Thrush, men

Thrush is a yeast infection caused by the Candida species of fungus. Thrush is also called candida or candidosis. It happens when a fungus called candida albicans grows too much.

Candida occurs naturally in the body, especially in warm, moist areas such as the mouth and genitals. It normally doesn’t cause any problems because it is kept under control by the immune system and other bacteria in the body. However, some factors can cause the fungus to multiply (grow), leading to infection.

Thrush infections usually appear in the mouth (oral thrush) or genitals. Candida is commonly found in the vagina, making thrush more likely to develop in women. However, the infection can also appear in men, too. Men with a foreskin are more likely to get thrush because the warmth and moisture underneath encourages the fungus to grow.

Thrush isn’t a sexually transmitted infection (STI) because many people already have a small amount of it in their bodies. It is actually more common in men who are not sexually active. The infection can, however, be passed on through sex.

For more information about oral thrush, please see the separate encyclopaedia topic.

The main symptom of male thrush is balanitis. This means inflammation of the penis. The head of your penis (glans) is very itchy, red and sore. You may have pain when passing urine and it can be difficult to pull back the foreskin.

You may also notice small red spots on the head of the penis, and you may have a discharge from the penis. A cheese-like material called smegma that smells a bit yeasty sometimes collects under the foreskin.

Thrush causes the foreskin to swell and crack in some men. This is probably caused by an allergy to the yeast.

You are unlikely to notice any symptoms until the fungus has already multiplied.

Many people have a small amount of the candida fungus in their bodies. It doesn’t usually cause any problems because the body’s immune system and other harmless bacteria keep it under control.

Anything that destroys the good bacteria in your body that keeps candida under control can lead to thrush. For example, if you are taking antibiotics for an infection the antibiotics won’t know the difference between good and bad bacteria and will fight off both types. If you are run down and your immune system is weak, the bacteria that cause thrush may also multiply.

Candida tends to grow in warm, moist conditions. Thrush can sometimes develop if you don’t dry your penis carefully after washing. Candida also thrives on skin that is already damaged. Using perfumed shower gels and soaps can irritate the penis, making thrush more likely to develop.

Thrush is also more likely to develop if you have uncontrolled diabetes (usually because you don’t realise you have diabetes). Other signs of diabetes include excessive thirst, lots of trips to the toilet to pass urine and weight loss. See your GP if you have these symptoms, and if thrush keeps coming back even after treatment.

The medical name for redness and soreness of the glans is balanitis. Balanitis is usually caused by thrush, particularly if you notice it after sex. However, the symptoms could also be a sign of something else.

If you’ve had thrush before and recognise what it is, you can buy over the counter treatments from your pharmacist to clear up the infection.

If you’re not sure what is causing the symptoms, you should see your GP or go to your local sexual health (GUM) clinic for tests. If you go to your GUM clinic, you will be seen in complete confidence and your GP won’t be told. You will probably have swab taken from the head of the penis or just under the foreskin to be looked at under a microscope – results are usually available straightaway. A doctor or nurse may also examine your genitals.

If you keep getting thrush, or it doesn’t clear up with treatment, your GP may test you for diabetes, as thrush in men can be the first sign of diabetes.

If you have thrush, it is likely that your partner may also be carrying it in her vagina. This is because the candida fungus commonly lives in the vaginal area. It is a good idea for both of you to get treatment to stop the infection being passed back and forth between you.

If you've had thrush before and you know what it is then you can get anti-fungal creams or a single dose pill (fluconazole) from your pharmacist without a prescription. Follow the directions on the packet, and see your GP if the infection doesn’t seem to be improving.

Your GP may suggest using a steroid cream as well as the anti-fungal medication to reduce the symptoms of the infection. If there is infection of the glans (head of the penis) then a steroid cream shouldn’t be used by itself because steroids can make infection worse.

Good hygiene and saline (salt) baths can help to clear up the infection. Wash the area carefully with warm water with enough kitchen salt added to it to make it taste like salt water. Dry your penis carefully after washing; the candida fungus thrives in damp conditions.

Don’t use perfumed shower gels on your genitals, as they can irritate them. Wash the area carefully with water (or temporarily with saline solution) instead.

Some men get a mild form of balanitis after having sex. This is probably caused by an allergy to thrush in your partner’s vagina. If your partner gets treatment, it will usually clear up.

Try to avoid having sex, or at least use a condom, while you are being treated for thrush, so that the infection doesn’t pass back to your partner.

In people who have a weak immune system, the fungus can sometimes spread into the blood. You may be at risk of this if you have leukaemia or diabetes mellitus, or if you are taking antibiotics over a long period of time or using intravenous drugs.

If the infection gets into the blood, symptoms can come on suddenly and may include fever, shivering, nausea and a headache. Blood poisoning needs to be treated to stop it spreading through the rest of the body and causing a more serious infection. If it spreads, it may affect the brain, eye, liver and heart.