Menopause Matters Forum
Menopause Discussion => All things menopause => Topic started by: Snowcat on September 29, 2025, 10:23:34 AM
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Hi everyone. My battle with thrush continues despite trying some Econazole pessaries that apparently the rare infection (Candida Krusei) was sensitive to when tested. Having to wait a week to even speak to the GP. All I asked for was to do another test!
My question is how do fellow sufferers cope with the irritation and, even worse, the itching please? It’s driving me nuts and making me very tearful. No-one my GP has spoken to has any experience in treating this particular Candida species. I feel like I want to dab some steroid cream there but as I’ve vulval atrophy too I’m very nervous about doing that. I’m just using estriol cream and hydromol at the moment. Plus the patches. Everything was improving until this started and I’m feeling really down right now … just feel like I’ll have this forever and can’t bear the thought of that. The lab suggested nystatin pessaries but they are no longer being manufactured … any advice very much appreciated- thank you.
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I feel your pain (and itch). I definitely wouldn't use steriod cream down there unless instructed to by a doctor, it could make it worse and cause other problems. Would canestan cream offer relief, even though it's not the right antifungal? I slap it on several times a day and it does help with the burning and itching. Alternatively live yoghurt straight from the fridge would be very soothing but I find added moisture causes soreness, but some say it helps. Are you boosting your good microbes with probiotic yoghurts, kefir or supplements? I'm finding this keeps it in check ( but doesn't cure it for me).
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Perhaps read back through your threads and make notes of responses and advice?
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I feel your pain (and itch). I definitely wouldn't use steriod cream down there unless instructed to by a doctor, it could make it worse and cause other problems. Would canestan cream offer relief, even though it's not the right antifungal? I slap it on several times a day and it does help with the burning and itching. Alternatively live yoghurt straight from the fridge would be very soothing but I find added moisture causes soreness, but some say it helps. Are you boosting your good microbes with probiotic yoghurts, kefir or supplements? I'm finding this keeps it in check ( but doesn't cure it for me).
I can’t use Canestan or clotrimazole as it burns too much. Yes I’m taking optibac for women and having kefir. They might help when I eventually get rid of it. Gynae advised not to use yoghurt down there though. I’m already using Ovestin cream and hydromol ointment so maybe a bit of a soup! 😂 I’m now waiting for advice on next step re treatment as nystatin is longer manufactured. That was the only suggestion the lab had. Thanks for replying. I’ll carry on with the probiotics etc x
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You could also try a PH vaginal wash to make things more alkaline which yeast doesn’t like. This could counteract the higher acidity that the vaginal oestrogen causes.
You can also get the Nystatin online from Europe yourself, as already mentioned.
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On that logic, you may find that a bath with bicarbonate (baking soda) added will give you some immediate relief.
By making the tissues drier and less hospitable will also make the yeast leave of its own accord!
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What reason did your GP give U for not using LIVE yoghurt? :-\ Thrush lives in the back passage and thrives on sugars and I, plus 5 other ladies, have used regular applications in the vagina with good success as well as eating it several times a day.
Bicarb of soda or epsom salts baths ............
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You could also try a PH vaginal wash to make things more alkaline which yeast doesn’t like. This could counteract the higher acidity that the vaginal oestrogen causes.
You can also get the Nystatin online from Europe yourself, as already mentioned.
I don’t have a bath, just a shower- and my doctor said that nystatin isn’t manufactured anywhere anymore. Here or abroad - he didn’t enlarge on that though.
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What reason did your GP give U for not using LIVE yoghurt? :-\ Thrush lives in the back passage and thrives on sugars and I, plus 5 other ladies, have used regular applications in the vagina with good success as well as eating it several times a day.
The reason was that it’s not been proven to help and could introduce unhelpful bacteria. I suppose because I’m already using Ovestin and vagifem and hydromol it might not be a good idea to introduce something like that - I don’t know really!
Bicarb of soda or epsom salts baths ............
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If you Google ‘buy Nystatin stada’ you will see lots of websites selling it from about 23 euros, depending on how big a pack you want to buy.
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You need to google it. It's some time since I looked it up but I think it's still sold for oral thrush but not for vaginal so check you're getting the right thing. I don't think (not certain) you can use the oral one with a suitable applicator. It also suggests something else instead of nystatin but I can't remember what it was now.
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I agree with CLKD live yoghurt always been a winner.
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NHS has advice on the use of Nystatin for oral use. .......... worth reading for information.
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7.02.02 - Nottinghamshire Area Prescribing Committee
100,000u pessaries (unlicensed)
For use only when imidazoles are inappropriate.
Nystatin pessaries and nystatin vaginal cream discontinued. If pessaries needed, an unlicensed version may be imported from abroad and available in secondary care.
Usual dose 100,000 at night for ~2 weeks
(See BASHH guidelines)
LIVE yoghurt will not do any harm, it cleanses the digestive system top to bottom when eaten - I usually swallow a large spoonful 3 times a day; my dog benefitted when she had heartburn caused by chemotherapy - as well as inserting into the vagina to ease itching.
It really is Trial and Error and there will be a reason why thrush is persistent. I think that somewhere on the Forum is a thread :-\ about diagnosing etc.? but I can't remember the subject title :'(
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Thank you everyone for your replies. I will discuss with gynae - they said they’d phone me next week. I’m not happy about buying stuff from abroad unless I know it’s the right thing so hoping doc will do another culture & sensitivity test first to see if nystatin is the right one- then I can ask them - I had a call from my GP to say that they have sourced a small supply from a local hospital if my sample is sensitive to it which was a nice surprise but I think they want to hold fire and see if the Econazole has worked first as that did show sensitivity even though when I googled it, it said it wouldn’t work! I’ll keep on eating the kefir and probiotics too. No sugar in my diet and see what happens. I suspect that when my atrophic skin has healed and things are healthy again it might not keep occurring. I’ve read that both low and high estrogen can cause thrush which to me means they don’t really know! I was on HRT for years and didn’t have a problem with it - the only difference this time is the use of estriol cream …
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On that logic, you may find that a bath with bicarbonate (baking soda) added will give you some immediate relief.
By making the tissues drier and less hospitable will also make the yeast leave of its own accord!
Unfortunately if you suffer with atrophy anything that makes the tissues dryer will make the condition much worse.
Best to not put so much into the mix and follow your medics advice, your issues are very complex and they are trying to find a solution for you. Its all trial and error for you but you will get there in the end.
Just also to say that when I was younger yoghurt didn't help me at all with thrush symptoms, it stung like hell.
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Thank you Ayesha - you always make a lot of sense! And thank you for helping me remain positive. I am getting better - it’s just this setback with the thrush … and the fact that it’s taken months for the doctors to request a culture & sensitivity- they just kept saying the fluconazole would work eventually! when there was actually no chance of that. Even now they insist I carry on taken that as well ‘just in case’ so I’m doing that even though I can’t really see why. As you say, a lot of patience is involved with all these feminine issues!
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The dilemma is that yeast love moist plumped up tissue to set up home, plus the food from the exogenous oestrogen, so you have to almost choose which is the most debilitating issue at the moment and treat that.
If atrophy is, then continue with the cream, if thrush is, then you may need to temporarily reduce the cream. It doesn’t mean you can’t return to it but you may need to do it once the thrush is under control and then having vaginal probiotics and/or natural antifungals, like caprylic acid, to accompany the cream. You could also try both at the same time but it may mean a fight that the Candida will take time to overpower.
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I did wonder if it was something to do with the estrogen but then again I would imagine that all the thin, sore and damaged skin would be more vulnerable to thrush anyway - I’ve read that both low and high estrogen can be a factor so it’s a balance thing - the atrophy is definitely the most troublesome thing for me but I have reduced the amount of cream I use at night and reduced the vagifem to every other day. I’m also taking optibac for women and Yakult. i have to wait until November for next gynae appt. It wouldn’t be so much of a problem if I had the normal C albicans - trust me! Thank you for your help.
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I've been there! I had persistent thrush for months and was finally told I had the Glabrata strain. I used Nystatin cream internally for 14 days and then boric acid pessaries for 3 days and I've been fine since. I am in Australia and Nystatin is readily available here. I got the boric acid pessaries from the iHerb website.
I'm not sure if Australian pharmacies ship Nystatin? I have horrible atrophy too and had to alternate my Vagifem with Nystatin but they weren't contraindicated, and it worked really well.
I believe the boric acid was the tipping point at the end. Now if I have the slightest tingle, I pop a pessary in and feel much better the next day.
Oh, I should mention that I had to go off Ovestin cream as it exacerbated the symptoms. Vagifem has been much, much better.
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:thankyou: for that update.
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I've been there! I had persistent thrush for months and was finally told I had the Glabrata strain. I used Nystatin cream internally for 14 days and then boric acid pessaries for 3 days and I've been fine since. I am in Australia and Nystatin is readily available here. I got the boric acid pessaries from the iHerb website.
Thank you so much much for that - that’s very helpful - and I’ll keep the boric acid pessaries in mind - do they irritate at all? I’m not good with most things in that area. I agree that it was when I was told to use Ovestin cream internally as well as externally that things got worse so I’ve gone back to the vagifem internally, and a smear of the ovestin cream outside!
I'm not sure if Australian pharmacies ship Nystatin? I have horrible atrophy too and had to alternate my Vagifem with Nystatin but they weren't contraindicated, and it worked really well.
I believe the boric acid was the tipping point at the end. Now if I have the slightest tingle, I pop a pessary in and feel much better the next day.
Oh, I should mention that I had to go off Ovestin cream as it exacerbated the symptoms. Vagifem has been much, much better.
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Sorry my reply got caught up in the middle of yours!
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I didn't have any irritation from the boric acid pessaries. I bought a good brand with excellent reviews. I actually used an Ovestin applicator to get the boric acid capsule into place - which worked well. Because I use Vagifem at night, I put the boric acid in mid afternoon. No issues there and I must admit, things were much better afterwards.
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Thank you Garnet that’s good to know - I’ll try the boric acid capsules if nothing else is suggested. Thanks for the tip about when and how to apply them - that would have been my next question!
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Never posted on here before, but I feel very strongly about this subject and wanted to share my experience.
I always get thrush after taking antibiotics, usually the canesten pessaries/fluconazole tablets work.
This time however after several attempts with pessaries/tablets and 3 trips to the gp and gum clinic it still hadn't cleared. By that point I had suffered for almost 4 months and felt pretty miserable.
Also tried candida diet/probiotics but nothing seemed to work.
My GP suggested possible resistance to the azole group and that it could be a different strain. The gum clinic said they would do a culture test but never got back to me.
I learned about nystatin on this forum, where a few people mentioned it is still available in europe but has been discontinued in the uk for commercial reasons.
I started researching on a german pharmacy website (I speak german) and saw nystatin for vaginal thrush is easily available over there, without prescription.
The brand name is called Biofanal-'bei Scheidenpilz' (means 'for vaginal thrush') and is sold as over-the-counter medicine in german pharmacies.
It cleared my thrush immediately! (1x vaginal tablet for 6 nights)
I think it is absolutely outrageous that this easy and cheap treatment option has been discontinued in the uk which means some women who have an azole resistant strain are suffering unnecessarily :-(
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I totally agree with you Sierra! Fortunately I now have a supply of nystatin pessaries - Southampton Hospital had a very limited supply left (probably at the back of a cupboard in the sluice room somewhere!) that they sent to me and I started them last night - but today I need to get an applicator as I had trouble with insertion due to a slight bladder prolapse 🤦🏽♀️ I spoke to my local hospital pharmacist when I collected this supply and he told me that although it’s no longer manufactured here, they do have the ability, in special cases, to order some from Germany if needed, and that I wasn’t to worry as I wouldn’t be left without treatment if I need more nystatin at any time. Somewhat reassuring I suppose, but I got the impression that it wasn’t economically viable to make it here as it’s rarely needed - not very helpful when you’re the one who needs it! Having said that, I’ve just read that it’s only 44% effective against Candida krusei … I can see myself ending up back at the doctor’s in a couple of weeks time! Also it said the duration should be no less than 14 days of pessaries - they’ve given me 12 days worth.
If the nystatin doesn’t work I’m going to mention boric acid pessaries. They seem to be effective against most Candida strains but no-one’s mentioned them to me yet… I wonder why if they’re a better bet! This has been going on for months now and, as you say, it makes you feel pretty miserable!