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[Midnight Shadow]

Does anyone suffer intermittent vaginal pain at night, not every night. I have had a good fortnight and then pain again last night keeping me awake. I am using 3 vagifem a week and estriol cream externally. Don’t use it internally as that was thought to have given me my thrush problems. I am aware that certain foods can exacerbate Atrophy yesterday had a small amount of tomato sauce and a little splash of vinegar. Not a good idea. In the mornings I use Naydaya victory oil and that eases the pain. Awaiting to see a gynaecologist to discuss thrush treatments for the particular strain I had (Glabrata)  Asked for estriol to be re added to my repeat prescriptions. Male doctor said I couldn’t use estriol and vagifem as they were the same thing. Soon put him right on that one. He checked with a female Doctor who has said I can use it externally. Would using vagifem more regularly or maybe using a loading dose ease the pain. Once I get up and start moving around the pain seems to ease. I also use Yes VM moisturiser. Your thoughts and replies are much appreciated.

[Dierdre]

Hi Midnight Shadow, when you say pain do you mean soreness and burning or actual stabbing, aching  or pelvic pain?
If it's soreness I'd up the vagifem for a while or do a reload. If it's the other I'd go to the doctors.
Hope you're on top of the thrush now or it could be cramps from that too.

[Midnight Shadow]

Thanks for responding Deirdre, the pain it is rather like tooth ache. It also burns a little as well.  I guess from the lack of estrogen. The pain is not every night and I can go several nights without it. It  subsides once I get up, like it has done this morning.  Perhaps not using enough vagifem I can use up to 5 a week, so will do a reload and maybe I’m  not enough estriol cream externally. Do hope you are okay now.

[Dierdre]

I'm fine thanks now, had a bad couple of weeks with thrush and a flare up of VA but think I've sorted it now. Just had to guess it was that as like gold dust getting an appointment at doctors.
Have you had a swab taken to rule that out too?
Try rubbing some estriol cream around the entrance to the urethra as that gets atrophied also but not going in too far to cause thrush.
Is everything intact, could it be a slight prolapse causing the aching and tugging on the urethra? Extra Vagifem will also help that.

[Snowcat]

Hi Midnight shadow.  Not sure I can help with the pains at night although I have had nights when my vulval discomfort generally can keep me awake - stinging, burning, itching etc then I can go for several nights with nothing.  It is odd but then I’ve found the whole experience of vulva atrophy unpredictable!

I was interested that you say you think using the estrogen cream internally gave you thrush as I’ve had the same experience and mine is Candida krusei.  I was given a course of nystatin pessaries but I had to stop as that made the symptoms of thrush and the vulval pain much worse! Now waiting for a different treatment but no-one seems in a hurry to find one! Do you find the irritation from thrush really bothersome or is it not the bad? Mine seems to come and go.  Maybe that’s not helping the whole situation… I use vagifem and estriol cream plus hydromol as a barrier but I’m not sure that helps as it often starts to feel itchy when I put it on.  Unfortunately I don’t tolerate clotrimazole cream and the fluconazole I was taking for 6 months did nothing as C.Krusei is resistant to it.  I just wish, as I’m sure you do, that someone could sort it out! We can’t be the only ones with atypical strains of thrush!

The other weird thing is that when I wake up everything feels comfortable but as soon as I start thinking about it, the irritation starts! I wonder if there’s a physcological   aspect to it although it certainly doesn’t feel like it! 

[Midnight Shadow]

Thanks for responding snowcat. Like you say the whole experience of VA is unpredictable. I was on Fluconazole for seven months and it did nothing, my strain of thrush was also resistant to that particular medication. It’s a shame there isn’t one medication suits all. My thrush was never itchy just the swab results came back as heavy growth yeast which eventually I treated with Nystatin pessaries which I had to source myself as they are not given in Lincolnshire. Hope we both get sorted very soon. Take care.

[Snowcat]

Apparently nystatin pessaries are no longer manufactured in the UK.  My GP spoke to a hospital microbiologist who managed to source some for me at a local hospital as they happened to have a small supply leftover.  They just made it feel worse though and I had to stop after 8 of the 12 pessaries, on my GP’s advice.  As I also have a mild bladder prolapse inserting them was a bit difficult too! Apparently my sample was sensitive to oral voriconazole, so I’m waiting to hear if I can have that.  It’s annoying because, like you, I’ve had months of fluconazole and yet each sample still said ‘heavy growth’ but no-one bothered to find out which strain of Candida it was - they just kept saying the fluconazole would work! Until I begged them to find out … it doesn’t help when you’ve already got skin issues in that area. 

There are more and more of these atypical strains, resistant to azole therapy, showing up so it’s a pity they don’t find out which one it is whenever a sample goes to the lab - would save a lot of time & money & appointments! The pharmacist at the hospital told me not to worry if I needed more as they can source some from Germany for me … although I don’t think I’d try them again … I still feel
like I’ve got it but who knows? Im back to gynae soon so I’ll see what they have to say … I hope your nighttime pains leave you alone soon!