Needless treatments and procedures

Your weekly dose of evidence

Every woman has likely experienced that unbearable vaginal itch at some point in her life. It’s ok if it’s a once-off, but there are times when it just won’t stop. Usually, a persistent vaginal itch is a symptom of thrush, which is caused by a fungal organism from the Candida family. Anti-fungal tablets, creams and pessaries (that you insert into the vagina) are usually available over the counter at the local pharmacy.

If the itching is due to thrush these often clear up the problem in a few days. But there are times when a persistent vaginal itch is caused by something else, such as bacteria. In this case, using fungal treatments over and over again won’t help and could lead to fungal resistance. Cathy Watson explains what you should do if you’re faced with this problem.

This article is part of our occasional series into needless treatments and procedures that have little evidence of effectiveness and can do more harm than good. They include knee arthroscopy for knee pain, spinal fusion for lower back pain, antipsychotics for dementia patients, and unnecessary colonoscopies.

Sasha Petrova

Deputy Editor, Health + Medicine

Sometimes the symptoms of thrush can be caused by other infections. from shutterstock.com

Anti-fungal creams or tablets don’t always work for vaginal itch

Cathy Watson, University of Melbourne

If symptoms of thrush persist despite treatment, you may have an entirely different condition that would not be helped by anti-fungal creams or tablets.

From the archives: needless treatments and procedures

Knee arthroscopy requires admission to hospital and an anaesthetic. It carries some risk of harm such as infection or further damage in the joint. from shutterstock.com

Knee arthroscopy is one of the most common but least effective surgeries

Ian Harris, UNSW; Denise O'Connor, Monash University; Rachelle Buchbinder

Doctors tend to overestimate how good their treatments are and underestimate the harms that come from them. But many studies have shown knee arthroscopy to no more effective than fake surgery.

Colonoscopies are on the rise in Australia. from shutterstock.com

When is a colonoscopy necessary?

Suzanne Mahady, Monash University

A colonoscopy is usually done to diagnose bowel cancer. It is an invasive procedure with risks such as bowel perforation. It's important to only have the test if you're likely to benefit.

Back pain affects one-quarter of Australians. from shutterstock.com

Spinal fusion surgery for lower back pain is costly and there’s little evidence it’ll work

Gustavo Machado, University of Sydney; Christine Lin, University of Sydney; Ian Harris, UNSW

Rates of spinal fusion surgery for back pain are on the rise. This is despite little evidence that it's an effective procedure and studies showing many will have revision surgery within ten years.

Antipsychotic drugs are rarely effective in ‘calming’ dementia patients

Juanita Westbury, University of Tasmania; Carmelle Peisah, University of Sydney

Because of their sedative effect, antipsychotic medications are often used – in fact they are over-used – to "manage" people with dementia. This is against clinical guidelines.

Antibiotics for colds, x-rays for bronchitis, internal exams with pap tests – the latest list of tests to question

Tammy Hoffmann, Bond University; Chris Del Mar, Bond University

Harm doesn’t just come in the form of side-effects or further testing. The "cons" of any treatment also include the costs, which can be financial, emotional, and the costs of the individual’s time.

Expert answers to serious, weird and wacky questions

Up to 80% of women experience PMS.

Health Check: why women get PMS and why some are more affected

Jayashri Kulkarni, Monash University

Studies show oestrogen protects against depression and psychotic symptoms. So falls in the hormone, as happens before menstruation, can lead to depressive and other symptoms of mental illness.