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[Snowcat]

Hi.  So, I was doing quite well with some kind of recovery from the vulval atrophy when I got an atypical thrush infection (krusei).

I’m now half way through a 12 day course of nystatin pessaries which are making me very sore.  I think when the residue leaks out it’s irritating my, as yet, un- healed, thin vulval skin.  I’m still using vagifem, estriol cream every night and hydromol ointment during the day but just wondering if anyone has any experience of this - thrush pessaries causing extra soreness?

I spoke to the hospital pharmacist who was very helpful but he said I should continue with the course if I possibly can as there are very few alternatives left for me to try.  He said to try Paracetamol for any vulval discomfort 😳 which actually made me laugh as that certainly won’t touch it! I’ve had oramorph in the past and even that didn’t ease things! I’m worried in case these pessaries will set me back - I’m already finding it uncomfortable to sit down again .. any tips would be much appreciated.  Also I’d like to thank everyone who’s replied to my desperate posts during these last 6 months - I don’t know what I’d have done without all your support!

[Minusminnie]

I use ibruprofen for vulval flare ups but I think you mentioned that you can’t use that ?

I also use Aproderm Barrier cream (not ointment ) I find that it is protective.

[Snowcat]

Thanks Minusminnie.  Yeah I can’t use ibuprofen as I’m on anticoagulants..

I’ve not heard of aproderm - do you mean epaderm?

[Minusminnie]

No I mean Aproderm.
I’ve read that hydromol is best not used on broken skin too.

I was given Amitriptyline at one time for vulva pain but it really didn’t work for me and could take more than the 6 days that you have to go on the pessaries to work anyway.

Could you stop the Vagifem and estriol for the next 6 days so that you are not using multiple products that might be interacting?

I would say then do a reload but you are using both nightly anyway.

[Snowcat]

Ah, ok.  I’ll look out for that - I’ve not heard of it.  I did wonder if I should stop using the other products for the duration of the course.  It’s just that I’ve had such dreadful atrophy for the last 6 months that I was scared even missing a day might make it worse … but maybe you’ve got a point.  When I asked my GP if I could still take the vagifem she said ‘possibly.  But not at the same time as it might affect absorbtion…’ she seemed to think the estrogen cream might help with any discomfort but I must admit I’m not so sure! Today it feels like I’ve got the worst case of thrush ever! Worse than what I’m being treated for ..

[Peana]

Hi Snowcat, how are you getting on?  I hope things are getting better for you.

I'm currently on a 6 day course of pessaries after previous treatments have not worked.  My gp said not to use vagifem whilst I was using the pessaries, but part of me did think I'd use it anyway.  However, now I'm thinking I probably shouldn't.

[Snowcat]

Hi Peana. Thank you for asking.  I had to stop the nystatin pessaries as they were too irritating - I felt worse than before I started them - the itching & soreness just increased and my GP advised me to stop.  My local hospital are now planning to treat it with intravenous caspofungin for 7-14 days, as my swan sample was sensitive to it and nothing else I’ve tried has worked … so I’m just waiting for the hospital to get in touch.

Incidentally my doctor said I could continue with the vagifem while using the pessaries but suggested using the vagifem in the morning and the pessary at night.  Her words were ‘oh yes, continue with the vagifem - you need something in there!’ lol.  What species of Candida do you have?  I hope the pessaries work for you.  All you read says that thrush is easily treated but that’s not my experience! Maybe albicans is easier but there are increasingly more azole resistant strains emerging. 

My current issue while I wait is finding a soothing anti itch cream for the outer labia which stings/tingles especially at night, but only about once a week! I’ve tried hydromol ointment, estrogen cream and even a mild hydrocortisone cream but it’s proving difficult to cope with. I don’t think it’s related to the thrush as it’s very localised and on the edge of the outer ‘lips’ I’m lying awake with it now - resisting the urge to scratch - and I’d had such a good day as well!

[Peana]

Thanks, good luck with the hospital treatment.l hope they resolve it for you.

I don't know what strain I've got - I had a swab to confirm thrush but that's all the info I have at the moment. Despite having it for a month or so now I'm not especially itchy (the gp identified it during a pelvic exam), but you must be going mad with it. Sounds awful. I hope you get an appointment really soon.

I'll take your advice about using a vagifem in the morning - what a simple idea. I'll mention it to my GP. She's been excellent recently and really supportive, so I think she'll be receptive to me mentioning it at my next appointment.

Once again, wishing you all the best for a speedy recovery

[Snowcat]

Thank you so much Peana.  My IV treatment starts on Monday - nurses are going to come to my home every day for 2 weeks and do the infusions which is good! I hope you get a speedy resolution of your symptoms too.  Xx