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[Snowcat]

Hi. Sorry if I’ve posted this before but my brain hasn’t been working properly for 6 months due to pain etc. 

I have thrush - again!! I’m on a 6 month course of oral fluconazole as I can’t tolerate the pessaries but it keeps coming back - GP said it won’t kill me but that’s not very helpful! The vulval atrophy is finally succumbing to the HRT patch & estrogen cream but now this is driving me mad with the soreness and itch! Any ideas of what else I can do please? I can’t have garlic as on blood thinners and I’ve just been told my diabetes is in remission so I can’t blame blood sugars.  I’ve had a lot of antibiotics over the last few months but I’m taking a probiotic called optibac - onky just started so don’t know if that’ll help yet.  It’s just driving me nuts at the moment! Thanks all x

[dangermouse]

It could be the HRT, particularly oestrogen:
https://pmc.ncbi.nlm.nih.gov/articles/PMC97188/#:~:text=In%20summary%2C%20the%20results%20of,albicans%20infection.

In summary, the results of this study show that estrogen is the dominant reproductive hormone that supports and sustains an experimental vaginal C. albicans infection and reduces the inhibitory activity of epithelial cells against Candida. Progesterone, on the other hand, has no demonstrable effect on the vaginal infection or on systemic and/or local immune responsiveness associated with the infection. Taken together, these results suggest that estrogen, but not progesterone, is important in the reproductive-hormone-associated susceptibility to vaginal C. albicans infection.

[Snowcat]

Hummm, interesting- so what do we do about it if it is the HRT?

Until 2 years ago I was on systemic HRT and vagifem for years and didn’t have a problem with thrush, but this started in April when I was diagnosed with a return of vulval atrophy but before I started the HRT again.  I’m now on patches and ovestin cream internally and externally and can’t seem to get rid of the thrush.  When I have had it in the past it hasn’t been itchy just sore but now it’s itchy.  Tried some clomitrazole cream (with much trepidation as I can’t tolerate the pessary) and that hasn’t helped.  I’m on weekly fluconazole but last swab came back ‘heavy growth of candida species’ …

[Dotty]

Have you had the thrush tested to see what strain it is and to see if the Fluconazole is the right medication ?

[Snowcat]

Yes I have Dotty.  I don’t know about what strain but it was tested for several different types.  Doc said if not gone by November they’d test again and that was it! She said there were other treatment options but best not to change mid course ..

[LDP]

Try taking ibuprofen alongside the flucozanle- it worked for me and others in this forum that have tried it.  It’s a horrible situation and really drags you down so with a go

[Snowcat]

Hi LDP.  Unfortunately I can’t take any anti-inflammatory pills as I’m on anti-coagulants :-(

[dangermouse]

Have you tried Caprylic acid (anti fungal) and Undecylenic acid (to stop biofilm)? They can be more effective than antibiotics and may allow you to continue using oestrogen. Probiotics are also hit and miss as they can feed the fungus. Also reducing any yeast foods in your diet will help to starve it.

I used to think that mild thrush was atrophy but it turned out that I never had atrophy as the symptoms can overlap. If you want to also use vaginal oestrogen, you could try following it with Canesten cream to allow growth of the tissues whilst reducing growth of the fungus.

[Snowcat]

Thank you dangermouse.  I’m
Not an easy woman to please sadly :-) I could never stop the estrogen - not after having been practically bedridden with pain for the last 5 months.  I’d rather not be here if that were the case.

I’ll check out those things you mention as I’ve not heard of them.  I’m using optibac probiotics especially designed for vaginal health.  I can’t use Canestan cream as it contains clotrimazole which I have had a very bad reaction to in the past. I’ve put in another sample today to make sure the candida strain I’ve got is sensitive to fluconazole.  Onwards and sideways!!

[dangermouse]

If it was the tablet form you may be ok with the cream, I also had a bad reaction to the tablet form and so I stick with caprylic acid as the anti fungal which also had other health benefits like reducing cholesterol.

Oestrogen is not the cause it’s just a growth promoter so if there is anything overgrowing in your body (like yeast) it will hit harder when your own levels rise or you add more in. You could also try to increase your progesterone to balance against any high oestrogen. My mum didn’t have many meno symptoms but she did have extreme thrush that my dad would take her to A&E for, and only sitting in a cool bath would stop the itching. It all stopped when she was through menopause so it will eventually get better.

[Snowcat]

Thanks dangermouse. Yes it was the clotrimazole pessary I had the bad reaction to. If the latest test comes back positive I’ll try the cream …

I never had all this trouble with thrush when I went through the menopause at age 32… or when I started on HRT about 15 years later.  I can’t help feeling that if I hadn’t stopped it 2 years ago (on wrong advice) and lost a lot of weight since then, I wouldn’t be having a problem now - I’m sure it’ll clear eventually - it’s just making the atrophic skin there even more sore which is the last thing I need right now.

Thanks for your suggestions and taking the time to reply. :-)

[Midnight Shadow]

I suffered thrush for 7 months and was treated for heavy yeast growth. Found the strain was Glabrata told I needed to treat it with Nystatin or Boric Acid as Fluconazole wouldn’t get rid of that particular strain. Neither Nystatin or Boric could be prescribed as not available in the area which I live, so I sourced my own Boric Acid. It did eventually go with that treatment. I believe that the estriol cream caused the thrush, although a locum lady doctor said estriol cream can’t cause thrush. I beg to differ on that one. I only use that externally now. It’s very difficult finding the right regime. Hope you get sorted. Sending a hug. X

[Snowcat]

Thank you midnight shadow.  I don’t understand why they always assume that fluconazole will work in all cases… last time it came back with ‘heavy growth of candida species’ and that was it.  It’s a real pain especially when it makes it painful to pee as well!

I hope they can isolate the culprit for me this time.  I’ve heard of boric acid being a treatment and nystatin.  I’m glad you got yours sorted (it shouldn’t be that difficult though!) thanks for the hug 🤗