Why do I keep getting thrush

Recurrent episodes of thrush can be frustrating and uncomfortable. Thrush, also known as candidiasis, is a fungal infection commonly affecting the mouth, throat or genital area. While a single bout of thrush is usually easy to treat, frequent recurrences may indicate underlying issues that need attention. Understanding why you keep getting thrush empowers you to adopt effective self care strategies and seek appropriate medical help, so you can reduce symptoms and prevent future flare ups.

What is thrush
Thrush is caused by an overgrowth of Candida yeast, most often Candida albicans. In healthy individuals this fungus lives harmlessly on the skin and mucous membranes. When conditions allow it to multiply unchecked, it can cause sore white patches in the mouth or tongue known as oral thrush, or itching and discharge in the genital area known as vaginal thrush. Thrush may also affect the skin folds, nails or other moist areas of the body. The infection can be mildly irritating or cause significant discomfort depending on its location and severity.

Why thrush recurs
A single course of antifungal treatment often clears thrush completely. However, if the factors that allowed Candida to overgrow are still present, the infection may return. Recurrent thrush is generally defined as four or more episodes in a year. Each new episode may develop more quickly and last longer than the last. Identifying and addressing the root causes of recurrent thrush is essential to breaking the cycle and restoring balance to the body’s natural microbiome.

Disruption of normal flora
Healthy bacteria and yeast live in harmony on our skin and in the digestive and genital tracts. These bacteria help control fungal populations by competing for nutrients and producing mild acids that inhibit yeast growth. Taking broad spectrum antibiotics to treat bacterial infections can disrupt this balance, killing protective bacteria and leaving an ecological niche that Candida exploits. While antibiotics are sometimes necessary, recurrent use increases the risk of thrush returning.

Hormonal influences
Hormonal changes can alter the environment in which yeast grows. Many women notice thrush around the time of menstruation due to shifting oestrogen and progesterone levels. Pregnancy also increases the risk of vaginal thrush because rising hormones affect the vaginal pH, making it more hospitable to Candida. Hormonal contraception methods such as the combined pill, implant or hormonal coil may also contribute to recurrent thrush in some individuals by changing the local hormonal milieu.

Immune system factors
A healthy immune system keeps Candida growth under control. Conditions or treatments that weaken immune responses, such as uncontrolled diabetes, HIV infection, chemotherapy, immunosuppressant drugs or long term corticosteroid use, increase the risk of thrush. Even stress, poor sleep and inadequate nutrition can impair immune function over time, making it harder for the body to fend off yeast overgrowth. Supporting immune health through a balanced diet, sufficient rest and stress management helps reduce recurrence.

Lifestyle and hygiene practices
Certain habits can inadvertently encourage thrush. Wearing tight synthetic underwear or wet swimwear for prolonged periods traps moisture against the skin, creating an ideal environment for fungal growth. Using scented soaps, bubble baths or perfumed toiletries in the genital area can disrupt the natural pH and irritate sensitive mucous membranes. Douching or using vaginal cleansers is generally discouraged because it washes away protective bacteria and may lead to more infections.

Dietary factors
Candida feeds on sugars and simple carbohydrates. Diets high in refined sugars, white bread, pastries and sweetened beverages can supply excess fuel for yeast, fueling overgrowth. While diet alone does not cause thrush, reducing sugar intake and focusing on whole grains, lean proteins, vegetables and healthy fats can help starve Candida and support beneficial bacteria. Probiotic foods such as live yoghurt, kefir and fermented vegetables also provide helpful bacteria that compete with yeast.

Genetic predisposition and anatomical considerations
Some people appear more prone to thrush due to genetic variations that affect their immune response or the composition of their normal flora. Others may have subtle anatomical differences, such as tight skin folds, ingrown hairs or minor structural changes in the mouth or genital tract, that trap moisture or irritate the skin. While these factors cannot be changed, knowing they exist allows for targeted hygiene and preventive strategies.

Medication side effects
Beyond antibiotics and corticosteroids, other medications can contribute to thrush. Drugs that suppress saliva production, such as some antidepressants and antihistamines, increase dryness in the mouth and reduce the natural antimicrobial action of saliva, making oral thrush more likely. Similarly, inhaled corticosteroids for asthma or COPD can lead to fungal growth in the mouth if the inhaler is used without rinsing and spitting afterwards. Checking medication side effects with your prescriber and adopting simple measures can prevent these forms of thrush.

Diagnosis and proper identification
Accurate diagnosis is key to effective treatment. Oral thrush presents as creamy white or yellowish patches on the tongue, inner cheeks or roof of the mouth that may bleed if scraped. Vaginal thrush causes intense itching, soreness, reddening and a cottage cheese like discharge. Skin thrush appears as red itchy rashes in moist areas. If symptoms recur frequently, your GP may take a swab for laboratory testing to confirm Candida species and check for antifungal resistance before prescribing a tailored treatment.

Effective treatment approaches
First line treatments often involve topical antifungal creams or pessaries for vaginal thrush and oral suspensions or lozenges for oral thrush. In cases of recurrent infection your GP may recommend a longer course of oral fluconazole taken once weekly for several months. Combining systemic treatment with local measures such as continuing antifungal cream for a week after symptoms resolve helps eradicate residual yeast. It is essential to follow the full course of treatment even if symptoms improve early to prevent persistence of low level infection.

Long term prevention strategies
Preventing recurrent thrush involves addressing all contributing factors. After completing antifungal therapy, maintain good genital hygiene by wearing loose cotton underwear, changing damp clothing promptly and avoiding irritants such as perfumed products. Rinse your mouth with water after using steroid inhalers and practice good oral hygiene. Support a balanced diet low in refined sugars and rich in probiotic foods. If you have diabetes keep your blood sugar under control. Regular exercise, stress reduction techniques and sufficient sleep all support a resilient immune system.

When to seek further medical advice
If thrush recurs despite preventive efforts, or if you notice unusual symptoms such as an unusual odour, pain during urination or intercourse, blood in urine or stools, or lesions that do not heal, consult your GP. They may refer you to a gynaecologist, dermatologist or specialist in infectious diseases for further investigation. Rarely, chronic mucocutaneous candidiasis indicates an underlying immune disorder requiring specialised treatment.

Summary
Recurrent thrush arises when Candida yeast repeatedly overgrows due to disrupted normal flora, hormonal influences, immune suppression, lifestyle factors, dietary choices, genetic predisposition, medications or anatomical considerations. Effective management combines accurate diagnosis, complete antifungal treatment courses and targeted preventive strategies. By maintaining good hygiene, balancing your diet, managing underlying health conditions and supporting your immune system you can reduce the frequency of thrush episodes and enjoy greater comfort and confidence.