Thrush or atrophy ?? What the hell is wrong with my fanny

[Missistoger]

Hi . 40 years old my nightmare began ! Please help any suggestions very welcome .

Nightmare started with the coil being fitted in August constant bleeding and itching had removed in Nov and found to be infected so given many antibiotics to clear resulting in thrush taken fluconazole (canestan ) both single dose and the 1 every 3 days followed with 1 a week started getting hives and itching on body feeling really sick stopped taking fluconazole and hives went
... reaction to fluconazole ??
however still had burning vagina and labia constant never goes away always the same since the coil being put in , took further thrush meds ( itraconazole , clotrimazole , econazole pessaries ) as swabs showed some candida growth .

Further swabs showed neg thrush but symptoms of persistent burning carried on no itching never itching always the same constant burning and chaffed feeling .

Given steroid ointment burned like a bitch didn't work .

More swabs showed thrush scant growth of candisis parapolopsis apparently not normal thrush ( normal.thrush is candida albicans ) so Nystatin pessaries given but still the burning persists :( hurts to walk :(

So is this even thrush ?? Surely it would be dead I've had every thrush treatment going for months on end .

Bloods show not menopausal levels however periods have gone very irratic sometimes come every 2 weeks ! Bleed for a couple of days then stop or last for over a week .

Vulva biopsy done on random brown patches of skin on labia thankfully neg for cancer but no other info given .

What the hell is this hellish constant burning feels like perminant chaffing pants hurt walking hurts , no discharge , and no visable rash swabs show no BV , no strep , normal flora , I am getting more and more miserable by the day :(

I have had similar, steroid creams made it sting so much. Ives tin has made things much better, as I reacted so much with the other creams I started applying it in tiny amounts during my period (weirdly the calmest time) and built up to using normal amounts nightly. Also vagifem has helped, and using Vaseline as barrier cream before going to the loo because urine is pretty acidic anyway. But the ovestin is brilliant.

I had atrophy when pg so agree could be that; however I also get extreme skin reactions there and flare-ups to any scented product which take a long time to calm down (including itching, burning etc). Try no scented product at all and just water for some time to see if that helps? (you might already have done this!) Hope you find a solution - it's miserable to be so uncomfortable.

Thanks everyone . I've bit the bullet and paid to see a gyne/ skin specialist today she has looked at the the history and test results she also did some tests for nerve pain she said it's not atrophy skin looks normal so lichens no excema no thrush . (Swabs also clear )
she has told me it's vulvadynia 😳 I have to take amatriptamine for the nerve pain to try and improve it ..... We will see 🤷

Given what she said today, I'll chip in my experience. I had months of "thrush" and every solution available to try to kill it off. Turns out that I have dermatitis from.... thrush treatments which is then further triggered (weeks after the last treatment) by a soap I never had a previous reaction to!

Only solution I found was to start washing hair in such a way as no suds went over my body, use aqueous cream instead of soap (all over so no runoff from other body parts) until it all calmed down. Epiderm comes in a pump action bottle or dermol does a good shower one that more liquidity and less greasy.

So glad you've had a diagnosis! I really hope you get relief from it soon :)

Glad you've got a diagnosis. I had similar issues, with itching and soreness not vulvodynia though. Saw gynae and vulval dermatologist. Things that have helped... no baths with products in, only use dermal lotion to wash fanny. Wash underwear in sensitive wash powder. Used prescribed betvonate steroid ointment for 6 weeks. Now moisturise vulva with Vaseline. Drink water. Stopped cycling. Went pantless as much as possible at home to get air circulating. Not sure what solved it but it's stopped. Maybe a combo of factors. Hope you can find some relief.

@Seaoftroubles

OP you say your periods are irregular, if there's a chance you are entering peri menopause it could be atrophy due to lack of oestrogen. The symptoms for this can mimic thrush and affects the Vagina and the Urethra. Ask your G.P for Ovestin, to be used internally and topically. If atrophy is the cause you will get relief pretty quickly.

Agree, I’m a gynaecologist and classic symptoms of hypo-oestrogenic vulval and vaginal tissue. There is point your GP having checked blood tests to see if you are “menopausal” - the standard test (FSH) only becomes abnormal when you are post- menopausal, ie: ovaries have stopped producing eggs and natural periods have stopped. You are in the peri-menopause, FSH will fluctuate but be normal range ( and obvs you are still menstruating).

You need a sufficient dose of vagina oestrogen to help - sounds like your GP may not be brilliant on this, so ask to be referred to a menopause specialist

thebms.org.uk/find-a-menopause-specialist/

Has lichen sclerosis been ruled out?

Sorry, that read “no point your GP having checked blood tests”

Sorry OP, just read your update. i was diagnosed with vulvodynia three years ago with very similar symptoms to you. It went on for months and months but actually mine have now resolved completely. I was offered gabapentin but never took it.

Vulvodynia just means “painful vulva” - this is a diagnosis of last resort, when all other known causes have been ruled out. With respect, although you have had some relevant and useful tests, you have had a lot of repeated, random tests and treatments, and some basic possibilities need ruling out.
Please do consider seeing a menopause specialist. Diprobase emollient cream is brilliant for using as a soap substitute, and as a vulval moisturiser in the meantime. Extremely gentle and non-irritant, will give the area a chance to calm.

I had these symptoms for 15 years before finally finding the solution. Similar to other posters I worked it out myself and asked the GP to prescribe. My life has now improved immeasurably. I was using thrush remedies which were only making things worse

So as others have said I use the vagifem pessaries - 14 consecutive days then two per week thereafter. I use organic liners in underwear so I don’t need to worry about washing powders. They are also helpful for the times when I use the epaderm ointment which I really really recommend (ointment not the cream - it has a Vaseline like consistency and moisturises so well) it helps any itch so much so if a small flare up starts use lots at night and a little in the day. Drink water. A LOT of water. I find if I slack on the water I can get a flare up. Aim for 3 litres a day. Use dermol cream to wash in shower so no soap running down. Don’t cycle and don’t wear tight jeans.

In flare up I also had symptoms akin to a severe UTI but tests showed I didn’t have infection but often had blood present from inflammation etc. After the urologist ruled everything out with cameras inserted etc he prescribed a daily antibiotic (macrodantin) to be taken at night. GP wasn’t happy to prescribe antibiotic as maintenance but urologist wrote to GP so that was sorted. I don’t really have to take it now - occasionally if things unsettle maybe have to go back on it for a few months every couple of years.

Around the time of starting all this above, I was also finally referred to a urogynae specialist who I saw a few years ago. She was fab and the first medic I met who didn’t think I was imagining it. She was horrified I’d been struggling for so many years and never referred. She prescribed amytriptaline and betvonate steroid to use in the next flare up. Guess what? I have never used them as I’ve never had a flare up since I started all of the above. She still sees me once per year to check if all ok. She had said if those solutions she prescribed didn’t work, a Botox injection into the area can be very successful. But as I said the vagifem and self help have done the trick.

I’m post menopause now I think but this started in my late 30’s and got so much worse through my 40’s. I wish I’d known all this back then instead of using thrush creams which made it worse. I wish you luck and hope you feel a lot better soon

By the way my periods remained regular for the first ten years of this from late 30’s to late 40’s but apparently I still needed the vagifem which was finally prescribed around 50 ish and helped immeasurably

Op, just to advise, my skin looks completely normal and I have atrophy and lichen sclerosus. You don't necessarily get skin changes in appearance. It can take a number of years for the skin to thin and go white with Ls.

@Ssmiler thank you for your reply X I too had issues with UTI symptoms a few years back and saw the urologist had cameras and found inflammation so was put on low dose antibiotics for a year to help this this did eventually calm down .

@Tootsey11 I have had vulva biopsy to rule out melanoma lichen and dermatitis all were clear thank fully X

I've randomly been found to have B12 deficientcy I have no idea if this has any relevance to the problems I've had but that's being sorted now too. They have given me amatriptamine to try too for nerve pain so I am going to do what they have advised and see what happens .

I do still think there is some hormone elements going on too but as the skin looks fine and the bloods show fine they don't agree but I will keep all your advice in mind if there is no improvement with what they have told me to do .

I really appreciate everyone who has taken the time to comment and although I am not happy that there seems to be many women suffering with this misery ,it has helped me to know that this is a thing and I am not completely mad !! ❤️

O. P, as Quince2figs says upthread you really should see a menopause specialist to rule out atrophy. You yourself feel that hormonal issues might be at play so if there is a delay in getting an appointment why not ask your G. P for Ovestin and Vagifem in the mean time ? It couldn't hurt to do so and might well be the solution to your problem. At the very least, if it doesn't help then at least you have ruled atrophy out if the equation.

@Seaoftroubles thank you for your reply . I have appointment on Friday I will ask for the ovesten and vagifem . Can I ask how you found out you had atrophy and lichens if the skin all looks normal ? was it that the hormonal creams worked so you then knew it was that or did you have other tests that showed this to be what it was even though everything looked normal ?
They have told me that as they cannot see anything looks normal it's not that 😱
Amatriptamine taken for over a week noticed only slight improvement . X

Hi Missistoger, l self diagnosed after doing some research on the Menopause Matters Website. Visually there was nothing to see so l went on symptoms. l thought initially l had cystitis or a uti but 2 lots of antibiotics did nothing to relieve the discomfort. I didn't suspect atrophy as l'd been on a low dose hrt for many years but sometimes you can need topical help as well. This was during lockdown so l had to rely on telephone appointments and in fact neither G. P suggested atrophy. After reading up on it l requested Ovestin
and it worked very quickly. Since then l've had an in person appointment with my Doctor and she also agreed to increase my hrt. When she examined me she said l didn't have lichen sclerosis but did agreed that atrophy can be very hard to diagnose visually.
If you have a look at the Menopause thread on mumsnet you will see that many women have found relief from Ovestin, Vagifem or a combo of both and these can be used alongside hrt if required. Please don't be fobbed off, your own doctor can prescribe these, you don't need to get them from a specialist!

Thank you !!! @Seaoftroubles and @Tootsey11 thank you for your reply to I have appointment on Friday I will ask for the ovesten and vagifem . Can I ask how you found out you had atrophy and lichens if the skin all looks normal ? was it that the hormonal creams worked so you then knew it was that or did you have other tests that showed this to be what it was even though everything looked normal ?
They have told me that as they cannot see anything looks normal it's not that 😱
Amatriptamine taken for over a week noticed only slight improvement . X

I will have a look at the menopaue matters site X and I will be sure to not be fobbed off by the GP ❤️ they really do seem to be useless ! Xx thank you for all your help X

You are welcome, l really hope you get some answers. As well as the Menopause Matters site also have a look at the Menopause thread on here where you will find lots of information about atrophy and hrt. As l mentioned before when you speak to your G. P just say you wish to try the Ovestin and/or Vagifem to rule out atrophy, at least you will then know whether or not that's the cause of your issues!

@Seaoftroubles thank you X I've spoken to doctors today and they have gave me the ovestin cream to try 😄 I am hoping this will be the answer thank you for your advice X 😄

That's great, l do really hope it helps. Please make sure you do a full loading of the Ovestin cream initially. So, insert the required amount ( up to the ring on the applicator) and appply for 2/ 3 weeks or even 4 weeks if you feel you need it). Then a dose 2x weekly afterwards. You can use a bit topically too if feel you need too. Good luck! l've got everything crossed for you!