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[Rose B]

Looking for advice on recurrent thrush, every 4-5 weeks,  which I've had  for last 3- 4 years.  Its definitely thrush, have had swabs. I'm on HRT and 7 years post menopausal. I used to get thrush a lot when on contraceptive pill. I also have mild VA and LS (well controlled / not active).  Ideally, Id like a pessary that I can use weekly as a preventative.  Anyone any suggestions or thoughts as getting really fed up with it!

Currently just treating each thrush attack with gyne pevaryl pessaries (econozole)  Works and not too much burning etc,  but they are 3 pessary dose, so impractical for maintenance treatment. And acidophilus capsules inserted twice weekly to help with ph balance, which seems to help a bit

This is what I've tried (and abandoned) so far:

canestan pessaries weekly- worked well for 2 years or so, then discontinued due to extreme irritation
fluconazole oral tablets - caused really bad gut issues
canesflor vaginally to help rebalance - discontinued due to severe burning
various ph balancing gels - multigyn, balance active, yes WB,
various vaginal oestrogen - vagifem - fine for 2 years or so, then extreme irritation so discontinued; ovestin & other estriol creams caused discomfort and obvious thrush rash.
Intrarosa- tried for a year, initially seemed good, then seems bit more irritation and bit more frequent thrush

I asked my GP for referral to specialist recurrent thrush clinic, but as there isn't one in my area, and Sexual Health will only see patients with STDs,, I recently had an appointment at vulval clinic.  Their suggestion was weekly fluconazole for 6 months.  I'm not keen due to previous experience.  Also restart vaginal oestrogen - Invaggis, Blissel or Intrarosa Plus poss yes vaginal moisturiser.

Sorry for long and detailed post

[Sue_M]

Hi Rose, have you tried going down the natural route? Acidophilus is really good for good gut bacteria. Have a chat with a good health food store. Cant offer much else advice wise but thus might be a start x

[CLKD]

If you have a regime which works:  .  Although you would like a weekly preventative, if it isn't avialable and in order to get the 'thrush' under control why not go with what is prescribed?

I would suggest 14 nights of appropriate vaginal atrophy treatment: 'vagifem' or 'ovestin' doesn't seem to have suited your tissues so mayB try the newer 'Invaggis' : to keep the whole vaginal area moist and plumped up.  Either can cause irritation initially : some find that 'yes' or 'sylc' products help.  It mayB reaction to the fillers but the active ingredient shouldn't cause burning.  The irritation may well have been due to your not using the product regularly enough so that the very thinning skin became extra sensitive.  [something I have been guilty of and learned the hard way.  VA is 4 me, like razor blades  up there].

I had thrush - after stopping the contraceptive Pill, the itch was too high up to scratch  . The Gynae Registrar gave me a pessary, can't remember what it was.  Told me not to scratch!

The 2nd time I had emergency surgery (1991) it happened again.  GP treated it with something, can't remember. When ever I have elective surgery I swallow LIVE yoghurt 3 times a day in the week prior and after the operation.  Cleanses the disgestive tract from top to bottom.

'canastan' made me burn  - I had to sit in a cool bath for 2-3 hours! so would never use that.  How about LIVE yoghurt: eaten and applied, although do keep both pots separate
;-).  Messy when inserted but Oh So Soothing  .  I have my evening bath then insert when necessary, laying on a thick, warmed bath towel. 

Thrush lives in the back passage and thrives on sugars.  It is important to wipe correctly so as not to pass the candida into the vaginal area. 

[Joaniepat]

Hi Rose B. Have you tried posing this question on the Vaginal Atrophy Facebook group (private)? There are one or two folk there who have had "embedded" thrush.

When swabbed, have you been told which species of Candida is prevalent? It may not be C. albicans, in which case your infection might not respond to the usual meds. Would seeing a GUM specialist privately be an option, so that you can get the microscopy done more thoroughly?

JP x

[Jasmine20]

Hi Rose B

You mention inserting acidophilus capsules internally I think? Which brand?

I ask because in my experience they vary hugely in quality. Allergy Research Group have a Women's Essential Biotic which contains amongst others L. Crispatus, a probiotic species which is thought to be key to vaginal health.
Invivo Healthcare have a formula called Bio.Me Femme V also containing this probiotic strain and others for vaginal health.

In my experience, I found taking a probiotic orally every day for several months was necessary to turn the tide although I saw improvement before then.

Best of luck!

[CLKD]

   Girls

Pity that we aren't told about vaginal health and care when we get our 1st attack of thrush? 

[Rose B]

Thanks for your replies and suggestions.

Will look into the suggested probiotics, and join the VA F/B group.

I do already look after my gut health with diet, probiotics and live yoghurt, which is why I'm reluctant to disrupt it by taking flucanozole tablets orally.

My last all strains swab showed albicans; getting another one done tomorrow.

Has anyone had success with thrush pessary, thats not canestan? I have used live natural yoghurt years ago, which helped I think, so might try that again.

Re VA treatment- thinking I might give Invaggis a try. Vulval clinic Dr said I would need a weekly thrush preventative regime at same time, as would using Invaggis would inevitably make my thrush more frequent, initially at least. 

Feels a bit like a vicious circle!!

[CLKD]

The important word is 'live' - natural may not have live in it.

Let us know how you get on!

[Bluesky]

Hello, I have VA and was misdiagnose with thrush for months, there was point were I could not wear underwear, begged my GP to give me oestrogen, after 3 months back and forth, got it prescribed. Used Ovestin for 2 months but it burned me leaving me sore especially in the urtehra for days, so changed to Vagifem, then Imvaggis, all these give me thrush. Got a swab to confirm. after 8 months waiting for my referral to a GUM clinic (not walk in available and on min services due covid) I had another swab to check specimen. Now another referral for end of Aug with a dr with interest in thrush....anyway, action plan is: clotrimazole pessaries once a week for 6 month (i react to fluconazole) and Intrarosa....the rationale behind using Intrarosa is that is not estriol so I may be able with time to shift the thrush and still be effective with my VA....they said use everyday for 6m then reassess....I have just also started systemic HRT.
I could see that every week I would get a bout of thrush after less than 24hours of inserting any of the oestrogen pessaries.....will report back, only 2 weeks using intrarosa....and on my 2 month of thrush pessaries...hoping my appointment in aug can give me more clarity on what the hell is going on with thrush......never in my life had it before....

[CLKD]

Thrush thrives on sugars.  Have you had a diabetic test?  Candida lives in the back passage.

It may be aggravation of the thin skin in the vagina from the fillers or applicator rather than the active ingredient.  Did U ever try putting the product onto your finger to insert gently?  Also, LIVE yoghut really helped my symptoms. Let us know how you get on!