks like cottage cheese, itching, vulvovaginal soreness, dysuria, and dyspareunia (pain during sexual intercourse). Almost 50% of people will suffer from recurrent Vulvovaginal Candidiasis. Amongst the general population it is most common for people with diabetes, pregnancy or immunosuppression.

Vaginal Flora

The bacteria that live naturally in our vagina are called Lactobacilli and they stabilize the vagina’s acidic PH. Nevertheless, when the appropriate conditions appear, the number of Lactobacilli is decreased and other microbes get the chance to multiply and cause Vaginosis, one of them is Candida spp.


Risk factors

  • Antibiotics
  • Frequent change of partners
  • Unprotected sex
  • Douching
  • Wearing panty-liners or pantyhose
  • Underwear made of lycra (or non-breathable synthetic material)
  • Damp bathing suits

How common is it amongst VSV people?

In a research study in 2008, 708 queer people, mostly Lesbians and Bisexuals, were examined in order to determine if Vulvovaginal Candidiasis is common amongst them. Vulvovaginal Candidiasis (either symptomatic or asymptomatic) was common in this sample of VSV people at 18.4%. Logistic regression (a statistical method to model a binary dependent variable) showed that Vulvovaginal Candidiasis was significantly associated

with larger numbers of female sexual partners in the previous year, but not with specific sexual practices, or numbers of male partners, or the use of lubricants or vaginal douching.

How is it transmitted amongst VSV people?

Fungi live naturally in our mouths, vagina and rectum, so the most common ways they can be transmitted are through oral sex, penetration with fingers in vagina or rectum and exchange of sex toys.


The diagnosis is made via vaginal cultures. In our femshop you will find the Vaginal Smear Culture Home Test in order to check the most common vaginal pathogens including Candida spp.

How do I take my sample?

Taking your sample is very easy and painless, follow the instructions below (also included in the kit) to use a swab and take a sample of your vaginal fluid. For the vaginal smear culture, you will take 3 samples.

  1. First, wash your hands
  2. Open the STERILE R tube, take out the swab
  3. In a comfortable position, hold the swab in one hand, and separate your labia with the other
  4. Insert the swab 5cm (which is about half the size of your index finger) into the vaginal opening
  5. Gently rub the swab against the walls of your vagina by turning it around for about 30 seconds
  6. Put the swab back in the tube and close it tight

Note: Follow the detailed instructions in the manual to ensure that all three samples are properly taken and preserved.

What happens if my results come in positive?

If you would like to discuss your results and/or receive a prescription from a certified doctor, head over to our telehealth page to view our list of recommended doctors and book an online consultation.


If you experience symptoms of Vaginosis, don’t practice any sexual activity, until they are completely gone. Also, if you are using sex toys, make sure you clean them before and after use and don’t exchange them. My next article will be devoted only to the prevention of all STIs.


The first line of treatment is Azoles and most commonly Fluconazole in the form of vaginal suppositories or oral pills. If that doesn’t reduce the symptoms, it could be a sign of rare Candida species, such as Candida krusei or C. glabrata. Alternative medications might be anti inflammatories or probiotics and prebiotics, which can also help to prevent the infection. We shouldn’t forget that all off our sexual partners should also take medications, even if they are asymptomatic.

Recurrent Vulvovaginal Candidiasis

The most common cause of recurrent Vulvovaginal Candidiasis are false positive lab test results. So, if you have 4 or more episodes in a year, you should confirm the result and the species of Candida that is isolated. 

If the Vulvovaginal Candidiasis is confirmed the first line of treatment is Triazole for 6 months. Another agent that might help is daily probiotics that help balance vaginal flora.

Alternative therapies

  • Boric acid: you can find it in the form of vaginal suppositories.
  • Vinegar: although it can reduce symptoms of Vaginosis, its use is not recommended anymore.
  • Tea tree oil: put a drop of tea tree essential oil in 1ml of water and apply topically
  • Soda: make a bath using 6-12gr of baking soda in every liter of water and soak your vagina in it for 15 min, 2 times per day for 2-3 times per week, until symptoms are gone.
Stay tuned for more info in our next article, until then…take care of your vagina!


  1. Thais Chimati Felix1 & Denise Von Dolinger de Brito Röder2 & Reginaldo dos Santos Pedroso3. Alternative and complementary therapies for vulvovaginal candidiasis. 2018
  2. Bruna Gonc¸alves, Carina Ferreira, Carlos Tiago Alves, Mariana Henriques, Joana Azeredo, and So´nia Silva. Vulvovaginal candidiasis: Epidemiology, microbiology and risk factors. 2015.
  3. JULIA V. BAILEY. Vulvovaginal Candidiasis in Women Who Have Sex With Women. 2008.

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