Recurrent Vulvovaginal Thrush
Embarrassment, shame and stigma
Some people found it easy to talk about recurrent thrush with family and friends. However, many of the people we talked to suggested that (recurrent) thrush could cause embarrassment, feelings of isolation, and concerns around being seen as having poor personal hygiene. This section covers:
- Talking to others about recurrent thrush
- Feeling dirty and concerns about hygiene
- Taboos around genitals and sexual health
- Perceived association with STIs
- Cultural and family considerations
- Overcoming embarrassment, shame, and stigma
Talking to others about recurrent thrush
Not everyone we spoke to felt embarrassment, shame, or stigma around recurrent thrush. Julia was happy to talk to her friends and mum about it and said “I don’t feel like that... I don’t feel shame at all. I don’t feel stigmatised at all”.
Several people though told us that they had found it challenging to speak openly about recurrent thrush.
Jody explained that others might think recurrent thrush has a “quick fix” and not understand the embarrassment of it repeatedly coming back (read by an actor).
Jody explained that others might think recurrent thrush has a “quick fix” and not understand the embarrassment of it repeatedly coming back (read by an actor).
I think because people just assume, ‘oh well, it’s just this thing that you... you know, you can just go get a cream and that’s going to fix it and that’s...’ you know, it’s as simple as that, but people just don’t really understand like the implications of what it’s actually like to live with this condition that just keeps coming back, and back, and back, as well as just like the stigma of it as well, because obviously it’s like an embarrassing condition to have, it’s not something you know that’s really talked about.
Taking part in this study was the first time some people had spoken openly about their condition. Nancy felt that thrush was not something people talked about. Some people said recurrent thrush was more embarrassing than a one-off episode due to how often it occurred.
Rowan found embarrassment made it hard to talk about recurrent thrush.
Rowan found embarrassment made it hard to talk about recurrent thrush.
I think it would be something that I wouldn’t feel super-comfortable talking about it. I feel like there’s quite a lot of like stigma around it, and if I was... like if I was feeling like similarly frustrated at like an ongoing like medical problem that I... and I felt like I wasn’t kind of getting the... the treatment that I wanted, or like my concerns weren’t being adequately addressed, I probably would like vent a little bit about that with like either my family, or my friends, and I kind of didn’t in this instance, not necessarily deliberately, but yeah, it’s just not something that’s super-easy to talk about.
And actually, just thinking about it, I did... so when I said... one of the times I said that I was going to the doctor’s and my mum kind of asked like, “Oh, why are you going?” and I did tell her, but I was... I was a bit like uncomfortable and I kind of... yeah, I wouldn’t have volunteered that information if she hadn’t asked, and then she kind of kept coming up to me and in like a... a hush voice being like, “How did it go?” rather than like just having an open conversation about it, because clearly it was something that she felt a little bit embarrassed by as well.
As a teenager, Imogen did not want to talk to her mum about the issue. Jody said “it’s not like the same as you know with other health conditions where you might just say to your mate like, ‘oh, you know, I've got this cough, what do you recommend?’. While Teddy had an otherwise open family, they found recurrent thrush difficult to discuss. Beth Sarah initially found it embarrassing to talk about with her partner or friends.
Despite feeling embarrassed, some people still tried to discuss the topic. Ella said “I’m telling more friends than I thought I would because I can't just go, ‘oh yeah, everything’s fine’”.
Discussing recurrent thrush with healthcare professionals could also feel embarrassing. Sasha “mumbled” through a doctor’s appointment due to shame and not wanting to talk about the issue. Similarly, when she was younger, Imogen felt embarrassed asking a pharmacist for medication and Nancy discussed speaking in hushed tones to a pharmacist. Beth said that it was embarrassing to have to seek treatment every month from the same pharmacist so she went to different chemists.
KJ discussed speaking quietly with the pharmacist due to ‘all that stigma rubbish in society’ about thrush.
KJ discussed speaking quietly with the pharmacist due to ‘all that stigma rubbish in society’ about thrush.
I think there is a stigma around it, but I’m kind of like... I’m quite an open sort of person, so I’ll just... I’ll just be like... you know I wouldn’t come out loud and go, ‘oh, I’ve got an itchy nu-nu,’ you know like or just say something... you know I’ll sort of... but I won’t think twice about saying... I must admit, when you get to the chemist and you sort of... I always approach a female chemist, and I’m always sort of like quite quiet, so there is... you know and trying to keep it very like: you know [mumbles] ‘I’ve got thrush,’ sort of, very on the down low, you know sort of when I’ve got it, so yeah, I do think there is a... there is a... a stigma there, you know it’s not something you know you can talk about, sort of, there is still that stigma rubbish in society about it, definitely.
Nancy said that she encountered embarrassment at pharmacies (read by an actor)
Nancy said that she encountered embarrassment at pharmacies (read by an actor)
When you go to the pharmacy actually and you say, “Can I have some...” and they have to like ask you, you know, like, ‘do you have any other conditions, have you had this before in the last whatever months?’ They kind of pull you to the side and they say it very quietly, and then... but when people go in and ask for like aspirin, they don’t do that. So I... I expect I’m picking up on that, that we don’t talk about this. But I mean I’m sure they’re doing it because they want to respect people’s privacy and they think that people don’t want to talk about it, but then that feeds itself in, doesn’t it, that it means that people don’t want to talk about it?
Teddy tried to not feel embarrassed when seeking thrush medications in the pharmacy.
Teddy tried to not feel embarrassed when seeking thrush medications in the pharmacy.
Generally, I've not found too much judgement. Every now and then I've had people... like pharmacists look at me kind of weirdly for wanting thrush medication and not having a prescription for it. I think I was... I do still worry when I go into a shop, like I still feel a bit like, ‘I have to mention the name of what I'm getting really quietly because it’s a stigmatised thing,’ but over time I've tried to kind of get out of that and be like, ‘who’s really going to judge me? I can't be the most embarrassing person in this shop, like come on, that can't... that can't be...’ and like everyone’s embarrassed about whatever medical ailment they've got, I'm not going to be... ‘this is not going to be the most personal order that this pharmacist has heard this week,’ so I try and remind myself of that has made me a little bit less nervous about it, I think.
Not being able to talk about recurrent thrush and the pain it was causing could contribute to emotional and mental health impacts.
For those that were able to speak to their family and friends, they often found support. Joy was able to talk openly with her family without embarrassment. Marie said her husband was brilliant and that she found support on online forums.
Feeling “dirty” and concerns about personal hygiene
Some people said recurrent thrush made them feel “dirty” and worried that others would see them as unhygienic. Nancy said, “No one’s said anything to me directly, but yes, I do get the sort of the feeling that in society you don't discuss it, thrush is a bit, ‘eww,’ and maybe people think you're like dirty or something like that”.
Kayla worried that somehow people would know that she had thrush – even though they would not be able to see it.
Kayla worried that somehow people would know that she had thrush – even though they would not be able to see it.
I’ll have like a couple of showers a day to try and keep clean, and I'm worried people will know I've got it, even though you know there’s no symptoms that would show that I have, but I... you know, I worry people might know that I've got it, and it just impacts my life you know because I'm so sore, you know it just hurt... as I said before, it just hurts to you know even if going out for a simple meal, sitting down is painful.
I don’t know, just because there’s kind of like a stigma to it, and I think people might think it’s you know because I'm not clean enough, or you know that I'm not doing something... I'm not keeping myself clean, which is why I keep getting it. I don't know, I just think there’s a stigma to it if you say you have recurrent thrush.
Sasha felt there was a lot of stigma around hygiene amongst women.
Sasha felt there was a lot of stigma around hygiene amongst women.
So, definitely there’s a lot of stigma around it, and especially in the broader women community: they really do not have time to talk about it, where you’re looked at, when they said, “Are you really washing your panties, are you wearing dry panties?” I mean this, you know, that is what you expect, and that is what they say, so I end up just keeping quiet and trying to find a way to minimise it and make sure that it doesn’t get to a stage and it smells or I feel uncomfortable to be around people.
Imogen said she felt “gross” and “disgusting”. Jody questioned whether she was an “unclean person”. Kayla said that persistent itching worsened feelings of dirtiness and that she worried about not being “clean enough”. Nancy said that embarrassing elements of thrush such as “cottage cheese discharge” made it harder to discuss openly.
Some people questioned their cleanliness and worried that others would perceive them as having unhygienic practices. Rowan wondered “am I doing something wrong, like am I unhygienic?’”. Beth became “paranoid” about not changing period products often enough and worried she was causing recurrent thrush.
Elliott worried what friends would think about their hygiene after learning about recurrent thrush (read by an actor)
Elliott worried what friends would think about their hygiene after learning about recurrent thrush (read by an actor)
The only thing I’d say is like when it being re-occurrent then like sometimes like friends have been like you’re thinking as if like you’re like your habits down there, or whatever, must be like wrong, or something, or like you’re doing things... like something that you could be doing to you know cause it, when I know that I’m really on it and it’s not anything that is actually being caused by like that, does that make sense?
Worries about smells were shared by Emma, Nysha and Sasha. The fear that there could be an odour from recurrent thrush caused self-consciousness.
Feeling dirty could make some people wash very often or use vaginal bathing products, but this could make thrush worse (See Prevention and changing daily practices). Harry wanted others to know that recurrent thrush was not linked to hygiene: “it’s not because I'm dirty, it’s not because I don't wash, if anything it’s probably because I wash too much because I'm conscious of it”.
Taboos around genitals and sexual health
Recurrent thrush affects intimate areas which adds another layer of shame and stigma. Teddy said that "I think vaginas are seen as really dirty anyway, so... any infection or illness that you get there will kind of be stigmatised."
Marie felt that “nobody wants to talk about vaginas or sexual health”.
Marie felt that “nobody wants to talk about vaginas or sexual health”.
But generally, I think women’s health issues are not widely discussed. You know we've been through the things like breast cancer and prostate cancer, but you know let’s talk about women’s health as well because there’s so many different conditions and they're not openly discussed: nobody wants to talk about them. Nobody wants to talk about vaginas or sexual health.
Chloe remarked that female sexual health was not talked about in general.
Chloe remarked that female sexual health was not talked about in general.
I have, I think... I don't know whether that’s just brought on personally, or what, but I think it’s sort of like female sexual health in general, it’s just it’s not talked about, it’s very taboo, so then if anything goes... I don’t want to say ‘goes wrong down there’, because it’s not wrong, if that makes sense, but if anything isn’t normal, or is abnormal down there, and it isn’t smelling of roses and doesn’t look perfect, then all of a sudden it’s... there’s something wrong with it, you know.
When I first started getting it, it felt like it was a lot of... a lot bigger thing than it is now, and I know more... like back then I didn’t really know what it was, I just knew it was an imbalance of some sort and I had an excess of yeast, whereas now I’m a lot more aware of, you know, yes it’s an imbalance, but... of everything that can cause it, like triggers, that, you know, it’s... whilst it can be passed on via sex, like it’s not an STD so it’s not something to be ashamed of, it doesn’t mean I’m dirty, like and it’s just that more of awareness, and it’s whilst it is a common thing among women, it isn’t a regularly common thing, if that makes sense?
Other people thought that they lacked proper information and education about their bodies and genital health.
Nysha explained that a lack of sexual education meant that she only learned about her anatomy later in life.
Nysha explained that a lack of sexual education meant that she only learned about her anatomy later in life.
Because I went to a Catholic school, so we didn't even learn about sexual education, we got taught the life cycle of frog, I don't know how that relates to a... you know there was never anyone talking to us about periods, and like you say, like thrush and things like that, these were never things... maybe it’s probably because of the time I was growing up, I don't know, but I know they don't really talk about it that much now and it... it’s really important that these conversations start from a young age, so young women, girls, know what to expect. Also, like people that are transitioning and you know are aware exactly what can happen and various other things.
Perceived association with STIs
Recurrent thrush was sometimes misunderstood as a sexually transmitted infection (STI) which several of the people we talked to thought led to social judgments that they had been promiscuous or ‘slept around’. Teddy worried that people thought recurrent thrush was sexually transmitted and that other people would conclude they were a “slut”.
Laura said that social media could contribute to this misinformation; she told us that she had seen a Facebook post saying thrush was only spread through sex. She explained the difference between an STI and recurrent thrush “I know you can transmit it if you've got it when you have sex, but it’s not... you can just have it spontaneously and it not be a sexually transmitted disease.”
Imani said that lack of awareness about thrush contributed to feelings of shame (read by an actor)
Imani said that lack of awareness about thrush contributed to feelings of shame (read by an actor)
I can say sometimes it’s shame. It might not be lack of... yeah, it can be lack of knowledge, maybe thinking though people will just think maybe thrush is... it’s a sexually transmitted disease and sometimes they are ashamed to talk about it, and however it can be triggered with different aspects which might not be what they are thinking, so I feel like sometimes people they don’t want to talk about it feeling that how people are going to pursue or judge them, so... yeah.
Imani said it could be difficult to discuss thrush due to fears of judgement and misunderstanding from others. Chloe explained that misinformation circulates around it being an STI as “you can get a lot of people who kind of don’t really know and they’re very much like ‘you’re dirty’”.
Harry explained misinformation around recurrent thrush being linked to ‘sleeping around’ or too much sex
Harry explained misinformation around recurrent thrush being linked to ‘sleeping around’ or too much sex
So yeah, there’s a lot of misinformation out there. I still think people think it’s something to do with having too much sex or it’s kind... because I think the people who come out about it are very confident in themselves, are quite often very sex‑positive as well, which is the best way to be, but a lot of people looking at that would be like, “Oh, it’s because they sleep around,” and it’s like, “No, it’s not, it’s not at all, they're just bold... like bold enough to say what they've got because more women that we realise have this problem and none of them are confident coming out and if you don't stop talking the way you are, then it’s going to keep getting like this,” but you know there’s a lot... a lot of rubbish online that’s inaccurate.
While thrush is not an STI, sexual health clinics could offer help diagnosing and managing recurrent thrush and often had specialists in vulvovaginal health. Yet, some people felt some stigma about attending a sexual health clinic for thrush such as Marie and Harry who worried about perceived judgement.
You can read more about how recurrent thrush impacted people’s sex lives and relationships here.
Cultural and family considerations
The people we spoke to came from different cultural backgrounds which they suggested influenced how hard it was to talk about recurrent thrush, or indeed any sexual health matters, with their family and friends.
Sai said that back home in India “these things are just not discussed as much”. Nysha found it helpful to break down stigma by speaking with people both within her Black community and outside of it, who were more open to conversations. Hannah said her Polish family was quite conservative which made it difficult to talk about sexual health.
Nysha said that in their Caribbean family, anything “below the neck” was considered a taboo subject.
Nysha said that in their Caribbean family, anything “below the neck” was considered a taboo subject.
In the culture that I'm from, my family are Caribbean, so anything below the neck is considered like a taboo subject, and it was trying to understand what was going on, and so I'd reach out to friends and go, “This is what’s going on, I'm so embarrassed,” I was really, really embarrassed, my friends were like, “You've got nothing to be embarrassed about, it happens to me too.” And that kind of then started a conversation between us all of what was going on in relation to our vaginas, vulvas, everything, just understanding why our body’s react the same, thinking... I think it was taking away the stigma that it’s just you and that... also like I said, I also had this feeling that I'm not a dirty per... that was all... all that was in my head was, ‘I'm not a dirty person, why does this keep happening to me?’
Zoya, coming from a South Asian background, said that older generations were more likely to avoid speaking openly about such matters, but younger generations may be more open.
Zoya said that talking about thrush and genitals was taboo in her South Asian family, but that she was not afraid to ask for help.
Zoya said that talking about thrush and genitals was taboo in her South Asian family, but that she was not afraid to ask for help.
Some countries and some cultures it’s probably quite taboo and don't want to speak to anybody about it and... and definitely if it was like... if... if it was my Mum, I mean if she had this she would just carry on, she wouldn't speak to anybody about it, that... you know because she is from sort of the south Asian side and stuff, but she would never mention it, whenever she’s struggling, she will not... she would not mention it, but I think it’s a different... I'm in a different generation, I'd be like, ‘yeah, I am struggling with this, I need help,’ [chuckles] I'm not afraid to ask for help.
Some people we spoke to suggested that shame and stigma around vulvas and vaginas was widespread everywhere across different countries and cultures. Imani said that stigma and a lack of knowledge was prevalent equally across England and their home country of South Africa.
Overcoming embarrassment, shame and stigma
Over time, some people we spoke to found that their understandings changed. Leah was embarrassed about her thrush when she was younger but says that she is not anymore. Emily said that she learned more about her body over time. Elliott and Harry spoke to the importance of having open communication to improve understanding and support.
Ella explained how talking openly about recurrent thrush would help explain what was going on in her life to others.
Ella explained how talking openly about recurrent thrush would help explain what was going on in her life to others.
I think that hiding and shame is a... is not good for anybody.
You know give us a kind of... give us an environment where we feel we can just say, ‘I don’t want to go on about it, but me bits are sore and I’m... you know I haven’t slept again and I’m just hacked off,’ you know just to be able to at least bring it into the room rather than this constant trying to leave everything outside the door, because then it means you... your... there’s less and less of you, you know, that you’re more disconnected from yourself, and I think that’s... that’s so bad for mental health and for ability to be present for whatever it is you’re trying to deal... you know work, with a project: how can you can you be fully present if you’ve had to deny this experience, that experience, and the other experience and leave them outside the door, you know because you’ve got all this effort trying to just keep them outside the door because you’re burning and you want to just say to someone, ‘for God’s sake, make this stop,’ you know and it’s... you can’t... it’s too much conflict, it’s conflict, it’s that conflict of, ‘I’m sore but I can’t tell you I’m sore.’
Some people reflected on how the shame and stigma associated with thrush was tied to ideas of womanhood and femininity that they were able to challenge.
Anna realises now that thrush is nothing to be ashamed of, but thinks that 20-year-old women are under pressure to appear ‘perfect’ (read by an actor)
Anna realises now that thrush is nothing to be ashamed of, but thinks that 20-year-old women are under pressure to appear ‘perfect’ (read by an actor)
Now I'm old enough that I'd really see the gamut of wild and wonderful things that women’s bodies do and I think there’s a huge amount of... I mean it’s hard though, I think just think being a 20-year-old woman in a... a 20-year-old person in a... particularly in a cis-female body, I don't know how you do it without being full of shame because there’s so much oddness that happens; whereas now like all my friends have like pushed babies out of their vaginas and ripped themselves open and had fibroids and had miscarriages and you're like, ‘oh right, these are just like wild vessels,’ but I think we don't know [laughs] that when we're 20 and we think they're supposed to be these perfect beautiful things for people to look at, but that’s not what they are [laughs]. So yeah, I would be like you know there’s nothing to be ashamed of, it’s just bodily... it’s literally just bodily fluids and like bacteria, but I probably wouldn't listen to it when I was 21.
Teddy noted that having recurrent thrush could make women feel “less of a woman in the way that a lot of cis-men with erectile dysfunction can feel like they’re less manly for it”. As a non-binary person Teddy remarked on feeling less personally concerned about this angle.
Teddy said that being non-binary meant that they had one less area of stigma to encounter as they did not feel “less of a woman”.
Teddy said that being non-binary meant that they had one less area of stigma to encounter as they did not feel “less of a woman”.
I think it’s... but I... it kind of from... let me know of a very common thing that is a lot of people do feel like it makes them less of a woman in the way that a lot of cis-men with erectile dysfunction can feel like they’re less manly for it. I do think a lot of people with things like thrush might feel it’s like a... it’s like that stereotype of like, ‘ah, pristine condition woman,’ but I do think that being non-binary’s kind of meant that I didn’t particularly get that to begin with, so that’s one less area of stigma that I happen... that’s like I’m less worried about it from... I’m not worried about it from that angle, so it makes that something.
Nysha said she is no longer ashamed to say words like vulva and vagina and is able to take ownership and autonomy for her body ‘well actually, I'm not a dirty person, it is what it is and these things happen to people’.
Imogen felt more informed and less ashamed as she got older.
Imogen felt more informed and less ashamed as she got older.
So, I’d say it’s probably on the last couple of years where I’ve not like stopped feeling disgusting and abnormal, and yeah, like I’m 30, that’s taken a long time and it’s something that, you know, I know everybody has issues and hang-ups, but it could... it didn’t have to be that bad, it really didn’t, and I think probably younger people today are growing up in quite a different time in terms of that.
So yeah, definitely changed in that way and I think just changed in the way I relate to it in terms of... you know, I think, you know, reading feminist literature and like academic literature and, yeah, just all that I believe in in terms of how we’re made to feel about our bodies, and I think that’s been really empowering and just how I relate to it, it’s not like part of me, it’s something that I’m prone to and it’s unfortunate and you can be like ‘why me?’, but also ‘why not me?’, like, lots of people have things to deal with that you don’t see, and this has been one of mine, like... yeah.
Online communities helped Teddy, Imogen, Nysha, and Marie overcome shame and stigma and you can read more about that here (see Support networks and information).
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