I want my happy healthy vagina back
March 15, 2011 2:17 PM   Subscribe

Do you have a vagina? Or do you know about vaginas? Specifically: I think I have a chronic candida/thrush infection but my doctor seems to disagree. And also: can you become resistant to antifungals?

Last year I had a pretty stubborn urinary tract infection which was treated with 8 months of strong antibiotics. It soon became apparent that this was leading me to suffer from thrush/candida, and so the urodynamics doctor prescribed me 50mg fluconazole (diflucan) to take every day, which I duly did for 4 months. It seemed to work, but after I finished the antibiotics, I found I was left with the same symptoms of thrush I had that the fluconazole could no longer shift.

I was told by another doctor I was probably resistant to the fluconazole, and miconazole pessaries were prescribed, which made everything better - but only for about 3 weeks.

Since then I have tried probiotics, cutting out sugar in my diet, avoiding harsh soaps and nylon knickers, etc etc, everything you're supposed to do, in an attempt to shift this naturally. But I am still left with these symptoms: sticky dryish yellowish discharge, itching, and pain during sex. I went to std clinic to eliminate other possibilities and everything came out negative.

My doctor then did a swab, which tested negative for thrush, and referred me to a gynaecologist, who examined me and said everything looked completely normal. He said that at the age of 27, I can expect my body to be changing, and he essentially said that the pain during sex was in my head - "If you are tense and worried before sex, that's more likely to make it hurt for you." I don't think this applies to me - when I am having sex I am the least tense and worried I get. Besides, the pain I'm having is 'further up', at the cervix, rather than around the prone-to-tensing vaginal walls. Mr Gyno also said it's not possible to become resistant to fluconazole and that if I'm taking it and it's not working, what I have isn't thrush.

So: basically the itching, pain, and discharge are all in my head. Or just a part of the natural ageing (!) process. This makes me angry but how can I argue with a negative test result?

Thank you for reaching this far if you have. I want to know if you had a thrush (candida) infection that went undiagnosed by a doctor, and if so, how did you get rid of it? Have you become resistant to anti-fungals like fluconazole? What did you try instead? I am so desperate to have my happy healthy vagina back I will try anything.

I am in the UK, so any over-the-counter suggestions available here also gratefully received.
posted by rose selavy to Health & Fitness (25 answers total) 4 users marked this as a favorite
 
Can you get a second opinion from a medical professional?
posted by anniecat at 2:24 PM on March 15, 2011 [1 favorite]


Response by poster: Well, the gyno kind of was the second opinion after my doctor. I want to believe them but keep thinking, the symptoms tally and it all started while I was taking anti-biotics. And the miconazole antifungal seemed to work, but it came back again.
posted by rose selavy at 2:30 PM on March 15, 2011


I agree that a second opinion seems to be in order, as this doesn't sound normal. However, I have had chronic thrush, and this also doesn't sound very much like that, especially the pain around the cervix. You deserve answers better than "it's all in your head" and you should absolutely keep pursuing this until you can get it sorted out. But I don't think you should go looking for a doctor who will agree with your predetermined conclusion that it's thrush, because it seems like it could be something different. You say you've been tested for STDs, but I know when I go for standard STD testing it's stuff like gonorrhea and chlamydia. Have you been tested for things like bacterial vaginosis or trichomoniasis? You may want to consider a vulvodynia specialist if you can't get a satisfactory diagnosis and treatment from the doctor or the gyno.
posted by ootandaboot at 2:37 PM on March 15, 2011 [1 favorite]


You need to go to a different gynecologist. He may be right that pain during sex is psychosomatic, but that's no excuse to be lazy and rule out everything else (it sounds like only thrush has been ruled out, and not any other vaginal disorders).
posted by muddgirl at 2:38 PM on March 15, 2011


Oh, and to follow up on your comment about how it all started with the antibiotics: in my experience, once your vagina gets out of whack, all sorts of things can go wrong. It's like (a very yucky game of) dominoes. It's possible that what started out as thrush has since cleared but created an opening for some other problem to arise.
posted by ootandaboot at 2:42 PM on March 15, 2011 [2 favorites]


I used to have some or all of these symptoms somewhat fairly regularly in my 20's. Similar doctor results to yours. When I was overseas, I was prescribed Clotrimazol cream and that worked really really well!

I've used this remedy ever since, but I've kinda grown out of having the problem entirely for the past 5 years or so.

At the time, it could've been caused by stress, or HBC, or diet - who knows?

Nth a new doctor, and/or ask for this simple prescription from your current doc.

Good luck!
posted by jbenben at 2:46 PM on March 15, 2011 [1 favorite]


Have you been tested for cytolytic vaginosis? I developed it after over-treating a yeast infection (thrush) with antifungals. The symptoms are very similar, especially the BURNING itch. My layperson's understanding is that when all the yeast have been killed off, the lactobacilli flourish and produce lots and lots of lactic acid which, being an acid, basically burns into the cells of the vaginal walls. You can imagine how much fun that is.

Speaking again from my layperson's understanding (this is not medical advice! consult your doctor!): the only treatment is to counteract the acid with baking soda, either in sitz baths, douches, or suppositories. Warning: in my experience, when the CV is raging and I'm already having a lot of pain/itching, the suppositories are too strong and result in even worse burning pain. I hate douching, but it seems to be the best method of combatting the acid.

If it's not cytolytic vaginosis, could it be bacterial vaginosis? I'm sort of mad that your gyn(a)ecologist basically said "if the antifungals aren't working, then it isn't thrush" but doesn't seem to have followed up on any of the other possibilities.
posted by LBS at 3:01 PM on March 15, 2011 [5 favorites]


Best answer: That's effed up. I feel pretty confident in assuring you that it's not all in your head, and that "things change at your age" is a dismissive, patronizing brush-off kind of thing to say to a 27 year-old.

Find another gynecologist. You deserve better than that.
posted by ErikaB at 3:49 PM on March 15, 2011 [4 favorites]


Are you on the pill? I had a lot of dryness issues that developed over time while on the pill.
posted by PhoBWanKenobi at 3:55 PM on March 15, 2011


This is the second AskMe today where a poster's male doctor was dismissive of her female symptoms. I sometimes feel like men should not be allowed to be gynos! And any man who thinks that regular pain during sex is normal for women is ...just...uuggghh...what a jerk!

Definitely find another gyno. You should not be this uncomfortable! Especially with so much discharge all the time. It can be normal to have regular discharge, especially when you're ovulating, but combined with itching is a sign that it's not normal.
posted by radioamy at 4:00 PM on March 15, 2011 [1 favorite]


Best answer: Just wanted to pipe in here and say thanks! I've had the exact same experience, honestly, right down to negative swabs and pick'n'mix treatments (also UK based).

I'm no nearer to knowing why I'm susceptible to these symptoms. I cut out all yeast for a month, including eating only one piece of fruit a day and no tinned tomatoes (?!). I lost half a stone and my liver loves me but its effect on the candida was negligible. The only thing that's working for me is a generally holistic lifestyle. I try to run three times a week, try (but fail) to avoid refined sugar, and sleep regularly. I don't know if any of these are the 'cure' but avoiding stress is the best management tool until the medical community gives me a proper diagnosis.

Sometimes, though, it's fairly inevitable that it will flare. I have a master's degree, and there are weeks when I'm in the library dawn til dusk with chocolate in hand.

By all means get another opinion. If you've been to the STD clinic you will already been tested for BV. Another thing that's made my life a lot easier is a genuinely caring (female) nurse at the uni. She doesn't have any answers but being treated like a human being helped a lot with putting the condition into perspective and getting on with my life. I'm coming up to my year anniversary with it and the symptoms are barely noticeable now (it all began with antibiotics for tonsillitis).

Good luck! Memail me if you want to vent about your GP.
posted by dumdidumdum at 4:02 PM on March 15, 2011 [1 favorite]


I know a lot of people think "candida overgrowth" syndrome is a load of bunk; but after running out of ideas for my similar symptoms after a run of antibiotics, I finally tried these pills and after feeling super sick for a few days (apparently that's common while the yeasties die off), I haven't had any problems. That is, as long as I remember to take two pills each morning before breakfast (note: I worked my way up to 3 in the morning and 3 in the evening for a couple weeks, then moved down to more of a "maintenance" dose of 2 in the morning).

So those pills are what seem to be keeping things in line for me. I would imagine you could find something similar over in the UK.

Good luck!
posted by Zoyashka at 4:11 PM on March 15, 2011


For a while I suffered from a nasty cycle, get a yeast infection, treat the yeast then end up with BV, treat the BV and get a yeast infection. After several months of this I ended up with yeast that were resistant to diflucan and the over the counter treatments, confirmed by my gynecologist (it does happen). I was prescribed a different antifungal (unfortunately I don't remember the name) which worked but I still struggled with the cycle (I think my partner was passing it back to me or sex itself was throwing off my internal pH off balance). I would suggest seeing a different gynecologist and consider (if you don't already) using condoms even if you are with a monogamous partner (just be careful with your lube choices, spermicide caused me problems as did those containing glycerin).
posted by estronaut at 4:20 PM on March 15, 2011


YEs YES YES to the suggestion above that you get tested for vaginosis if you haven't already. I've had it, my symptoms were exactly what you describe.
posted by Mimzy at 4:35 PM on March 15, 2011


You might have a latex sensitivity that is causing these yeasty flare-ups and pain during sex. And if you are not using condoms, your partner may simply be reinfecting you every time you have sex, especially if he's uncut.

I got rid of stubborn thrush with long-term large doses of oral antifungals which are usually given for post-surgical systemic fungal infections (sporanox). They get the job done but they're really really hard on your liver.
posted by elizardbits at 4:44 PM on March 15, 2011


Your sex partner needs to be treated too. Whatever you haves likely passing it back to you as soon as you treat it.
posted by fshgrl at 4:54 PM on March 15, 2011 [1 favorite]


Yeah, please get tested for BV.
posted by tristeza at 6:34 PM on March 15, 2011


I think this situation is not uncommon. At least, I've known a few women who were in this situation including, to a minor degree at a couple points, me. I think that women tend to over self diagnose yeast infections. This whole "yeast diet" thing which is very popular doesn't help matters in my opinion, as we are led to believe that surely we are doing something wrong (eating sugar) which dovetails nicely with social ideas about women's eating and so forth.

/feminist rant

Anyway, BV or lactobacilli overgrowth are possible explanations. I have not heard of resistance to fluconazole. Did your doc test you for STDs like chlamydia? Likely, you're not going to get a definitive diagnosis. Also and obviously, your doc is full of shit about the cause of the pain. Sex shouldn't hurt.

I personally have used a few home remedies that I've found some success with when dealing with ambiguous vaginal discomfort. Yogurt, garlic, and vinegar have all given me some relief at some point (though not all together salad dressing style).

I also find daily showers help. Using lube can make penetrative sex more comfortable (and fun!)

I bet this will just go away on it's own after a while - as mysteriously as it arrived. Sorry to not have more definitive suggestions.
posted by serazin at 7:06 PM on March 15, 2011


If it is in fact yeast, you may find that a weeks worth of boric acid suppositories help. It has worked for me, when over the counter creams didn't seem to help. Around here you can buy boric acid in powder form at the drug store in the first aid section, or you can ask a pharmacist. It is sold as a topical antiseptic. Fill small (size 00 if possible) gel caps and put one in each night for a week to 10 days. It increases the acidity of your vagina and makes it less hospitable to candida.

However if it is cytolytic vaginosis as mentioned above, then this seems like the opposite of what you want to do.
posted by keeo at 9:05 PM on March 15, 2011


Best answer: Just chiming in to agree with everyone else.

1) Go to a GUM clinic to get comprehensively tested for all the STDs mentioned, as ootnaboot suggested. But there's an art to the test request. When you go in, don't start off with your theory - all doctors hate that, but British ones especially. Describe your symptoms and treatment history in the plainest language possible ("I was treated for x with y, but still have z.").

If you don't see a light bulb switch on, only then say should you say something like "a friend of mine, who is a nurse [lie!], suggested it could be q". This tugs on the threads of collegiality, while it expresses respect for the doc's more senior position. Do not mention "the internet".

2) If test results are inconclusive or the offered treatment doesn't resolve your problem, like everyone has said, get another referral - from a different GP at your surgery. Ask the receptionist to book you with a lady GP if you can. Tell this GP you do not want to see Mr Gyno, because he dismissed your symptoms as psychosomatic and didn't test you.

3) Nurses at walk-in clinics are, very often, awesome. You could try them as well.

My experience in the UK was like dumdidumdum's. No coherent or easy pathway to gyno care; reluctance to test and treat (though not sure if this has to do with limited resources or cultural attitudes). I have also received incorrect information.

By the way - if it is BV, it doesn't necessarily disappear on its own, and isn't harmless (can cause pelvic inflammatory disease, which in turn can cause infertility).
posted by nelljie at 9:56 PM on March 15, 2011 [4 favorites]


typos. angry.
posted by nelljie at 9:59 PM on March 15, 2011


Nthing the "try another doctor." If they tested for thrush and the results were negative, then they need to test you for other things. I have a really good book about gynecological stuff ("the v book) and the author says that painful intercourse is never OK:

"Sexual intercourse isn't supposed to hurt, not ever...Painful intercourse is called dyspareunia ('say dis-par-OON-ee-ah'). When it involves the vulva, vestibule, or vagina, it's superficial dyspareunia. There's another kind of sex pain known as deep dyspareunia, which originates up in the pelvis and lower abdomen. Deep dyspareunia may come from a variety of conditions that affect the pelvic organs, such as pelvic inflammatory disease from chronic infection, endometriosis, or large uterine fibroids. Your regular gynecologist can help..."

I am not a doctor, but I am also a little curious about how long you were taking both the antibiotics and the diflucan. Is there any possibility that one of them might have side effects that could, say, mess up your hormones? I'd explore that question with my new doctor.

Good luck, and I can't believe that doofus was trying to tell you that at 27 it's fine if your vagina just gets all painful and falls off.
posted by hungrytiger at 1:06 AM on March 16, 2011 [2 favorites]


I had constant discomfort and reoccurring yeast infections and tried everything you've mentioned and the one thing that has helped me combat all the symptoms you've identified is not to let soap go anywhere near my vagina and to use Lactacyd wash for the area around there.

Even if you don't have a yeast infection, which it doesn't sound like you do, this will still probably help ease some of your discomfort, particularly if you have an abundance of lactic acid due to rampant lactobacilli in the absence of yeast.

I agree with everyone saying you should see another gyno but in the meantime, I really, really recommend trying this. You can get it at Boots, it's under £6 and will last ages. It's usually in the pharmacy section with the yeast medications and pregnancy tests, NOT with the tampons, which will have other feminine washes like FemFresh, which I don't recommend. Lactacyd is what you want, if you can't find it, ask someone.
posted by Polychrome at 3:19 AM on March 16, 2011


From another UK-based vagina owner - both dumdidumdum and nellgie's suggestions are spot-on. Unforutunately sometimes in the NHS it's the squeaky wheel that gets the grease - so don't be ashamed or worried about asking to see another GP at your surgery and asking for a different gyn referral. People do this all the time.

And just as a data point, I've had a pretty good experiences at GUM/STD clinics - and you don't need a GP referral for these. You can locate one here. If you have a long-term monogamous partner, it may be an idea for him to come along, too.

Finally - are you on hormonal birth control? I had issues with chronic intermittant thrush variably responsive to long-term fluconazole, probiotics, etc. The problems finally stopped around the time I stopped taking birth control pills.
posted by peanut butter milkshake at 4:29 AM on March 16, 2011


Nelljie's advice about dealing with GPs in the UK is, sadly, right on, which makes me so very angry. We shouldn't have to dance around and flatter egos just to get the treatment we deserve.

I am currently dealing with extremely long, heavy, painful periods and what seems from my research to probably be endometriosis, and I've been trying for months to get a doctor to acknowledge that I need treatment beyond birth control pills, ibuprofen, and heavy-duty pads. Any theory or idea that the GP didn't think of him (or her) self is dismissed out of hand.

I've been through three of the GPs at my local surgery and next week I'm registering somewhere else to try again. It makes me especially furious that, based on anecdotes from friends and from the internent, this patronising, antagonising behaviour from GPs seems to be directed at women with reproductive issues more than anything else. Keep trying, even if you end up seeing every GP in your city.
posted by cilantro at 4:33 AM on March 16, 2011


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