Genital Thrush 101

The yeast that thrives on chaos and mild discomfort

Genital thrush is a yeast overgrowth caused by Candida. It is not a sexually transmitted infection and is not necessarily a sign of poor hygiene. Having thrush does not imply anything negative about your body or your sex life. It is a common biological imbalance that can affect anyone with genital skin or mucosal tissue.

This article is for people with vulvas, people with penises, non-binary and intersex bodies, and anyone experiencing hormone-related tissue changes, including people on testosterone. In short, it’s for anyone who’s ever wondered why their genitals suddenly feel uncomfortable, irritated, or itchy.

What is thrush?

Thrush occurs when the normally harmless yeast Candida grows out of control. Candida naturally lives on the skin and mucous membranes, such as in the mouth, genitals, and groin, and usually coexists without causing problems. However, when the natural balance is disrupted, which can happen for a variety of reasons we will discuss shortly, this yeast can overgrow and lead to infection (Stay STI Free, 2020).

Symptoms in every body

For vulvas

According to InformedHealth.org (2022), symptoms for people with vaulvas include:

• Itching or irritation around the vulva

• Thick whitish-yellowish discharge (yes, the dairy analogy is alive)

• Redness, soreness, burning with peeing or sex

For penises

In people with penises, thrush is also known as candida balanitis (Cleveland Clinic, 2022). Common symptoms include:

• Redness, rash, tender bumps, or flaky skin on the shaft or under the foreskin

• Itching or irritation at the tip or along the skin

• Burning or stinging during urination or sex

• Thick, white discharge that may resemble cottage cheese

• Swelling of the foreskin if uncircumcised

• Cracks or splits that feel painful or uncomfortable

Thrush can also be asymptomatic! Meaning nothing obvious shows up. This can be particularly true early on or between flares.

Who gets thrush?

Pretend biology threw darts at a board. Every body with skin and mucosa is a target:

• People with vaginas

• People with penises (definitely)

• Trans men and non-binary people

• Intersex folks

• People on testosterone

• People after antibiotics

• Phimosis, or a tight foreskin that is difficult to retract, can increase the risk of penile thrush by creating a warm, moist environment where yeast can thrive.

Thrush doesn’t care about your orientation or lifestyle. It can happen to anyone.

What causes it?

Thrush tends to show up when something shifts the microbial vibe:

• Antibiotics that kill “good bacteria” along with the bad

• Hormone changes, including testosterone and oestrogen swings

• High blood sugar / diabetes

• Stress (the sneaky immune saboteur)

• Tight underwear or sweaty costumes

• HIV and other autoimmune diseases

• Scented soaps & washes, which irritate and disrupt pH balance

• Sex and toys, especially without barriers or cleaning

For penis-owners, the warm, moist environment under a foreskin (if present) can be an especially cosy spot for Candida to set up shop.

Thrush vs bacterial vaginosis (BV)

Thrush often gets confused with BV, but they’re different conditions and need different treatment.

Thrush usually involves:

• Thick white discharge

• Itching and redness

• Little or no smell

BV usually involves:

• Thin grey or white discharge

• A strong fishy smell

• Less itching

If you’re unsure which one it is, especially if symptoms keep coming back, a swab test can save a lot of guesswork.

Is thrush sexually transmitted?

Thrush is not classified as an STI, but yeast can pass between partners through friction, fingers, toys, or oral sex.

If thrush keeps returning, it may help for partners to check for symptoms too, especially if they have a penis and notice redness, itching, or irritation on the head of the penis.

Condoms and cleaning sex toys thoroughly can reduce reinfection.

How thrush is treated

Most thrush responds to antifungal medications:

• Topical antifungal creams - apply where it itches or burns

• Oral antifungal tablets - for more stubborn or recurrent cases

For people with penises, treatment often focuses on the skin (including under the foreskin if uncircumcised.)

Important note: Some antifungals can damage latex condoms or dams, so check the instructions and switch to silicone or polyisoprene barriers if needed.

When to see a clinician

It’s worth getting checked if:

• It’s your first episode of thrush

• Symptoms don’t improve with treatment

• Thrush keeps coming back

• You have pain, bleeding, or unusual discharge

• You’re pregnant

• You’re immunocompromised

For trans and gender-diverse people, it’s okay to ask for language that fits your body and identity. A good clinician will meet you there.

Can you prevent thrush?

You can’t always prevent thrush, but you can reduce your risk:

• Avoid scented soaps, washes, and douches

• Wear breathable underwear

• Change out of damp clothes quickly

• Clean sex toys thoroughly

• Use water-based or silicone-based lubricants if dryness is an issue

• Manage underlying conditions like diabetes

If you’re on testosterone and experiencing dryness or recurrent infections, topical vaginal oestrogen can sometimes help, without affecting systemic hormone therapy. This is something to discuss with a knowledgeable clinician.

The takeaway

Thrush is common. It’s not dirty. It’s not a moral failure. It doesn’t mean your vagina or penis is "broken" or that your sex life is to blame.

It’s just biology doing what biology sometimes does, inconveniently.

And you deserve care that’s informed, affirming, and free from shame.

References

Cleveland Clinic. (2022, June 6). Male yeast infection (Candida balanitis): Symptoms, causes and treatment. Cleveland Clinic. https://my.clevelandclinic.org/health/diseases/23199-male-yeast-infection

Healthdirect Australia. (n.d.). Genital thrush in males. Australian Government Department of Health. https://www.healthdirect.gov.au/genital-thrush-in-males

Healthdirect Australia. (n.d.). Vaginal thrush. Australian Government Department of Health. https://www.healthdirect.gov.au/vaginal-thrush

InformedHealth.org. (2022, April 4). Overview: Vaginal yeast infection (thrush). National Library of Medicine Bookshelf, U.S. National Institutes of Health. https://www.ncbi.nlm.nih.gov/books/NBK543220/

Sexual Health Victoria. (n.d.). Genital thrush (candida). https://shvic.org.au/for-you/genital-health/genital-thrush

Stay STI Free. (n.d.). Thrush. https://www.staystifree.org.au/get-the-facts/thrush

Healthy WA. (n.d.). Thrush (genital). Government of Western Australia, Department of Health. https://www.healthywa.health.wa.gov.au/Articles/S_T/Thrush-genital

National Health and Medical Research Council. (n.d.). Thrush (candidiasis). Australian Government.https://www.nhmrc.gov.au/about-us/publications/staying-healthy-guidelines/fact-sheets/thrush

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The information provided in this blog post is intended for general educational purposes only and does not constitute professional medical advice, diagnosis, or treatment. While I am a registered health practitioner, this content is not a substitute for consultation with a qualified healthcare professional who can consider your individual circumstances.

This blog reflects my personal views and professional experiences and does not represent the views of my employer or any affiliated organisations.

In line with AHPRA guidelines, no testimonials are included, and this blog post is not intended to advertise or promote specific services or treatments.