Ongoing thrush problem (I think?) not responding to anti-fungal treatment anymore

[smith2000]

Last summer, I developed a white thicker discharge than normal that looked like it had little white specs in it (what looked like and felt like dead skin or wet tissue). However, I didn't really have any other symptoms like itching or soreness. I bought the oral pill (Fluconazole) which got rid of it after about 4 days. It then came back 2 weeks later. When I went to the doctor, they told me to repeat it, and it went away but came back again after 2 weeks. After trying the pessary which didn't seem to work at all, I was put on maintenance treatment with Fluconazole which I have been taking once a week every week. The doctor did not undertake a swab test, as they presumed that it was thrush and couldn't see what else it could be since it had been responding to treatment at this point. However, it came back in bouts and now treatment seems to not be working at all. I have been back to the doctor numerous times and have had multiple tests and STI screenings, which all came back clear, but I'm not sure if this is because I am still on treatment? Upon examination, the doctor also couldn't see any inflammation or redness. She advised me to take Balance Activ which I took for a week but this seemed to not do very much. I am also taking probiotics to see if this helps to clear it.

I'm not sure what else to do, is there any advice as to how I could get rid of this discharge? Does this sound like it is thrush or could it be something else? Is it possible that I have become resistant to treatment for thrush?

[lakem]

I have similar issues. All tests negative. The only comfort I get is sitting in an bath with epson’s salt. This has reoccurred after two months. Help

[smith2000 in reply to lakem]

What symptoms do you have?

[Galen70]

You should be attending a sexual health unit for microscopy when the COVID situation has settled down. They are the specialists in discharge. They can also tests the vaginal acidity . If all this candida treatment is not working, its most likely not candida. However they will test for everything.

[smith2000 in reply to Galen70]

Hi, I have actually attended a sexual health clinic last month and they looked at it under a microscope, however they couldn’t see much, apart from a bit of inflammation. I was also spotting at the time because my period was nearly due so I don’t know if that affected it. I also don’t recall that they tested the acidity, so I will go back when coronavirus has been resolved.

If it isn’t Candida, what could explain white clumps in discharge? And how come treatment worked at first and not now? It is the same discharge that I had before my treatment was working so I can’t see how it can be something different.

[Galen70 in reply to smith2000]

vaginal acidity would be affected by blood ( more alkaline ) Its hard to comment on the microscopy without seeing it. Candida is hard to detect sometimes on microscopy, did they take swabs at the same time ? Disorders of discharge could be candida, BV, aerobic vaginitis , strep/staph infections . Sometimes people have changes in discharge and all the tests are negative. Do you take any oral medication ? have you changed your contraception ?

[Galen70 in reply to Galen70]

and how long did you take fluconazole for ?

[smith2000 in reply to Galen70]

I have been taking fluconazole regularly every week for about 5 months, however on advice from my doctor I have now stopped it to see if my symptoms persist or change.

[smith2000 in reply to Galen70]

Yes they took swabs at the same time and they came back negative on everything including BV. I have not heard of the other infections you mention though. I had a swab at my GP as well and that came back negative, however there was a presence of Strep B which they said did not require treatment. Would that have anything to do with my discharge? The only medication I had been taking was fluconazole and I recently had the coil put in however I had this discharge before I had it done and I don't think it has affected it.

[Galen70 in reply to smith2000]

Yes strep B is considered a commensal and normally does not need treatment. However it is not impossible for it to cause changes in vaginal discharge.

[Galen70 in reply to smith2000]

5 months is a bit excessive. If someone has proven recurrent or persistent candida then 2 months of suppressive therapy is enough. I am wondering if you are 20 this year given your nickname on here, are you sure that the changes in discharge are not just part of the normal maturing process ?

[smith2000 in reply to Galen70]

I'm not sure, but surely clumpy white discharge isn't normal?

[Galen70 in reply to smith2000]

I think if you have had every test possible done, then I would be considering whether this is normal ( physiological ). Every woman is different - some women have a lot of normal discharge, others little, and the consistency can be different too. Even if it was candida, it doesn't do you any harm and is normal in the vaginas of 1 in every 5 women. So if you feel well, then why worry ?

[smith2000 in reply to Galen70]

I don’t understand how it could be normal for me though, because it went away with fluconazole at first and has only stopped working in the last few months. Could it be possible that because I had fluconazole in my system when I had the tests done that the tests were affected by this?

[Galen70 in reply to smith2000]

yes of course if you were taking fluconazole it could stop candida growing. But again - if you feel well with no symptoms other than the appearance of your discharge, with negative tests, why worry ?

[smith2000 in reply to Galen70]

I just think maybe my body has gotten used to fluconazole and maybe the candida has developed a resistance to it somehow? The doctors I have seen said that this is really rare but I can't see what else it could be. It is just when it comes to intimacy, it makes me really anxious and self-conscious, I wouldn't worry otherwise. I am still going to pursue it when everything with coronavirus has settled down to have more tests done which hopefully might be more accurate when there is no fluconazole in my body. Would you recommend using probiotics/prebiotics?

[Galen70 in reply to smith2000]

Ok - candida albicans has not developed resistance to fluconazole fortunately. There are about 5% of yeast called candida glabrata that are resistant - however they respond to clotrimazole - which you already used. I would emphasise you have not had any yeast grow in samples so far.

There is little evidence for probiotic therapy working .

I think the issues here may relate to what you feel is normal and what you feel another person may perceive when intimate. Every woman is different and discharge is different. If you have been extensively tested and all ok, then you should try to relax about this. It is not an STI.

[Hidden in reply to smith2000]

This happened to me exactly 8 years ago recurring vaginal discharge/thrush. 2 months after the birth of my last child (2012) I decided to have copper coil inserted and ever since then I was going in and out of the hospital/surgery as a result of reoccurrent thrush/vaginal discharge infection.

They gave different kind of medications both oral and the ones I will insert inside my vaginal, and canestene to apply. Note I was prescribed different medication each time I go for appointment not in one go. Upon all of that it kept on coming back. I was so careful that I advised my husband regarding his personal hygiene when using the toilet to be mindful when sitting in the toilet. I was mindful of my personal hygiene yet it didnt solve it, I then decided to remove it.

I then tried patch after some months however I was constantly having itchy skin exactly where I stuck the patch. That particular place will be scratching me. I got fed up of all of those. One of the days my 2+ years older son removed it. He saw it when I came of from the shower with towel round my body. He said mummy mummy sticker sticker😂😂😂😂😂 he was so quick in removing it, I screamed oh my goodness and replace it immediately. However my worry was the fact that I was constantly itchy anytime I stick it on my body.

Today I'm happier than ever, I'm using natural method though it's scary coz it may not work for everybody. It does work for me as long as my period and ovulation is regular and know how to calculate it. That's what I ve been doing for the past 8 years.

[Blue-sky-10 in reply to Galen70]

Galen70, 5 months is not excessive for a treatment.

see extract from BASHH guideline

bashhguidelines.org/media/1...

Recurrent VVC

Recommended Regimen:

• Induction: fluconazole 150mg orally every 72 hours x 3 doses* (1A)

• Maintenance: fluconazole 150mg orally once a week for 6 months* (1A)

[Galen70 in reply to Blue-sky-10]

I have reviewed the BASHH guidelines , which were updated in 2019. Previously there was no agreed consensus on the duration of treatment. The length of treatment is based on a Cochrane review of evidence ( 1A ) but I don't know from which studies the six month duration has been sourced. In practice a shorter course often works, 2-3 months. But yes, the new guidelines do state 6 months.

And remember the original poster did not have a proven diagnosis.

[Roohaha in reply to Galen70]

When do you think we can go back to clinics again I wasted tested for chlamidya a month ago had treatment but also get persistent thrush and bv outbreaks constantly . I’m so uncomfortable right now I don’t know wether it’s the bv , thrush chlamidya didn’t go away or anything???? There is an odour more like bv but itching like the thrush so frustrating what would you suggests for time being until the covid situation is better to go see someone for test again. The pains are shooting down my groin and leg now and not slept for days due to discomfort . Feel in limbo

[Galen70 in reply to Roohaha]

You should retest for chalmydia minimum 5 weeks after treatment. You could order an online free NHS testing kit depending on where you live.

The other symptoms need assessment by a sexual health unit. If you are concerned re candida , you can buy either fluconazole tabs or clotrimazole pessaries over the counter in pharmacies which are still open despite COVID. There are some over the counter acidity treatments for BV in pharmacies too. If your symptoms persist after all of this you need to go back to a sexual health unit or GP

[Roohaha in reply to Galen70]

Thankyou

[Galen70 in reply to Roohaha]

most welcome