Dr Sharon Dixon

Brief Outline:

Sharon sees some people who present for the first time with possible urogynaecological issues, as well as providing ongoing support for those with known conditions. She has worked in general practice for 22 years. Sharon also works as a researcher.

Background:

Sharon is a general practitioner (GP).

A doctor explains how recurrent thrush can look over different life stages

Symptomatic thrush can be experienced by anybody throughout their life, and that starts right from before your periods start before puberty to after the menopause.

And the thrush is the same. But sometimes the way in which it interacts with the stage that your body is at can change a little bit.

And one important example of this is that after the menopause and after periods stop when they're lower levels of oestrogen in the body, the skin around the vulva and the vagina can already become a little bit drier and a bit more delicate. And that can sometimes be mistaken for thrush, but also it can potentially aggravate the discomfort or distress if you've got itch. And that also goes, of course, throughout the whole course of your life, if you have another condition or skin condition affecting that area.

These are important reasons why, if you've got difficult symptoms, particularly symptoms that aren't getting better with something that you've tried yourself, with something that's worked for you before, that it's really, really important to go see a doctor, talk about the difficulties you're having, and arrange a time in a place where that can maybe be looked into further, usually with kind of somebody having a look and doing an examination and maybe some check-ups.

A doctor acknowledges that recurrent thrush can impact intimate relationships

So having thrush or discomfort in the kind of genital area can have an impact across all aspects of your life and how you feel. But one important kind of aspect of life, where it can have an impact is in sex or sexual intimacy. That's something that it can be really important if you are having difficulties in that area, to get some kind of personalized assessment advice and guidance on, and maybe a chance to talk through all the bits of that, that might be relevant to you and how those can be supported.

And that will include thinking about thrush itself, but also about anything else that's affecting that kind of aspect of the experience and how that can be supported and helped.

Options for getting that kind of support could be through places like your GP or through a sexual health clinic. I think that depends on what your needs are, what your priorities are, what's easier for you and what feels right for you.

What is important is if it's something causing you difficulty to find a space in a place where you feel able to get that kind of holistic support across everything that's relevant to you and get some guidance with it.

A doctor speaks about what can cause recurrent itching

And I guess at the heart of this, it's just worth kind of always remembering that not all itches is thrush, even if there is thrush yeast there, if it's not getting better, it's really important to be checked to make sure that there isn't something else that could be contributing to the itch or exacerbating those symptoms or something that's happening alongside it, whereby both of those things might need treating in order to help you feel better.

It's also worth remembering that sometimes the things that we use to treat thrush, can potentially aggravate itch. So sometimes it's even possible to become kind of sensitised to things like panty liners or fragrances and panty liners or some of the thrush creams.

The most important thing about recognising this is that if you've got symptoms or discomfort or anything that you're experiencing that doesn't feel the same as it had before, or that isn't getting better with things that usually work for you or that you've tried, it's really important to hold an open mind and to take that and get further appraisal and assessment. Because the critical question is whether there might be something else that's contributing to it, something that's making it more likely, something else that's causing the symptoms, or something that's happening alongside the thrush that is exacerbating the symptoms because if we can recognise that, then we can try and tailor the treatment so that you're getting the right treatment for the right condition and for all of the things that might contributing to your difficulties to try and help people feel better.

Because we recognise how discomforting and uncomfortable and distressing this can be.

A doctor gives some tips for having pelvic examinations

If you've got difficult symptoms that haven't got better with the treatment that you've tried, there are lots of really important reasons why we would suggest going and getting further assessment. And that includes making sure, that you might have a strain of thrush that's perhaps resistant to the treatment you've tried or there might be other things happening that either kind of aggravate the thrush that's there, or it might be that something else altogether, for example, another skin condition or another difficulty in that area are causing the symptoms, that have been thought to be thrush.

So, it's really important if things aren't getting better or if you've got ongoing symptoms or any concerns to get assessed by a health professional. And usually, the first thing that they will suggest is to have an examination as part of both understanding the problem, but also creating an opportunity to do some further testing, like specific types of swabs and look and kind of considering those other possibilities so that you can get the right treatment and the right care for you and the right tests.

But we do recognise that that can, for some people or sometimes feel that could potentially kind of uncomfortable or worrying thing to encounter. And there are things that I guess we can think about that sometimes can try to help. If there are things that you know from your experience, maybe being examined or make facing examination easier, then talk to your doctor about those. Try and plan the examination and see if you can build those in. Examples include thinking about where and when and with who you have the examination, having at a time when it's planned, or when you've anticipated or known that's going to happen. Sometimes, talking the steps through can help, and sometimes having a friend or an advocate or a supportive person of your choosing with you can help.

There might be things that make it feel particularly worrying or uncomfortable, and if you can create some space to talk to your doctor beforehand, including sharing together ideas about how you could together work to make it feel more manageable and more kind of acceptable, then that can be a really useful thing to do as well.

Sometimes it takes a bit of time to build up to these things, or to build the trust and to build the relationship, and trying to work to do that is also something that can be really helpful.

There are times when none of this feels possible, and there are things that can be considered in that space. And self-taking swabs are a really good example of that, and that can be an incredibly helpful thing to do. But I guess the difficulty is that if despite a swab and despite treatment, you're still not feeling better. It can still create spaces and opportunities for more tailored or more accurate care for you if you can take those next steps.

So, I think I think we recognise it's difficult, but having your voice and working in partnership with your health care professional to try and navigate a space, where, to manage that. If it's something that would be helpful to you for your health, can be can be worth doing, and it is absolutely okay to find a way to have your voice as part of that process.

A doctor explains how to care for sensitive vulval skin

So, while part of thrush will be the specific treatments that are targeted against it, it's also worth thinking just slightly broadly about general things that can help the vulval skin and vaginal skin feel more comfortable because it is quite delicate skin at all times. And if it also kind of additionally to that being aggravated or irritated by the thrush, that you're experiencing or actually even sometimes by a reaction or irritation to things that you might be using to manage the thrush alongside it. So, like panty liners, often with fragrance in or kind of excessive washing or soaps, or even sometimes the creams themselves.

So, it's also important to think kind of generally about treating that delicate skin with some gentleness. So, washing with kind of plain water, being careful to avoid things that might be drying or quite irritant, so, bubble baths, perfumed soaps, things like that, that can maybe aggravate skin in general, but certainly kind of exacerbate already irritated skin, avoiding things that could be kind of traumatic to the skin, like steaming or douching particularly with chemicals or astringents. And then just like anywhere else on the body, if the skin is delicate and fragile, using something like a dermatological emollient. And I would ask for advice from your health care provider about which of these might be suitable or recommended for use, that can give kind of comfort and protection as well from dryness and irritation. And they can also help and can be used to wash with as well.