Menopause Matters Forum
Menopause Discussion => Postmenopause => Topic started by: Midnight Shadow on October 16, 2023, 09:26:02 AM
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Thank you to all the ladies who have offered advice regarding my on going thrush. I have just heard back from the gum clinic that my strain of yeast is Glabrata. This strain of yeast can be resistant to fluconazole. She recommended Nystatin pessaries and Clotrimazole. Phew! at least I might get somewhere now and rid this thrush. So will get in contact with my GP tomorrow and request Nystatin and Clitomazole. Just hope it hasn’t got manufacturing issues. Hope those of us suffering thrush all get relief very soon. Take care.
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Thank you Midnight Shadow for sharing all the information that you have gathered.
I’ve noted to head to the GUM clinic if no joy through the GP.
I had oral Nystatin at one time for oral thrush after too many antibiotics it was good stuff.
Hope that you start to feel better soon. :)
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I've sent you a PM Midnight Shadow so hopefully you got it but glad that they got to root of it. 🙏 new meds work 🤞
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Hope you finally get rid of this now. I've just finished taking one fluconazole every 72 hours x 3. Feeling ok today. Doctor refused my second dose so got one myself. The locum doctor then prescribed my third one and agreed that some (1 in 5) need more than one dose or it will keep coming back. Why is it always a battle? NHS guidelines state 3 x 1 dose every 72 hours if recurring.
If there are so many strains and some resistant then all swabs should be tested for the correct strain, they do this with infections to confirm which antibiotic is needed.
Might be best to go straight to the local gum clinic and not waste time at the GP.
I remember having Nystatin years ago and no recurrence. Clotrimazole are the pessaries so can't do them, unless I try the gel ones. Hoping I don't need to though.
Let us know if this one works Midnight Shadow, I'm sure it will now and you'll be ok, it's been a long time coming.
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Thank you for responding Dierdre. Quite agree why aren’t the strains of yeast infection identified from the first swab, instead of having to take unnecessary medication. I hope I can get rid of it now, it’s gone on far too long. I’ll keep you posted. I do hope you get some relief very soon. We shouldn’t have to suffer like this. Take care.
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:bouncing: :ola: we shouldn't have to push for treatment >:(. Let us know how you get on Girls! the GP should have tried a different route, surely! :-\
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Midnight Shadow I am glad they have identified the strain and hope your get the right medication quickly. It should not have to be this hard!
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Thank you LPD for responding. Quite agree it should have to be this hard. In my opinion the strain should be identified from the first swab. Take care.
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Midnight Shadow,
It shouldn't be so difficult. I'm sorry you had to suffer unnecessarily. Hope you're feeling better soon.
Your diagnosis corresponds to something I read recently:
"However, one interesting trend was noticed upon comparing the distributions of Candida species for the different age groups. The data showed significant (P ≤ 0.05) increases in the prevalences of non-albicans species, along with steady decreases in C. albicans, with increases in age. C. glabrata accounted for >18% of isolates in women of menopausal age and older (≥51 years), compared to <4.8% for young adults (<30 years) and <11.8% for middle-aged women (31 to 50 years).
This increase in non-albicans species, specifically C. glabrata, is an important observation that was reported in smaller studies of the elderly. Similar increases in non-albicans species have been reported for diabetic patients, in which C. glabrata was the primary species isolated. Understanding the changes that occur in patient populations which exhibit higher prevalences of non-albicans species is warranted (i.e., menopausal and postmenopausal women and diabetic patients). Possible explanations include changes in patient physiology, hormone balance, and decrease in immune function."
From the CDC:
"Echinocandin resistance appears to be increasing, especially in the species Candida glabrata. C. glabrata already has high levels of resistance to the antifungal fluconazole, and this resistance has remained fairly constant over the past 20 years, according to CDC surveillance data. Echinocandins are the preferred treatment for C. glabrata, and echinocandin resistance could severely limit treatment options for patients with candidiasis caused by C. glabrata."
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Wow, that is really interesting.. its annoying that it seems wet mount slide (microscopy) to identify the strain is generally only available at GUM clinics. My GP even said that the swab they use (& the lab assesment) is notoriously unreliable in identifying thrush sometimes and it does not indicate the strain. No wonder it's a tortuous and painful journey for some. Hope you get some relief soon Midnight Shadow..
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Thanks ladies for your response. The article makes interesting reading. A lady Doctor I saw said it’s unusual for someone my age 66 to get thrush. Well it clearly isn’t. Hopefully, my painful journey will end with this new medication. Thanks again.
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Agreed, all this info is really useful. I have copied it onto my phone for my next GP visit next week if the latest fluconazole I have taken doesn't work.
(I'm probably on my 7th dose now with a couple of pessaries thrown in + weeks long course of fluconazole, been ongoing for approx 2 months after being on antibiotics)
I wonder what all this medication we are being given that's not working is doing to our bodies.
I may have posted this previously too that I asked the GP I was seeing what else could be given apart from fluconazole or clortimazole+ she said nothing !!!! Hence my appt next week is with another GP.
Again I think I said this B4 but I think you ladies know more than the GPs do xxx
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I’m sorry you have had to suffer so much with this, Midnight Shadow. It really shouldn’t be so difficult to get the strain identified in the very beginning!
I really hope you can get relief from this now you know the treatment required.
It would appear that GUM clinics are definitely the way forward for thrush problems (my experience also!).
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Morning ladies
After reading these posts I decided to phone my local GUM clinic + have appt for tomorrow afternoon.
I probably wouldn't have even thought about contacting them if I hadn't read these posts, thank you.
🙏🤞
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Hope you get some answers Brownie. Apparently, you can no longer get Nystatin pessaries from the Doctors. The Practice Nurse who dealt with my request this morning on Ask My GP was going to contact the Gynaecologist to see what else they can recommend. Fingers crossed it is something that works. Take care.
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Please let us know what they recommend Midnight Shadow. I have looked online + I think pessaries/cream discontinued in UK. I think there is an oral but think for mouth thrush.
Have you used clortimazole (the pessaries) I have used a few but thrush came back but maybe a longer course would work x
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You can get Clotrimazole pessaries and the new soft gel pessary OTC. That was also recommended for the glabrata strain
I heard good results for the gel pessary as it dissolves easier and absorbs with no chalky undissolved residue coming back out. Hopefully be easier for us with atrophy where the hard pessary doesn't dissolve.
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I bought a gel pessary to try it, was better I think than hard capsule but thrush still returned for me but hopefully a longer course would do the trick 🙏🤞
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I don't think one dose of any of these treatments is enough.
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Hope you get some answers Brownie. Apparently, you can no longer get Nystatin pessaries from the Doctors. The Practice Nurse who dealt with my request this morning on Ask My GP was going to contact the Gynaecologist to see what else they can recommend. Fingers crossed it is something that works. Take care.
Apparently they are unlicensed, but they are available, Midnight Shadow. Have a look here where they are listed:
https://www.selondonjointmedicinesformulary.nhs.uk/chaptersSubDetails.asp?FormularySectionID=7&SubSectionRef=07.02.02&SubSectionID=A100
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Phoned the gum clinic yesterday and the lady said she would get a nurse to ring me back to get a prescription for Nystatin. Well a nurse did ring back and she can't prescribe Nystatin. She suggested long course Fluconazole and Clotrimazole. I seem too be taking 1 step forward and two steps back. Yes, I am improving, so maybe the weekly Fluconazole is now taking effect. Have another 6 to take. It's all very frustrating. Why can't we ladies be prescribed the treatment we need. Have sent another message via Ask my GP. Thinking of trying a Clotrimazole soft pessary as the hard ones don't seem to dissolve properly, as I am so dry from my Atrophy. Replies appreciated.
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There should be a healthcare professional at the GUM clinic who has the authority to prescribe unlicensed medication, Midnight Shadow. If not, they should know how it can be obtained.
If Nystatin is what is needed to treat Glabrata, then Fluconazole will never eradicate it, as far as I am aware.
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Hi Jenna, have just contacted the Gum Clinic this morning lady on the desk said she will get someone senior in authority to give me a call back to see if they will prescribe. Fingers crossed they do. I’ll keep you posted.
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Hi MidnightShadow have you tried the Canesten internal cream instead of the pessary ? I use that as it feels a lot softer x
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Hi Dotty, no I haven’t tried Canesten internal cream. Someone recommended the soft Gel Pessaries. I spoke to a lovely senior nurse at the gum clinic who said Clomitrazole is equally as good as Nystatin and does treat Glabrata strain of thrush. Contacting ASK My GP in the morning to get some prescribed, she said she would if I couldn’t get anywhere with the Nystatin. The nurse said to stop Fluconazole as Glabrata is resistant to Fluconazole. Thanks for responding.
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https://www.canesten.co.uk/discover-canesten-products/canesten-thrush-internal-vaginal-cream
This is it x
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Thanks for posting that Dolly. Have just sent a message on ASK my GP to see if they can prescribe Clotrimazole Cream or Pessaries. Will keep you posted as to how I get on. Take care.
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I've just bought a Caneston Soft Gel pessary to take on holiday, so far no sign of thrush but I'm armed and ready if it comes back with the Clomitrazole pessary. Scared it will burn like hell but no choice, if it's back it's going to be because of resistance to the strain as I've been doing fluconazole for the last 6 months.
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Back from holiday 10 days now and had no problems, however started getting clumpy discharge a few days ago so used the Canesten external cream just externally and it seems to have cleared it up and was very soothing. Applied my Ovestin last night and had to wash it off during the night as it was burning me. Today used the Canestin again and that's now burning, maybe should have washed of the Caneston last night before applying Ovestin but it had soaked in hours before.
Just applied my hydrocortisone cream and feels ok, not using anything for a day or two except for Vagifem.
How are you now Midnight Shadow?
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Thank you for asking how I am Dierdre. Went to the gum clinic a week last Monday, for another swab to see if thrush has gone. Still awaiting results the nurse did say it can take a fortnight. The first swab and results came back within a week. Still having the ache from 6.15am for about 3 hours and then it goes and I have quite a good day. Aching this morning but did sit quite a bit yesterday playing my keyboard at the carehome. I could set my watch by the ache. It’s as though the muscles are all waking up. Not sure whether is the Atrophy or thrush. Feel annoyed, I have not had the right treatment for my particular strain of thrush for nearly 5 months. If I still have thrush and can’t get Nystatin pessaries I am going to ask about Boric Acid pessaries. Have heard good reports about them. There must be something available to treat this strain of thrush. Probably should have had a longer course of Clotrimazole, but the Doctor wanted to see if I still had thrush. Fed up with it all now. Sorry for the doom and gloom reply. Hope you get relief very soon. Do take care.
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I do know how you feel, it's become a bit of an obsession now, examining myself every day and getting stressed at the first itch or soreness. Not knowing if it's atrophy or thrush or just residue from the vagifem and ovestin, is very frustrating.
You should hear something soon and then get this sorted.
I was thinking this week of resorting to old fashioned methods with live yoghurt up there or douches with whatever they used back in tha day.
Took ibuprofen as thats supposed to kill of strains that fluconazole misses.
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Thanks Dierdre for responding, yes, it is very stressful which I suppose doesn’t help. I take ibuprofen to try and rid the pain. All very debilitating. Hope you can enjoy your day. Take care.
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MShadow: where exactly is the pain felt? Does over the counter pain relief help? 3 hours seems a long while for those symptoms.
Deirdre: sometimes it can be the fillers or packaging that causes irritation/soreness/burning rather than the active ingredient. Have U tried a moisturiser i.e. 'sylc' or 'yes' or even KY Jelly to ease the sensations? The skin in that area is so thin so can soon become sensitive to everything :-\. Plus any itchiness ........ 4 me thrush is felt too high up to reach in to scratch! It happened at the end of each bleed [for 8-10 days], followed by a 2 day gap then brown staining + itching :o :(
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Thanks for responding CKLD. The pain is just inside the vaginal entrance. Could be from my VA or it maybe still the thrush. Until I get the results back from the clinic, not sure what is what and what I am dealing with. Ibuprofen does help a little. Having been on the wrong treatment for Glabrata Thrush for over 4 months hasn’t helped. Don’t think sitting helps that area even with my cushion. Take care.
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Is the pain less when upright or laying flat?
What about bicarb of soda as a 'douche' ? It was my paternal grandma's go to for most things including burns ::). Washed in and out? It's the waiting ......
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I think CLKD the pain is better when lying down. Think all the muscles start working at 6.15am in the morning that's when the ache starts..Just grateful it doesn't last all day as it was doing in the initial stages. Any progress is better than none at all. Thanks for your concern.
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Could be the bladder filling early in the morning. When I first had thrush back in April it got quite bad as I didn't realise at first and was treating it as an atrophy flareup. Went to the doctors because my bladder was spasmodic and painful when filling. He did swabs and sent me for scans. Turned out it wàs thrush and that was irritating the bladder and urethra so much it was cramping. Also the fluconazole oral tablets caused stomach cramps for weeks even after stopping them.
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Thanks Dierdre, for that response. I did wonder about the bladder filling early morning, that because that is when the ache starts. Guessing I still have thrush and it is aggravating the bladder early on in the morning. It’s all a right pain. I think because the treatment I have been for the last 4 and a half months was resistant to my strain I won’t feel much better until on the correct medication. Yes, I have improved a little but not near enough for my liking. All very frustrating. Hope you can have a nice day.
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MShadow: where exactly is the pain felt? Does over the counter pain relief help? 3 hours seems a long while for those symptoms.
Deirdre: sometimes it can be the fillers or packaging that causes irritation/soreness/burning rather than the active ingredient. Have U tried a moisturiser i.e. 'sylc' or 'yes' or even KY Jelly to ease the sensations? The skin in that area is so thin so can soon become sensitive to everything :-\. Plus any itchiness ........ 4 me thrush is felt too high up to reach in to scratch! It happened at the end of each bleed [for 8-10 days], followed by a 2 day gap then brown staining + itching :o :(
I've tried so many moisturisers, YES lubricant helped but stopped using it after recurring thrush as wasn't sure if it was thar causing it because it came back after using YES. May have been coincidence. I'm ok inside just need something external , usually ok when I first apply but after a couple of hours I'm sore and worse than before using whatever. I did find a lot of relief and very soothing with the Caneston external cream but can't keep using that without thrush.
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Thanks Dierdre, for that response. I did wonder about the bladder filling early morning, that because that is when the ache starts. Guessing I still have thrush and it is aggravating the bladder early on in the morning. It’s all a right pain. I think because the treatment I have been for the last 4 and a half months was resistant to my strain I won’t feel much better until on the correct medication. Yes, I have improved a little but not near enough for my liking. All very frustrating. Hope you can have a nice day.
Keep taking the ibuprofen, that kills some strains of candida too.
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Yes, Deirdre just had some ibuprofen to try and shift this ache. Had a look down below this morning and had quite a lot of white clear discharge. Sorry if too much information. Wondering, if that may be thrush, hence me aching all morning. Don’t think it was estriol cream from two nights previous. Job knowing what’s what. Atrophy or thrush. I just wish there was a quick fix for all us ladies who are suffering. Thanks again for responding.
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Or normal vaginal secretions? The vagina does cleanse itself.
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Yes, Deirdre just had some ibuprofen to try and shift this ache. Had a look down below this morning and had quite a lot of white clear discharge. Sorry if too much information. Wondering, if that may be thrush, hence me aching all morning. Don’t think it was estriol cream from two nights previous. Job knowing what’s what. Atrophy or thrush. I just wish there was a quick fix for all us ladies who are suffering. Thanks again for responding.
Thrush discharge is usually clumpy like cottage cheese, although I've tested for thrush before with no discharge. Maybe caught it early that time.
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Yes, Deirdre just had some ibuprofen to try and shift this ache. Had a look down below this morning and had quite a lot of white clear discharge. Sorry if too much information. Wondering, if that may be thrush, hence me aching all morning. Don’t think it was estriol cream from two nights previous. Job knowing what’s what. Atrophy or thrush. I just wish there was a quick fix for all us ladies who are suffering. Thanks again for responding.
A white discharge sounds okay and normal. I've found that constant irritation starts affecting muscles causing tightening.
Dierdre and Midnight Shadow do you rate the vaginal infection test kits that you can buy over the counter ?
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Yes, Deirdre just had some ibuprofen to try and shift this ache. Had a look down below this morning and had quite a lot of white clear discharge. Sorry if too much information. Wondering, if that may be thrush, hence me aching all morning. Don’t think it was estriol cream from two nights previous. Job knowing what’s what. Atrophy or thrush. I just wish there was a quick fix for all us ladies who are suffering. Thanks again for responding.
A white discharge sounds okay and normal. I've found that constant irritation starts affecting muscles causing tightening.
Dierdre and Midnight Shadow do you rate the vaginal infection test kits that you can buy over the counter ?
I've never tried them, usally get a test from the doctors. There expensive from Boots, maybe cheaper online, Fluconazole is much cheaper online. Might pay to have one in hand if you cant get GP appointment. Have a look at reviews for the kits.
Just looked at reviews and not very good. Works by testing your ph balance, turns yellow for thrush and blue for BV but not very accurate.
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When I had thrush neither time did I have a 'cottage cheese' discharge, it was the intense high up itch that alerted me.
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Yes, Deirdre just had some ibuprofen to try and shift this ache. Had a look down below this morning and had quite a lot of white clear discharge. Sorry if too much information. Wondering, if that may be thrush, hence me aching all morning. Don’t think it was estriol cream from two nights previous. Job knowing what’s what. Atrophy or thrush. I just wish there was a quick fix for all us ladies who are suffering. Thanks again for responding.
A white discharge sounds okay and normal. I've found that constant irritation starts affecting muscles causing tightening.
Dierdre and Midnight Shadow do you rate the vaginal infection test kits that you can buy over the counter ?
I've never tried them, usally get a test from the doctors. There expensive from Boots, maybe cheaper online, Fluconazole is much cheaper online. Might pay to have one in hand if you cant get GP appointment. Have a look at reviews for the kits.
Just looked at reviews and not very good. Works by testing your ph balance, turns yellow for thrush and blue for BV but not very accurate.
Thanks. I just wondered if you had tried them.
Sounds best to stick with the doc or clinic to get tested.
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Rang for my thrush results this morning and I still have thrush. Spoke to a very nice lady who could access my results. Apparently the team are working out which medication to prescribe. lets hope they get it right this time. She also said my Glabrata strain was resistant to Clotromizole which I was prescribed previously after Fluconazole. Fingers crossed I get the correct medication to rid this thrush. Will keep you informed as to which medication they give me. Thanks ladies for all your support
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I didn't know that candida was such a b****r to shift! MayB someone could do a Thesis on your symptoms and treatment ::) 'cos they seem to be dragging on.
Have U any symptoms in your mouth?
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Yes CLKD, it does seem to be dragging on. Hopefully not for much longer. No I haven’t got any symptoms in my mouth. Thanks for your concern.
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That's great they're now on to it and you'll be getting the right treatment at last. Good to know we can go to these clinics when GP'S can't help.
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Thanks Dierdre, yes, quite a relief to know they are hopefully going to prescribe the correct medication. I will let you know what they end up prescribing. Can’t wait to feel normal again. It’s been a right tarrididdle. Hope you continue to improve.
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You too 👍
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Would it be worth messaging aidansrest to ask how her clinic in her area got hold of nystatin pessaries in case the clinic you are attending start back sliding ?
https://www.menopausematters.co.uk/forum/index.php/topic,67816.msg925268.html#msg925268
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Thanks Minusminnie, for responding. Hopefully, I will hear from the clinic today. Haven’t done as yet. I did mention Nystatin Pessaries and Boric acid. So fingers crossed they will prescribe one of those. I will keep you posted.
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Hi Midnight Shadow,
I came across this forum when I was googling C. glabrata. I was wondering how you are and if the infection has been cleared.
I have been suffering with a vaginal C. glabrata infection for nearly a year. I was initially given fluconazole and, five months later, a clotrimazole pessary and then 15 days of oral itraconazole. Even though I told the doctors this species is resistant to azoles, they kept prescribing these treatments. Nothing worked. At last, a GP contacted the head of the Microbiology department at the hospital and they referred her to the BASHH guidelines. I was given Nystatin (14 pessaries) and, since the symptoms persisted, I went on to 14 pessaries of boric acid. I still have symptoms, though. I have been reading a lot about this and it seems that it's very difficult to eliminate glabrata. I might also be in an early stage of perimenopause, and the hormones might be playing a role in the balance of vaginal flora. About a month before feeling the first infection symptom, I started feeling very intense lower back/pelvic pain. I went to a pelvic floor physiotherapist, and she helped a lot! That back pain is nearly gone. Coincidence or not, my symptoms (which were mainly discomfort in the vulva and around the entrance of the vagina) became a lot less, too. Nevertheless, they are still here, and lately I have been feeling some pain in the pelvis. It's not constant, but it's enough to keep me on alert mode.
The thought of having yeast overgrowth that is difficult to treat is not doing any good to my mental health.
I welcome any suggestions and would be happy to hear about your experience.
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Tnx for responding, this is the thread that I was trying to remember :-\
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SPIC
If Midnight Shadow misses your post you can click on her name to get a profile up where you can click again to read through some of her previous informative posts and threads.
Here is one such
https://www.menopausematters.co.uk/forum/index.php/topic,68297.msg931727.html#msg931727
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Thank you Minusminnie. I'm new to the forum.
I'm happy the treatment worked very well for Midnight Shadow! There's hope!