Vaginal atrophy, estrogen cream gives me thrush😢

[TheEmojiFormerlyKnownAsPrince]

So fucked off.

Bad vaginal atrophy, estrogen cream/pessaries gave me thrush. Swapped to patches and they’ve done the same. I obviously can’t tolerate them. Tried vaginal moisturisers but they weren’t any good.

Sex life a joke. Where do l go from here?

Tablet form HRT ?

But don’t tablets contain the same stuff as the other 2?

Not necessarily . You may need a higher dose. The cream / pessaries may not be a high enough dose. I went onto patches and that was a step change for me.
There are also dermal gels.. not topically applied to the atrophy.
Please note , I am not an expert . Go back to your GP.
Sometimes the VA is mistaken for thrush.

www.mumsnet.com/Talk/menopause/a3429137-Vaginal-atrophy-Lets-mention-the-unmentionable?msgid=83555078#add_message

I’ve had thrush all my life. Couldn’t ever take the pill. Every anti biotic treatment will trigger it.

I don’t know what to do. When l had the pessaries a swab was taken which indicated the presence of Candida. Just waiting for a swab result on this one.

I’m ultra ultra sensitive to side effects from anything, and this has got worse as I’ve git older. I think both the pessaries and the patches indicate thrush as a side effect.

Seen a gynaecologist who seemed a bit baffled. I’m bloody desperate! I can clearly tell the difference between how thrush feels and the itching/soreness from atrophy and they feel totally different

Ok ; just trying to help .I did say I was not an expert .
Maybe someone else out there will provide information that is more useful to you.

Using systemic estrogen (patches) should not give you thrush. In menopause, the vaginal pH becomes less acidic, and this is how thrush takes a hold. When you start to use pessaries or Ovestin, for some reason it may make thrush flare up a bit. But there is no reason why you can't have treatment for thrush from your GP at the same time. Have you used oral diflucan? And maybe Nystatin ( medicine.)?

You may also need to look at the whole issue of candida, which means changing your diet- cutting out sugar, refined carbs, fruit - for a while. This helps if the thrush is systemic. Obviously no hot baths, tight trousers etc.

If you have had thrush all your life, it seems to be s systemic issue.

Why not try the double dose of the difluclan tablet- 2 weeks apart- and also use vaginal estrogen again. You may have to put up with some thrush short term but it will settle down. You can also get some acid-balancing gel- think the supermarkets sell it- which will help the pH balance.

I can’t take flucanazole. It interacts with another drug I’m on😰.

And once l get thrush it is hell to get rid of

Can these HRT things trigger thrush which then calms down?

You could take Nystatin which is different.

Have you heard of the anti candida diet? If you get thrush so easily, it could be your whole digestive system is out of kilter, and / or you have lifestyle factors that make thrush more likely. You might want to read about systemic candida and diet.

I think the product I mentioned is Aci-gel (something like that.)
It balances vaginal pH.
carepharmaceuticals.com.au/brand/aci-jel/

Yes, thrush is listed as a side effect on the info leaflet with Ovestin. What happens is that any change- even a potentially good change through using estrogen- can upset the vaginal flora. You have to push through it.

Meanwhile, nothing to stop you using vaginal pessaries for thrush- don't see how they can interact with oral meds.

What else do you take? Could whatever meds you use be affecting your gut microbes?

You might like to investigate pre-biotics and
pro-biotics (food and supplements) to help your gut health which is where this thrush is coming from.

Optibac pro biotics for women are good.

When you suffer from long term chronic thrush as l have had in the past, then it slowly becomes immune to all medications.

This is situation is thought to be hormone related as it is basically about extreme sensitivity to both eestrogen and Candida. From what l understand about my condition it is about extreme reactions in the Catina rather than a whole body issue. I have no other symptoms of Candida.

I will try the probiotics, but have not had much success with those or Candida diets in the past. I thought of asking for a smaller than usual dose of oestrogen pessaries, like half the amount. Just to see if l can tolerate that.

Catina=vagina!

There is no lower dose. The available dose is 10mgs (used to be 25mgs until 2 years ago.)

Are you getting the same reaction to Ovestin and Vagifem?

You could try Gynest which is like Ovestin but weaker- the only downside is the applicator is bigger and you are supposed to use 10x as much as with Ovestin, so you could use less. OR simply use Ovestin and don't use the whole dose.

You should still try some of the gels that help the acid balance. Just insert them at a different time of day to the estrogen.

Could you sort out your HRT and see if you can get away without the vaginal treatments?
I use Yes lube or coconut oil which are both very gentle for sex rather than using vagifem every week etc.
I did struggle with thrush for a couple of years, very hard to deal with. I found the specific womens optibac probiotics very helpful, try not to take antibiotics.

I’ve tried Yes stuff. I used it every day internally and externally. It didn’t do much. I think l must have quite bad atrophy😖

YES is mainly a lubricant and will help with moisturising but it won't reverse atrophy. This has to happen at a cellular level and takes time- sometimes 6 months.

You ought to try a smaller dose of the estrogen creams and also daily use of something like Acti-jel.

Have they ruled out lichen sclerosus? Very similar symptoms to VA & quite often gets missed.

Please try organic Red Maca Root. It definitely works.

All hrt can cause thrush. I've been exactly the same... patches thrush by day 3 on estradiol plus numerous extreme side effects unable to go past 10days. No hrt after that...horrifying experience fir me. 2yrs later atrophy so tried estriol and the new 10x lower dose called blussel and straight away thrush. I'm already of daily dose of fluconazole 50mg for low estrgen causing dry mouth caysing recurrent oral thrush for 18months and had 3 pessary doses and 2 high dose fluconazole and I'm still itchy. It's more complex than just vaginal ph. All estrogen in hrt increase glycogen (sugar energy) in your cells especially in your vagina. So as your lowering hormones in perimenopause or menopause naturally causes less glycogen the healthy bacteria called lactobacilli decrease as they feed off glycogen. Then these good bacteria are unable to fight off the bad candida which also naturally lives in our bodies. Candida also feeds on glycogen but then can breed out of control very quickly when we introduce any estrogen in the form of HRT. The only possible help we can offer ourselves is to help our gut and vaginal microbiome with probiotics using ones that help the vagina or Lactic Acid pessaries. While they may help to a degree I really don't think this is a 100% cure solution if some of us are genetically prone to these side effects. Equally all this low sugar diet thing does have a place in a healthier body overall but if never heard a case of a miracle cure by cutting sugar. Natural foods break down into sugars which put brains need but refined sugar obviously isn't best for us all the time. I'm like this lady, wad in desperate need of hrt in patches but effects were too extreme to improve my quality of life and Equally more gutted that even the lowest safest doses of vaginal estrogen has caused mtme instant thrush and constant nausea and really bad constant heavy stomach like bad period pain. Woke every morning with stomach pain and nausea and barely ate food i felt so miserably unwell. Now I've had to stop the estriol cream, no more stomach aches or nausea, but also atrophy symptoms back within days so have no choice but go non hormonal with creams and pessary. I'm just too genetically sensitive to all this HRT stuff. Covid vaccine made me so unwell I got tinnitus for life from the vaccine fever so this whole midlife had turned my health and wellbeing upside-down after a previous life if good health barely seeing a gp. Now I'm there every few weeks....it's just not good when the dream of these solutions don't work out.

i couldnt use Ovestin as it made me feel quite sore and itchy a few weeks after using it. My GP changed my prescription to the weaker estriol cream (which you need to use more of) and i've been absolutely fine ever since

I assume as this is a life long problem you've had underlying causes like diabetes ruled out and have been on a 6 month course of anti-fungal medications? Has your partner been treated too?

Well not diabetic at all, been tested numerous times. And no, not had long term issues with thrush at all through any part of my life until either trying any form of hrt, plus the recurrent thrush due to late perimenopause causing my dry mouth from lowering estrogen. A dry mouth allows candida to grow fast and even though I chew gum constantly nowadays to stop the burning mouth symptoms and to continuously re salvation my mouth the thrush jeeps re-energing in z week of stopping the antifungal ms. Nystan is hopeless and the only alternative option of a different antifungal has been stopped in the UK (miconazole) I need checking for which type of candida I have but nhs gps dint offer this. I'm seeing an oral specialist next week so I'll be asking her to dig deeper into other options. Thing is the fluconazole does work for my mouth but stopping the medication causes the return. NICE guidance won't allow long term usage unless you're HIV positive have an immunity problem or on chemotherapy. There is no management for thrush caused by perimenopause or menopause although its a known side effect of this hormone change. All m6 body has been highly effected just by perimenopause, thing is I have atrophy and its been kicking in the last few years but the last 6months very much more quickly during to my regular v heavy perimenopause periods stopping last year for 3 months to.then return extremely light and 60days apart. This is directly the same time my burning mouth and oral thrush started along with a sudden influx of hourly day and night flushes constant for over 4months. Max 3hrs of sleep per night, soaked smelling of sweat really syring, drove me to tears, distraction, unable to work without constantly feeling anxious paranoid hopeless exhausted and useless with no ability to concentrate. I also have chronic dry eye from low estrogen too. So as for thrush any hrt just causes massive amount of glycogen in my body cells to feed all this thrush. I'm just too reactive to any hormone treatments no matter the dose or method. I fely crap on 6months oc contraception in my teens so came off it. I'm a doctors anomaly and too much of a challenge for them so that's why I've educated myself rhrough all this perimenopause since hitting 40. All I get to my questions is I don't know, and a look of disbelief when I explained how extremely I react to any hrt patch cream spray or gel with multiple symptoms a tially worse than perimenopause itself in a lot of ways. My saviour has been fezolinetant as its stopped my flushed but I gave to purchase it privately awaiting NICE uk approval for the nhs.

That sounds horrendous I'm so sorry you're going through this. Have you seen an endocrinologist about this at any point? If not I'd highly recommend requesting a referral.