Perimenopause thrush hell

[Lifeisarollercoster78]

I’ll give some background I’m 48 now been on HRT since I was 42 I had the coil and patch then in August last year I had my coil changed and end of October had pelvic pain I was getting watery discharge and what looked like slightly yellow discharge on my pad anyway after a long time of trying to get sorted in November I was told I had a yeast infection. I had a lot of bloating and discomfort was told to take over the counter thrush treatment but the pessary and pill didn’t touch it. I also had an internal scan to check the position that caused sloughing of the skin inside. Fast forward to January after trying longer courses of treatment no luck at shifting it so I had the coil removed and moved to utrogestan daily and have been going well on that on the last strip of month three. I’m now under a women’s health doctor at the gps. We did two weeks of vaginal pessaries and have now moved on to once a week pessaries and twice a week Vagifem because not being able to clear thrush can be a sign of vaginal dryness. I’m not using pads I never use soap down there I’m not eating bread cutdown on sugar (I eat healthy anyway). So I’m on week two of the one pessary and two Vagifem but I feel the thrush when I’m doing the vaginal estrogen. I just want some reassurance really I feel like it’s never ending. I’m seeing the doctor tomorrow and am going to ask if she can swab again but check what strain the yeast is. I can’t have fluconazole as it makes me nauseous and feel ill on it.
can someone reassure me this will get sorted I try to be positive about it but after 5 months I find it hard.

have now moved on to once a week pessaries and twice a week Vagifem because not being able to clear thrush can be a sign of vaginal dryness.

I don't understand this-

Vagifem is a pessary.

Which pessary are you referring to?

I can’t have fluconazole as it makes me nauseous and feel ill on it.

Not even the 1 tablet that you can take?

Estriol cream might help

@JinglingSpringbells
thrush pessery on Wednesday after doing two weeks of them and Vagifem on Friday and Monday. This is to try and keep the thrush at bay while repairing the tissue. I have tried lots of thrush meds since November I need to do a more intensive regime so one has not touched it. I also had lots of side effects trying the loading phase of the Vagifem I was told by my doctor that I’m very hormonal sensitive all the HRT I’ve tried I always get symptoms it’s just the way I am. They also said in the loading phase some get a systemic effect because the tissues lets it through into the blood stream until it’s re plumped and healthy . I desperately want a solution maybe what I’m doing is it and it’s just a slow process?!

@JinglingSpringbells
just to clarify chronic/ recurrent thrush can also be a sign of vaginal atrophy all the swabs confirm thrush. I wish I’d never had the coil the second one definitely triggered it. I was scared to try utrogestan because I had terrible anxiety at the start of this but it turns out in better on utrogestan than the coi and now im in this mess!

Maybe you need to stop the pessary for thrush?
I've never heard of anyone using them daily for 2 weeks - is this via your GP? And now it's once a week.

Thrush is also a possible side effect of vaginal estrogen- it's in the patient leaflets.

If what you're doing isn't working, maybe it's time for a change of plan?

It's possibly too much of everything, so could you reduce the thrush meds? And maybe try vaginal cream instead of vagifem? It's a different type of estrogen but still effective.

@JinglingSpringbells It’s is the standard treatment for recurrent stubborn thrush. This is thought the gp who specialises in women’s health at my gp surgery. I had my coil out at the end of January I don’t know how long it takes for things to rebalance after that. Vaginal estrogen won’t treat the thrush. I don’t know it just feels a bit sore and itchy and the discharge and that’s horrible for so long. I was wondering about the cream to see if that suits better. It’s a real nightmare at the moment. I do know it was really bad at the start I bless and nearly passed out when I did my first pessary when I woke the next morning and also lost internal skin after my internal scan. I never knew this could happen.

bled not bless!

Lots of women need vaginal oestrogen more often than twice a week.

I was told to use it daily until no symptoms then slowly cut down aiming for twice a week but not to worry if I didn't get there. Happy on three times a week.

Pessaires didn’t work for me at all when I had recurrent thrush (mine was caused by antibiotics) Have you tried fluconozale? (Available over the counter). Mine was pretty stubborn so I was eventually prescribed a long term (6 months) course of Itraconzale which cleared it up for me.

For the dryness, I switched to Estriol cream, which seems to be more effective for me than the Vagifem tablets.

OP is there a GUM clinic you could go to? It might help to get fresh eyes on it. It could be something other than thrush.

The only thing that worked for my recurrent thrush was taking prebiotics. I bought them from Amazon, take two tablets in the morning on an empty stomach. My bloating significantly reduced as well so for me it was linked to my gut flora. Took a week or two to take effect and I've been on them for a few months now.

@trainedopossum I’ve had loads of swabs checking everything always comes back as thrush!
@BeefNoodlePho I’m taking obtibac for women I’m on my second pot now. I literally feel like I’m doing everything with no resolution. Maybe it’s just going to take time I’m nearly 3 months post coil removal and week 2 of the maintenance therapy. I think it got so bad before my vaginal flora is messed up just when I feel mentally well on my HRT this comes along!
thanks for the ideas though I do appreciate any help. X

I feel your pain OP!
I also had bad recurring thrush as a symptom of vaginal atrophy. What worked for me in the end was Vagifem x2 a week (& being careful not to push them too high - they seem to work better when the tablet is inserted just an inch or so) then oestrogen cream for external use (I just put this on when I feel a bit itchy) alongside Fluconazole to use as & when I needed. I know you said you can't tolerate Fluconazole but it might be worth another try? Otherwise perhaps there's a different oral medication you could try. I found the pessaries for thrush absolutely useless.
Hope you can find a solution! It's a beast but if you can get on top of it & into a good routine the topical oestrogen should keep it at bay long term.

This. It's literally their area. I've no idea why women don't go to the experts from the off and faff around with GPs

You can have thrush alongside other things, it doesn’t exclude other conditions. I treated miserable thrush for years before I went to GUM and was diagnosed first with psoriasis and eventually (years later, slightly different symptoms) with lichen planus.
What I see on threads like these is that if the GP is convinced it’s thrush they may never consider something else. Fresh eyes from a GUM specialist might help.
Good luck, it’s miserable.

You should follow Laura Dowling (The Fabulous Pharmacist) on Ista.
She is so knowledgeable about the likes of this and many other peri/meno related issues. You can pm her and she will answer you too. She has written a book called Love your Vulva and has been on Loose Women talking about it.

I had this for years too and Doc's kept passing it off as thrush. Eventually I grew out of it as my Nan would say. Hope you get relief soon.

@gamerchick I had the coil put in there and went back with the discharge and pelvic discomfort and they did nothing so I went to my gp so am reluctant to go back to them as they fob me off and I found out when I went back with the pain and discharge that when changing the coil the doctor had cut my cervix as I have scar tissue from a previous issue and didn’t tell me at the time.
@QuietlyLurkingintheCorner thank you so much for posting you give me hope I was thinking of trying the fluconazole again but not the 3 close together that’s what floored me and I did wonder about the cream.

I have recurring thrush too. Been to the GP twice and had swabs and it's always thrush. Yet it doesn't feel like thrush. There's no itching but loads of awful burning. I was told to try Canesten which did nothing so I was prescribed Estriol which just made my discharge so much worse. I haven't been back. I dont have HRT as I'm too sensitive to it. I don't have a coil either. My periods have almost stopped. I had a massive bleed a couple months ago and I keep spotting. I suppose I'll have to go back to the GP.
Hope you get somewhere with your thrush issue. It's miserable isn't it?

@BooseysMom it really is horrible I hate to hear other people suffering but I am glad I’m not alone hope you get sorted hopefully the doctor will help tomorrow fingers crossed I’m nearly at a turning point!

It is very normal to have more discharge with vaginal estrogen treatment and if you can possibly persevere, it ought to help change the tissues in order to prevent thrush coming back.

Vaginal estrogen won't treat thrush but it will make the vaginal tissues more acidic, resilient to thrush and healthier, so that thrush can't thrive so easily.

This might not be helpful as I don't have thrush, but I had no idea that vaginas/vulvas needed moisturising. Like basic moisturising, whether you use vaginal estrogen or not. It sounds obvious but it wasn't obvious to me, and all that itching, thinning skin and so on can be so sore. I use coconut oil (organic), which was recommended on here but if it's all very inflamed, something more specialist might be better, although I find this completely neutral and cheap. It makes a big difference in comfort for intimacy, even walking around.

There are also devices increasingly used for vaginal atrophy as well as pelvic floor exercises to build muscles.

I think they have to be used in conjunction with the treatments suggested, but I agree with everyone that you need to get a second opinion and test for anything else, the GP may be running out of options or not aware of the latest thinking on the issue.

Once you truly know what it is, the treatment pathways will be more obvious. I do think though it's a shame we don't get educated on vaginal atrophy before it gets bad, as there are quite simple things you can do that at least stop the decline, and then treatment options if you run into more serious problems.

I should have said moisturising in peri and during menopause, afterwards as well, due to the fact our tissues dry up all over our bodies, not just there. Everyone I know is using eye drops and has dry eyes, we need to also think about other areas of our bodies and pay attention to those before they become troublesome. I hope you get some relief, OP, as these supposedly small problems can grind you down.

I had constant thrush when I had a mirena coil and got it removed in the end and things did go back to normal for me.

@JinglingSpringbells
so are you saying eventually the balance will shift if I keep using the estrogen it will become an environment will not be hospitable to the yeast. That’s worth knowing thanks