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[Snowcat]

Hi, can anyone tell me please if their VVA symptoms often feel like thrush? I’ve had thrush before so I know what it feels like (I don’t get a noticeable discharge just itching & irritation) and yet, I’ve just been examined by the gynaecologist and she didn’t mention seeing any sign of it.  I’m on a long course of oral fluconazole (once a week for 6 months) as, when I first had VvA diagnosed, I kept getting thrush too.

Now, shes told me to use Ovestin internally as just inside the vagina looked sore (vagifem has looked after the deeper part very well and she said that looked healthy) but I read you can’t use Ovestin internally if you’re taking oral fluconazole! Weirdly, I don’t get the itching lying down or standing just when I’m sitting on my donut cushion or on the edge of the bed which I can now do for a few moments. 

I have to admit that I’m very nervous about using the cream inside as it’s stings enough on the outside (where the main skin damage is) but I’m assuming as my vagina tissue is mainly healthy it might not sting so much inside or, worse still, itch! I think I prefer pain to itch as it’s just so intractable and you daren’t scratch! Anyway so I’m wondering do I have thrush and so maybe not use the cream inside yet or could it just be the very symptom it’s supposed to treat? Maybe as it’s healing a bit now it’s turned from painful pain to painful itch? I really don’t want to open a can of worms at the doctors as I read they might want to reduce the HRT if you’re taken fluconazole and that’s the last thing I want! 

[Dierdre]

A far as I know you can continue with local estrogens whilst on oral fluconazole but not if using pessaries for thrush. Have you had a swab taken to confirm if you have thrush?
I apply Bepanthan baby ointment after using ovestin as this stops the stinging on the outside, although it doesn't sting when I apply a little inside around the urethra area.

[Snowcat]

Thanks Dierdre.  No I haven’t.  It only started bothering me again yesterday.  I had it a bit over a week ago but as I’m on long term fluconazole (I can’t tolerate rge pessaries) and I’d just taken one that week, and because the symptoms went away quickly, I’d forgotten about it. 

It’s probably unlikely to be thrush as I’m on a weekly fluconazole pill but I don’t know how persistent it might be!

[Snowcat]

Oh, and it’s very sore at the end of the stream when I have a pee - just at the end - it kind of builds up to it! I can’t take anti-inflammatory pills or I’d try one!

[Lime]

Hi Snowcat,

That is very interesting about fluconazole and estrogen cream.   Apparently fluconazole interferes with an enzyme that breaks down estrogen allowing for more estrogen to remain in system.   

All I know is that it can be very difficult to distinguish between VA and thrush, especially for me because I do not get itch
or discharge, only pain.  Been that way forever, long before using hormones.

I understand about the twingley pain at end of a pee and not due to uti.   

Perhaps we need to buy microscopes and learn how to read our own slides, if only we could.

[Snowcat]

Hi Lime! I remember you saying you only get pain with thrush.  I’m very much like that too but sometimes there’s just a hint of an itch or maybe just irritation that’s hard to ignore!

Yes maybe we need to get ourselves back to science lessons and do something interesting with a petri dish! I dread do think what I’d grow in mine! 😂

[Dierdre]

Oh, and it’s very sore at the end of the stream when I have a pee - just at the end - it kind of builds up to it! I can’t take anti-inflammatory pills or I’d try one!

The ovestin should help if you apply just inside and around the urethra as atrophy causes uti symptoms when the urethra is inflamed.

[MrsMitch]

Well this is news re Ovestin & fluconazole. My GP didn't mention anything about that recently with all the antibiotics I was prescribed for UTI. I wonder now after 4 courses of antibiotics, whether they had an effect on absorption of that & pessaries. Perhaps that's why when I started Intrarosa I found it to be such an irritant- because my body hadn't properly absorbed VA treatment for all those weeks of antibiotics?

[Snowcat]

Hi Mrs Mitch! Another minefield for to wander aimlessly through! I think antibiotics are ok - except for a couple of the lesser used ones.  To be honest it seems most things re-act with fluconazole! I remember a doctor once saying to me that if we worried about all the reactions we’d only ever be able to take one pill at a time .. I think the side effects of mixing it with estrogen are nausea, vomiting & bleeding - fun eh! I’ve decided not to mention it unless I get any strange effects - when doctors prescribe a red flag 🚩 comes up if there’s any contra-indications so presumably (haha) they decided it’s ok!  How’s it going with the intrarosa?