From the Guidelines
Vaginal thrush frequency can increase with menstruation due to the alteration of the vaginal environment, which becomes less acidic and provides nutrients for Candida growth. This occurs because menstrual blood has a higher pH of around 7.4, temporarily making the vagina less acidic during menstruation, and provides nutrients that can feed Candida organisms 1. The use of tampons or pads can also create warm, moist conditions that further promote fungal growth. Some women may notice recurring thrush infections that appear just before or after their period due to these hormonal fluctuations.
Management and Prevention
If experiencing recurrent thrush with menstruation, several strategies can help manage this pattern, including:
- Maintaining good hygiene during periods
- Changing tampons or pads frequently
- Avoiding scented menstrual products
- Wearing cotton underwear
- Considering preventive antifungal treatment, such as fluconazole 150mg taken just before menstruation, as recommended by the 2021 Centers for Disease Control and Prevention guidelines 1.
High-Risk Groups
Women with diabetes should be particularly vigilant as they already have a higher thrush risk due to elevated blood sugar levels 1. The clinical practice guideline for the management of candidiasis also emphasizes the importance of proper diagnosis and treatment, especially in cases of recurrent vulvovaginal candidiasis, which can be caused by azole-susceptible C. albicans or other non-albicans species 1.
Treatment Options
Treatment options for vulvovaginal candidiasis include topical and systemic oral agents, with fluconazole being a commonly recommended treatment 1. However, the choice of treatment may depend on the severity of the infection, the causative species, and the patient's underlying health conditions. In cases of recurrent vulvovaginal candidiasis, maintenance therapy with fluconazole or other antifungal agents may be necessary to control symptoms and prevent recurrence 1.
From the Research
Vaginal Thrush Frequency and Menstruation
- The relationship between vaginal thrush frequency and menstruation is not directly addressed in the provided studies, but some studies suggest that hormonal changes during the menstrual cycle may affect the risk of vaginal thrush 2, 3.
- A study published in 2019 proposed a treatment scheme for recurrent vulvovaginal candidiasis that takes into account the menstrual cycle, with the goal of preventing new events by countering potential risk factors of recurrence 2.
- Another study published in 2000 discussed the management of chronic vaginal candidiasis in postmenopausal women, but did not specifically address the relationship between vaginal thrush frequency and menstruation 3.
- A 2022 systematic review of treatments for recurrent vulvovaginal candidiasis found that antifungal treatments may reduce symptomatic clinical recurrences, but did not examine the relationship between vaginal thrush frequency and menstruation 4.
- A 2005 study investigated the effect of hysterectomy on response to treatment, type of colonization, and recurrence rates in postmenopausal women with recurrent vulvovaginal candidiasis, but did not address the relationship between vaginal thrush frequency and menstruation 5.
Risk Factors for Vaginal Thrush
- Hormonal changes during the menstrual cycle may affect the risk of vaginal thrush 2, 3.
- Other potential risk factors for vaginal thrush include diabetes, immunosuppression, and use of certain medications 3, 4.
- The presence of certain fungal species, such as Candida albicans, may also affect the risk of vaginal thrush 2, 5.
Treatment and Prevention
- Antifungal treatments, such as fluconazole, may be effective in reducing symptomatic clinical recurrences of vaginal thrush 2, 4.
- Maintenance therapy with antifungal medications may be necessary to prevent recurrence 2, 3.
- Other treatments, such as probiotics and topical antifungals, may also be effective in preventing and treating vaginal thrush 2, 4.