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Two days ago I engaged in sexual activity with my boyfriend for the first time. We used a condom, and there was no breakage or leakage. He is significantly larger than my previous sexual partners, so it was very painful and most likely caused some tearing. Yesterday, late at night, I went to the restroom and in the toilet was a small, flesh-colored sheet of what looked like skin. It was only about an inch long, and the center was slightly pinker than the rest. No cramping preceded or followed. Is this normal? Should I be concerned? I want to avoid an unnecessary doctor's visit if possible.

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Hi there

You probably have vaginal thrush.

Approximately 10-20% of women with thrush are asymptomatic. Symptoms are often worse in the week before menstruation. Symptoms of thrush can include:

  • A thick white or creamy vaginal discharge (may be cottage-cheese like in appearance)
  • Itchiness and redness in and around the vagina
  • Discomfort and/or pain during sexual intercourse
  • Burning on urination

There are a number of practices that are said to reduce a woman's chances of getting thrush. While in some cases there is limited scientific evidence about their effectiveness, many women believe they are helpful.

Practices include:

  • Avoid wearing tight fitting clothing like jeans and pantyhose, underwear made from synthetic fibres and panty liners (as these creates a moist, warm environment which may encourage the growth of Candida)
  • Avoid douching and taking baths with bubble-bath, soap, bath salts (can upset the natural balance in the vagina)
  • Change underwear daily and wash underwear in hot water (to destroy fungi)
  • Maintain a strong immune system by eating a well-balanced diet, getting enough sleep, not smoking and managing stress levels
  • If prescribed antibiotics for a health complaint, ask the doctor about also taking anti-fungal preparations in combination as a preventative measure
  • Consuming yoghurt or other products (eg., capsules) containing the 'good' bacteria, lactobacilli.

There is currently insufficient evidence to support dietary changes (eliminating high sugar foods and/or foods containing yeast) in the prevention of thrush. Using plain yoghurt in the vagina also appears to be of little benefit in treating or preventing thrush. Good luck

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