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[fiftyplus]

Hi Ladies, thought I’d give an update.

HbA1c was normal.

Symptoms cleared up toward the end of the week of 72 hourly Fluconazole. A week later (last Sunday), on the day I was due to take my first weekly maintenance tablet, I noticed I was a little sore and itchy again, and this had got worse, despite taking the medication. I’m back at the GPs next week for another swab. I’ve asked the surgery on three separate occasions if I’m meant to continue taking the weekly Fluconazole and I can’t get a straight answer!

What was your HbA1c? - the reason I ask is sometimes patients borderline/pre diabetes can still get diabetic related problems which get better/disappear when 1 reduces sugars/carbs intake.  This is something I speak about from personal experience.  Another medical issue GP's have no clue about ...

[CLKD]

I buy GREEK LIVE yoghurt.  Eaten from a spoon when I fancy it ;-).  Also applied into the vagina in the years prior to being diagnosed with VA, the idea being to cleanse the digestive system from top to bottom.

The GREEK has 'live' in red on the carton.  No additives.  I also eat Waitrose 'live' with hazelnuts in YUM ;-)

It worked after in the 1990s I had emergency surgery = intense thrush [appendicetomy].   .  My Aunt had brain surgery in the 1980s and used it following surgery, as her digestive system was wrecked.  She had trigenimal neuralgia and underwent 2 lots of surgery to get rid of the intense, shooting pains; 15 years apart. 

[Emzib0b]

The national guidelines for the treatment of thrush (vulvo-vaginal candidiasis) can be found here https://www.bashh.org/resources/22/vulvovaginal_candidiasis_2019

Getting the thrush treated AND getting extra oestrogen into the vagina at the same time might be the way to go. The oestrogen helps reduce symptoms of VA and also helps protect from fungal infection. You may not need to continue with the thrush treatment for the whole 6 months if the symptoms start to reduce or resolve altogether. Check whether the fluconazole (for treating thrush) could interact with any other medicines you are prescribed.

NightNurse, thank you so much! I’m about halfway through the guidelines and it’s given me quite a few points to discuss at my next appointment. I was surprised to learn that ‘azole antifungals are less effective in an acidic environment.

[Emzib0b]

What was your HbA1c? - the reason I ask is sometimes patients borderline/pre diabetes can still get diabetic related problems which get better/disappear when 1 reduces sugars/carbs intake.  This is something I speak about from personal experience.  Another medical issue GP's have no clue about ...

Hi fiftyplus,

My HbA1c was 36. Looking at previous test results I’ve had similar numbers for the last 10+ years. Do you think this is ok?

[fiftyplus]

What was your HbA1c? - the reason I ask is sometimes patients borderline/pre diabetes can still get diabetic related problems which get better/disappear when 1 reduces sugars/carbs intake.  This is something I speak about from personal experience.  Another medical issue GP's have no clue about ...

Hi fiftyplus,

My HbA1c was 36. Looking at previous test results I’ve had similar numbers for the last 10+ years. Do you think this is ok?

yes, 36 is absolutely fine - what mine is as well actually.  I had thought if it was maybe 47 say which is borderline diabetic then that could be the problem but no your 36 is all good but as others have said high sugars are known to cause thrush but this is not the case for you but what on earth could it be - how debilitating for you - I have had thrush once and it was awful - sending virtual hugs your way - I hope you get this sorted out soon - take good care of yourself xx

[Emzib0b]

I buy GREEK LIVE yoghurt.  Eaten from a spoon when I fancy it ;-).  Also applied into the vagina in the years prior to being diagnosed with VA, the idea being to cleanse the digestive system from top to bottom.

The GREEK has 'live' in red on the carton.  No additives.  I also eat Waitrose 'live' with hazelnuts in YUM ;-)

It worked after in the 1990s I had emergency surgery = intense thrush [appendicetomy].   .  My Aunt had brain surgery in the 1980s and used it following surgery, as her digestive system was wrecked.  She had trigenimal neuralgia and underwent 2 lots of surgery to get rid of the intense, shooting pains; 15 years apart.

I love the Yeo full fat Greek yoghurt, I could eat loads of it! Asda keep putting the price up every few weeks and it’s getting ridiculously expensive. They sell Lancashire Farm but only the fat free version, but it’s half the price of Yeo…

[Emzib0b]

yes, 36 is absolutely fine - what mine is as well actually.  I had thought if it was maybe 47 say which is borderline diabetic then that could be the problem but no your 36 is all good but as others have said high sugars are known to cause thrush but this is not the case for you but what on earth could it be - how debilitating for you - I have had thrush once and it was awful - sending virtual hugs your way - I hope you get this sorted out soon - take good care of yourself xx

That’s really good to know! I’d love to know what’s thrown my body out of balance in the last six months, this meno journey is full of surprises and huge learning curves! Virtual hugs were gratefully accepted 

[CLKD]

I don't go for fat free - what ever that means 

It's the LIVE cultures one requires.  Actimel etc. can boost too.

I've bumped my other thread about candida

[Emzib0b]

How is the acidity in your vagina as this may impact on 'thrush'.

I bought a pack of Litmus paper…apparently my pH is 6…that seems a bit high?

Still waiting for the swab results. The Nurse Practitioner prescribed three Clotrimazole pessaries but I’m waiting to see what the results are first.

Symptoms were starting to settle down by the time I had the swab. I’m not there yet, but a lot better than last week.

[CLKD]

That's good.  Is there no advice on the litmus test packet?

[Emzib0b]

No info on the packet, just the pH each colour represents.

My period finished a couple of days ago, so blood probably isn’t the culprit, but I may check again in a few days to be sure.

I found a couple of papers that point to either bacterial infection or low oestrogen as a cause of raised pH:

“Measurement of vaginal pH is useful, effective, and inexpensive for screening purposes. A vaginal pH of 4.5 is consistent with a premenopausal serum estradiol level and the absence of bacterial pathogens. An elevated vaginal pH in the 5.0 to 6.5 range suggests a diagnosis of either bacterial pathogens or decreased serum estradiol. In patients with an elevated pH, vaginal culture should establish the diagnosis. In the absence of bacterial pathogens, a vaginal pH of 6.0 to 7.5 is strongly suggestive of menopause. Titration of estradiol level by vaginal pH during estrogen replacement therapy may help menopausal women avoid side effects or cessation of therapy.“
https://pubmed.ncbi.nlm.nih.gov/9215184/#:~:text=An%20elevated%20vaginal%20pH%20in,is%20strongly%20suggestive%20of%20menopause.

One of the NPs I saw earlier this year said it can be common to flip between thrush and BV, so I hope the lab have checked for that, too! If it’s not thrush/BV, I think I will need to do as you and a few other ladies suggested and resume the vaginal oestrogen.

[CLKD]

I wonder where she gets that idea from?

BV is I believe characteristic with a fishy smelling curdy discharge?  If a request isn't made, it's unlikely that a Lab will check . 

If this regime fails to get the condition under control, mayB visit a GUM Clinic for advice.  Also get started with the appropriate vaginal atrophy treatment ASAP, what's to lose 

[Emzib0b]

I’ve heard many strange things at my GP surgery…

I don’t do things normally  - I’ve had BV twice in my life with no signs/symptoms.

Oh well, let’s see what next week brings!
 

[CLKD]

How did U know that you had BV if you didn't have symptoms  which are usually a fishy smelly discharge. 

When I don't get the gist of what my GP might mean I return a week later : "I must have been dreaming last time but I didn't take in everything that you were trying to explain".   

We are the same age so there's no conflict, simply lots of discussion  and I never get the feeling "Oh it's HER again" 

[Emzib0b]

First time was in my early twenties. I was getting recurrent UTIs and had also found out my ex boyfriend was a serial cheater so I went to the GUM clinic for a sexual health screening. Thankfully no STIs but BV was identified.

The second time was identified after having a routine smear test. The nurse was concerned that she could see blood on my cervix. I had just finished a period but she took a swab to be on the safe side.