If you’re taking HRT how to cope with constant thrush?

[intrepidwalker]

Been taking HRT for around 3 years and it means I can function and it’s given me my life back, however I have constant thrush am now allergic to ALL remedies ie Fluconazole and Clotrimazole. I also have painful BV a couple of times a month too - again allergic to Metronidazole so I can only treat with the balance gels.
Its got to the point where can no longer sleep under a duvet cover and have to sleep on top of our duvet with just a light sheet at night even in winter so I do t get hot/warm down there at night. The thrush feels painful so does the BV as I’m extremely sensitive down there. I have swabs down at the doctors to confirm the infections - it’s not just in my head.

I’ve gone to a private doctors but they couldn’t help and make me feel like a freak.

Before I started taking HRT I had insomnia, crippling anxiety and such severe atrophy that I couldn’t sit down. Oh and constant hot flushes and palpitations- so I was unable to work. A week after taking HRT I was back to my normal self - so I don’t feel it’s an option to not take it.

If anyone has any advice I’d be so grateful. I take women’s probiotics tablets daily, don’t eat sugar and don’t drink alcohol. I’m 56

I had to stop taking it because of constant thrush.

I heard something on the radio this week about a probiotic supplement specifically targeted at thrush, it was something like The Gut Health GP?

Vaginal microbiome supplement This is it, I think.

Thank you for replying - this looks great. I’ve just ordered it. Fingers crossed

I know I’d have to give up work if I came off HRT and it’s not an option financially at the moment.
Do you mind me asking if antidepressants worked better for you instead?

Do you know what it is in the HRT which gives you thrush? If it's the progesterone, could you switch to a combi patch or Mirena, if it's the oestrogen, could you try patches if you're on gel, or gel if you're on patches?

Not something I've come across!!

Yes I’m on anti depressants. I had to leave my job due to menopause anxiety.

There is something called Halofemme (l think) for vaginal dryness. It doesn’t contain oestrogen. It’s quite helpful.

I went from being confident and outgoing to scared to leave the house.

Menopause is awful.

What type of HRT are you on and do you use topical oestrogen as well?

I developed chronic thrush in peri too but it's part of the vaginal atrophy. I manage it with topical oestrogen - both the pessaries and the cream. I'm also on Oestrogel but that doesn't deal with the atrophy symptoms on its own.

Thank you, I’ve never heard of this before. I’ll give it a go.

My gynaecologist told me it’s the estrogen that causes the thrush. I take Evorel patches 75 and 100mg Utrogestan and vagifem tablets that I insert. (I was allergic to the cream versions that I used to insert.)

The gynaecologist is removing a polyps this month (very small and only had this for 2/3 months) but he’s suggesting I have a mirena coil inserted at the same time. I’m very sceptical of this as I have BV infections a couple of times a month (and am allergic to metronidazole) so I don’t think it’s a good idea.
Will consider asking about the gel estrogen though thank you instead of the patches.

I use oestrogen gel and since I increased my dose from 2 pumps to 3 I am plagued with itching in vulva and was diagnosed with thrush recently. The treatment for thrush helped a bit but it’s not totally cleared.
so not sure if changing the form of oestrogen will make much difference….

likewise I don’t want to give up the HRT although I am still cranky and quick to snap at my children.

My gynaecologist told me it’s the estrogen that causes the thrush. I take Evorel patches 75 and 100mg Utrogestan and vagifem tablets that I insert. (I was allergic to the cream versions that I used to insert.)

I’ve thought about maybe reducing the patches to see if that helps. I’ve been prescribed testosterone gel but sadly it doesn’t agree with me at all which I know is unusual but given my medical record with allergies, not totally unexpected.

Thanks for your reply - it does make me wonder if I should reduce my dose to a 50 patch maybe, although this will affect my sleep and other symptoms.
Yes HRT has really given me back some quality of life too, except for the thrush issues.
Hope you get it sorted.

Interesting ... My GP says it's the lack of oestrogen that causes it (or makes it more likely anyway). Horrifyingly, I think both are probably true 😬

For me, thrush was one of the first symptoms of peri although I didn't know it until much later. So it pre-dated the HRT. And I'd only had it once in 20 years before that. I have to use the topical oestrogen like clockwork though, if I miss or am late with one dose I'll have thrush within days. It's a bugger. I do hope you find a solution that works for you.

It’s so confusing! I’m so sore and sensitive I’ll keep using the vagifem for sure but the advice is so conflicting I agree.

I thought it was the progesterone that caused the thrush. I had a terrible time with it and reluctantly swapped from patches to plain oestrogen patches and a mirena and it’s been amazing. The atrophy has disappeared, I hardly get any bleed at all whereas before it was monster, and I feel like me again.

@intrepidwalker I'm just going to repeat some stuff which you've mentioned but are you 100% sure it's thrush all of the time?

I used to think I had thrush (for years- soreness) and kept treating it, but and it was vaginal atrophy. I've used Ovestin now for around 17 years.

You mentioned being allergic to the cream- it does tend to sting a bit if you're sore, IME, but it's something that gets better as the cream takes effect. You may have thought it was an allergic reaction but my experience is it does sting if you're sore, but you have to keep going.

Have you tried using it externally on the soreness? Vagifem only works internally - it won't help the outer parts. If you want something weaker than Ovestin there is a gel called Blissel.

I agree that it's usually progesterone that causes thrush as it raises the body temperature.

Are you doing all the usual stuff like cotton pants, no tight jeans, no synthetic tights, no hot baths, no perfumed bath stuff like shower gel or soap - and using only water on yourself?

This is really interesting as my consultant is offering to insert the coil when I have my polyps removed in 3 weeks. I read up on the coil and it says it’s not for people who have infections though so am undecided about what to do.
The gynaecologist said it may help as the thrush may or may not be due to progesterone but then he went in to say that it could also be the estrogen patches! So I’m so confused!!

Thanks for your reply. Yes to the thrush - I have no discharge at all, just discomfort and get swabs taken regularly by the nurse which confirms the thrush. As I am definitely allergic to the OTT thrush treatments (causes nerve damage and ended up in A and E) it tends to linger.

Maybe I’m not actually allergic to Ovestin though, as you say it does really really sting but maybe I should go back to this as I need something externally too.

Yes I’m doing all the things like no jeans, only quick showers. I can’t even wash my hair in the shower- I do it over the bath! Cotton pants, no tights and wear mainly skirts with long socks underneath - its ridiculous!!

The thought of having a mirena coil scares me so much though as I also get BV regularly (confirmed through swabs) and it could turn into PIV. With getting nerve damage also from taking metronidazole- I don’t know how they could really treat me.

I mean PID (pelvic inflammatory disease) not PIV!!

I'm glad I just came across this thread, although I'm very sorry to hear that so many of you are struggling. I'm 49 and not yet on HRT but have recently had a mirena fitted to try and help with heavy periods and I'm struggling with thrush. I'd assumed it was the fitting itself that somehow upset things but perhaps it's the progesterone.

Not wanting to derail but how the fuck are women struggling with this supposed to have sex? My libido is at rock bottom already but it's important to our marriage so Ive been making an effort. But now I'm dealing with this it feels like the final nail in the coffin because sex always makes the thrush worse.

Ironically I have always found that when I have a little bit of thrush it goes away with my period, but if the mirena does its job then I won't have that reset.

One thing I will share is that I was sore for years and thought it was thrush. Ironically, I once had a swab which showed thrush even though I had no symptoms!

My advice is you start using a pea sized blob of Ovestin once a day (or more) and see how you go. Yes, it will sting inflamed skin initially but it's a case of powering through it. The skin eventually becomes thicker and less irritable.

I suffer with thrush not hrt related. I find the cream does sting but is effective.
I know nothing about hrt as never needed it (very lucky I know) but would a different recipe hrt be possible? Have you got to stay on hrt forever?
This sounds horrendous and I hope something helps.
BTW I had 3 mirena coils for heavy periods and contraception over 13 years. Completely stopped my periods and maybe that helped with menopause. Had the last removed at 55 years old.

Thanks I’m going to try this. I thought the stinging was skin irritation as I had to change ALL my facial creams as I became and makeup too during the menopause (allergies!!) and now only use Weleda. Anyway I’m just going to power through with the Ovestin. Thanks

I know!! My husband is very patient but it’s rare these days I feel well enough for sex down there!
I have been prescribed testosterone as I know there are receptors in the vagina that help with vaginal health but there’s very little information about what that actually means. Anyway I’ve tried off anout 6/7 times with the testosterone for about 6 months - but every time it gives me severe stomach cramps. The nurse says this is the first time she’s ever had a patient with this side effect - again makes me feel like a freak!!