Emma
Emma has had recurrent thrush since she was a pre-teen, up until the last year. She has seen multiple healthcare professionals including a GP, urogynecologist, and nutritionist. A six-month course of antifungal medication offered relief for a short time-period, but a probiotic has helped Emma resolve the issue in the long-term.
Emma (she/her) is a straight woman. She has a 13-year-old son. She works as a pelvic health physiotherapist. Her background is white British.
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Emma began experiencing recurrent thrush at 12 when she first got her menstrual cycle. Her symptoms occurred every month up around her period, until a year ago when the issue resolved. Her mother and sister have also suffered with recurrent thrush and Emma wonders if there could be a familial link.
Recurrent thrush impacted Emma’s daily life. She found it difficult to enjoy activities like taking her son to play ice hockey as it often involved hour long bus journeys. She also found intimate relationships were affected due to discomfort and embarrassment.
When she was younger, Emma said she focused on seeing her GP, getting a swab, and then a prescription for thrush medication. However, as she got older, she said it was quicker and easier to self-treat by purchasing medication over-the-counter. Purchasing medication over-the-counter long-term could be challenging as Emma said she was questioned about how many episodes she has had and chemists would redirect her to the GP.
Emma found getting a GP to take a swab difficult and that the COVID-19 pandemic made this worse. Further, Emma said waiting for an appointment without self-treating could be very uncomfortable and intolerable, leading her to prefer self-management. She mentioned one case of a GP recommending she “just get a self-testing kit” from the pharmacy, but Emma did not think this was a suitable option as the results would not be recorded anywhere.
Emma has also been diagnosed with other health conditions such as endometriosis (where tissues similar to the endometrium grow outside of the uterus), polycystic ovarian syndrome or PCOS (where her ovaries and hormones are affected), and an underactive thyroid. Emma had recurrent thrush at the end of her pregnancy when she was 30 along with Group B Strep and wondered if there was a link between the two. At one point, Emma was also treated for bacterial vaginosis and thrush, and her GP suggested that the coil could aggravate thrush.
After having positive swabs, a GP did prescribe Emma a six-month course of antifungal tablets (fluconazole) which helped for a “very short period of time”.
GPs provided advice about not sleeping in underwear or wearing tight clothes, and to use gentle laundry detergents and iron the gusset of underwear. Emma also stopped using pantyliners after recognising they were causing irritation. Emma also paid privately to see a nutritionist who advised against eating bread and mushrooms, but this did not make a difference.
Emma tended to not look online for forums or communities because she found these are not “always the healthiest of forums” when the people do not have positive or optimistic outlooks.
Working in pelvic health, Emma learned on her colleagues and discussed recurrent thrush with a urogynaecologist and asked whether it would have an impact on her ability to get pregnant.
After using a probiotic this year, Emma no longer has recurrent thrush described this as a “miracle cure”. She has found it worked better for her than antifungal tablets or pessaries. Emma says that the probiotics are costly but that it is the same she would pay for over-the-counter medication and prefers a preventive solution.
Emma now feels more empowered and informed about manging her condition and plans to share her experience with others. Working in pelvic health, she now asks her patients about if they have experienced thrush and how this might be impacting them. She encourages other healthcare professionals to look beyond treating “that particular bout of thrush” and find long-term strategies for patients.
Emma felt that thrush was seen as regular or expected in pregnancy.
Emma felt that thrush was seen as regular or expected in pregnancy.
It was very much accepted that this... you are more at risk of thrush during pregnancy, and this is how we treat it. It was again, very evidence based, and it was very much not made a big deal. Afterwards, I think it’s possibly considered a little bit more because it’s not something you expect someone to have outside of pregnancy as regularly.
Emma worried about using the self-testing kits properly and the consequences of not having the test results on her medical record.
Emma worried about using the self-testing kits properly and the consequences of not having the test results on her medical record.
That the... I suppose more the... the flippancy that a GP will recommend, ‘just get a self-testing kit,’ and then you can obviously buy a pessary, and maybe there are, as a result of that, more people who are trying to self-manage that GPs don’t know about. It’s great that there’s like self-testing kits available: are you doing the swab properly; are you doing it high enough; and what do you do with the results?
It’s not recorded anywhere, is it, if you’re doing it yourself? Although I appreciate it’s a convenient option to try and identify whether you genuinely have BV or thrush, and then subsequently to treat it, but that’s not being recorded in your medical notes.
Emma thought it would be beneficial to record thrush episodes but found it unrealistic.
Emma thought it would be beneficial to record thrush episodes but found it unrealistic.
Because the problem is getting to your GP to get a swab, even prior to the pandemic, it was really challenging: post-pandemic even more so, and by the time that appointment comes through, particularly if you’re working full-time, you’re so symptomatic that the... you just think, ‘yes, I know that having this recorded on a system would be hugely beneficial because they can actually record how many episodes I’ve had,’ But it just... the symptoms to me become too intolerable to manage it that way, so I chose to self-manage.
Emma found it difficult to go on long bus journeys to watch her son play hockey due to prolonged discomfort.
Emma found it difficult to go on long bus journeys to watch her son play hockey due to prolonged discomfort.
The only thing really, I can think of is... which might sound a little bit silly: my son plays ice hockey and he has some long bus journeys, and if I’m uncomfortable on a long coach journey with his team, that’s where you start to feel really frustrated and sometimes a bit angry. You know, you’re... again, ‘what do I need to do differently? I feel so uncomfortable, I’ve got another four-hour bus journey to go before I can get home and... and I’m going to have to wait till the chemist opens.’ And it’s... yeah, I wouldn’t say it has a huge impact on my mental health, but when those... when you start to feel symptomatic at a time when you can’t do anything about it, it can be really uncomfortable, and quite upsetting I suppose.