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[Garnet161]

Hi all,
I started on Vagifem 10 nights ago (after Ovestin for 8 months).
Not sure if it is the use of Vagifem which has caused the thrush - I did have a dose of antibiotics a week prior to the Vagifem so perhaps it was that.  Perhaps it was both.
But OMG, can one not catch a break??
I have to use Nilstat vaginal cream for the thrush for 2 weeks.  The doc says keep using the Vagifem at night and then 12 hours later, (in the morning), use the Nilstat internal cream.
Does anyone have any experience with using both?  Doc says they will not interfere with each other.

Has anyone had thrush after starting with Vagifem, getting rid of the thrush and then continuing on with Vagifem, happily ever after?
Because the Vagifem helps my bladder and I don't want to have to stop it!

[Minusminnie]

Maybe get a Fluconazole 150mg tablet for thrush either from the chemist or online.  It is a one off tablet to clear thrush.
A gynae told me that thrush is systemic anyway.

It may avoid use of the cream you've been given but you may want to continue with that if you feel you need 'belt and braces'.

Others will be along to advise.

[Garnet161]

Hi, thanks - I did question the one-off tablet but the doctor said no - I had swabs taken and I need the Nilstat 14 days cream this time.
I am resigned to the fact that I have to use the cream for a fornight.
I did just watch a YouTube vid from an American doctor who said that thrush can be common after starting vaginal estrogen due to the acidity of the cells returning.  She said to 100% continue using the vaginal estrogen - try for 12 hours apart as my doc recommended.  She said that as the microbiome settles in 2-3 months, the thrush will not return.  Unless there is antibiotic use or another contributing factor.
I feel better listening to her 

[Minusminnie]

That sounds reassuring hope you feel some improvement soon.

[bombsh3ll]

Restoration of estrogen can transiently increase the chance of thrush as your microbiome adjusts.

This is not a reason to stop estrogen.

Fluconazole oral tablet can be bought from a pharmacy.

There's no harm in using two vaginal products if necessary but it is more convenient and less messy to take a pill.

[Garnet161]

Thanks - I've had the fluconazole tablet twice in the past 6 months.  The doc said pathology indicated internal Nystatin for 14 days this time after taking a swab.  I guess I will follow their instructions for now.  It appears there is no drug reaction listed between Vagifem and Nystatin. 
I'll stick to Vagifem at night and use the cream in the afternoon when I get home from work at lunchtime when I am more sedentary.

[bombsh3ll]

If you keep getting thrush I would also make sure you have been checked for diabetes.

Thrush is common when starting, or starting a therapeutic dose, of vaginal estrogen, but it shouldn't be chronic.

[Dierdre]

Thanks - I've had the fluconazole tablet twice in the past 6 months.  The doc said pathology indicated internal Nystatin for 14 days this time after taking a swab.  I guess I will follow their instructions for now.  It appears there is no drug reaction listed between Vagifem and Nystatin. 
I'll stick to Vagifem at night and use the cream in the afternoon when I get home from work at lunchtime when I am more sedentary.

We had a couple of threads last year regarding the different strains of thrush as fluconazole wasn't working on the Glabrata strain and clotrimazole was prescribed instead and boric acid. The thread was from Midnight Shadow and contains alot of information that might help. Type Thrush in search and Midnight Shadow.

[Garnet161]

Thanks ok, I appreciate that.
I have been tested for diabetes and I'm fine.  My blood sugar is good, albeit a bit low.  Both times that I took fluconazole, it was without being tested - I was just a bit itchy and it was back when I first started Ovestin.  The other time was because my husband had thrush - he has diabetes.

[Minusminnie]

There have been threads on here in the past about a partner, thrush and the circle of re infection.

Presumably your doctor knows about your husband ?

[CLKD]

Also your husband must have a dedicated diabetic nurse to check his levels etc..

I had thrush twice: the 1st time after I stopped The Pill,  oh the itch was too high up to scratch. Years later I had it after emergency surgery, now if I need operations I eat LILVE yoghurt 3 times a day: lots of - and apply it into the vagina.  Eating it will cleanse the digestive tract from top to bottom, helping to replace good bacteria.

Hopefully the thrush treatment will work.  If Vagifem is giving symptoms then mayB try estriol instead?

[Garnet161]

My hub is thrush free now - he was medicated back when it was found at the start of the year, and he was recently checked.  His type 2 diabetes is much better now - diet controlled and he takes medication.
I have Ovestin here - I used it for 8 months, but it wasn't good enough for my bladder.  I just use it on the exterior now.
I have used one dose of Nilstat for the thrush already and there was instant relief - I finish the fortnight as instructed.  Also, I ordered some boric acid suppositories to hopefully keep thrush at bay from now on.

[Minusminnie]

As Dierdre mentioned above boric acid was for a certain strain of thrush.

You may find a sexual health clinic rather than a GP better at finding which strain. 

[CLKD]

How often did U use the ovestin and was it internally? 

[Garnet161]

Ovestin every night, internally for 8 months.  I seemed to have bladder relief for a couple of months and then the relief tapered off, even though I didn't reduce the dosage.
Which is why I switched to Vagifem.
The doctor told me the candida strain was not the typical candida albicans - she did not tell me which it was because I didn't think to ask.  I might ring to find out. But she said it was reasonably common and that the pathology lab directed her to script Nystatin for it for 14 days.
I have purchased some boric acid suppositories as a backup.
I have done quite of lot of investigating, and I got in touch with a friend who is a women's health nurse.  She says that boric acid suppositories are excellent for glabrata, tropicalis, krusei and parapsilosis which are the more unusual strains of candida and are typically resistant to fluconazole and canesten.  She said Nystatin is usually recommended and success is seen sometimes but she said boric acid is great to knock them on the head.  She said boric acid is good as a preventative too.  The study below is interesting.
https://pubmed.ncbi.nlm.nih.gov/33969547/