Harry

Age at interview: 25

Brief Outline:

Harry has had recurrent thrush for three years. She has seen a GP and sexual health specialist. After being on two six-month courses of antifungal medication, her symptoms have improved. She is cautiously optimistic for the future.

Background:

Harry (she/her) is a straight woman working as a human resource coordinator. Her ethnic background is white British.

More about me...

Harry first had thrush in 2021 and then recurrently every month since. She noticed that her symptoms coincide with her menstrual cycle and flare up the week of ovulation. After four or five months of these symptoms, Harry recognised that this was a recurrent problem.

Harry’s symptoms include “unbearable” itchiness, skin irritation, redness, and tearing. Harry’s symptoms began at the start of a new relationship which she says was difficult to navigate. Now her symptoms make her feel unclean and unable to have sex due to pain.

While Harry feels able to talk to her mum, sister, and friends, but finds that others do not understand that recurrent thrush is “horrendous”. She finds that there is misinformation online and in society about recurrent thrush, such as associations with being promiscuous.

At first, Harry tried over-the-counter medication to clear the infection but found that the symptoms would return a month later. Harry would visit different pharmacies in her small town as she worried about being denied medication and told to see a GP if she was honest about having more than three episodes in six months.

Harry found it difficult to see a healthcare professional while her symptoms were “active” due to wait times. Once symptoms appeared, Harry would self-treat with antifungal medication and start to feel better in 2-3 days. In these cases, Harry felt that the GP was “dismissive” when the swab came back negative as she had already taken medication.

When she was finally able to see a GP while having symptoms, she said that the doctor was sympathetic. While doing a pelvic examination, the doctor said it was the “worst case of thrush” they had seen. The doctor referred Harry to a sexual health dermatologist, but they had a month and a half wait time.

Harry found that there was “stigma” calling sexual health clinics and people thinking she had an STI. However, she found the sexual health specialist was “phenomenal” and saw him once a week to take swabs and follow-up.  At the sexual health clinic, Harry was prescribed oral antifungal medication (fluconazole) every three days and then a maintenance dose once a week for six months. While on the six-month course of antifungal medication, Harry had to take antibiotics for an ear infection. These antibiotics put her “straight back to the beginning” of her symptoms. Harry was then given a second six-month cycle of fluconazole to complete, but she worries about being on long-term medication and paying for prescriptions.

The specialist also prescribed an antihistamine which he said could help with the thrush. She has also taken probiotics recommended by her doctor. Harry avoids products that she is sensitive to, such as period pads or body washes. Harry has looked into the low candida diet, but said it was not a good idea for her as she has had an “interesting relationship with food” in the past.

Harry has been symptom-free for the past five months, but is nervous about whether she has “broken the cycle” or if her symptoms will return. She is trying to stay optimistic, but has backup antifungal medication just in case.

Due to her experiences, Harry’s relationship with healthcare providers has changed as she feels more confident to ask for what she needs. Harry encourages patients not to be ashamed and to advocate for themselves because “you know your body better than anyone else”. Her advice to healthcare professionals is to take recurrent thrush seriously, diagnose it earlier, and offer treatment plans with clear expectations.

Harry’s commitments meant she was sometimes not able to consult the GP immediately. When she did go with active thrush the GP was very sympathetic.

So, I would just go and take a pill the day I spotted it, from the over-the-counter, but by the time I'd got to the GP, which was two or three days later, most of the symptoms had kind of cleared up, so unless I pre-emptively booked an appointment, I couldn't... and that’s not to say... I'm very lucky with my GP, I can call and get an appointment probably for the next day, they are very quiet, which is almost unheard of in the UK because I know they're very busy, but I... just because of work commitments, all of that stuff, I’d have to time it to get there, so she only actually saw active thrush maybe once, but yeah, she was like, “I don't even want to put the speculum in because it looks so painful, I'm not going to even bother with that because I can see what it,” yeah.

Harry describes the differences in impacts between one-off and recurrent thrush.

I think the... the difference is how it impacts your life really, isn't it? Because I... if I had it once or twice in my life, yeah, it would be uncomfortable, but the fact that when you get it recurrently, when you get it every month, it doesn't give your body time to recover from the last bout before you get the next. So, the itching stays, you have the split skin, it’s just... it’s a completely different condition in my eyes, I think you should... they should almost be treated completely separately and not related. Because thrush is bad on its own, but how... when you have it like so consistently, it’s just... it’s another kettle of fish, it’s not... it’s just horrendous, it’s a completely different thing.

After thrush recurred monthly, Harry tried to balance the need to document her symptoms with also managing discomfort.

The first few... the GP, she was a bit... she was a bit dismissive I think because I wasn't going with active symptoms, because I'd treated them myself, which is what you're supposed to do and I said, “I've had it for the past three months,” or the past four months at this point, I said, “I can't keep doing this,” and she was like, “Are you sure it’s that because you haven't got any symptoms?” and I was like, “I haven't got any symptoms because I've treated it, but yes I'm absolutely dead-certain it’s this, and like there’s no denying that it’s this because it’s... ticks every box of the criteria and it goes away when I take the pills.”

I think she just didn’t seem to believe me, because she was just like, “Oh, it... you've got a bit of redness but it looks fine, oh, it’s a bit irritated but it looks all right. And like I've been with this doctor for years, I know her very well, but I think she thinks sometimes that we exaggerate things, and I was like, “I'm really not exaggerating this problem,” and then like I said when I did see and I had it active, she was like, “Oh my God, this is...” so I think... and she did say to me, I don't know if she says this to everyone, but she was like, “This is actually the worst case of thrush I've ever seen in my life and you are... it’s horrendous, and you need to get this sorted.”

Harry explained misinformation around recurrent thrush being linked to ‘sleeping around’ or too much sex

So yeah, there’s a lot of misinformation out there. I still think people think it’s something to do with having too much sex or it’s kind... because I think the people who come out about it are very confident in themselves, are quite often very sex‑positive as well, which is the best way to be, but a lot of people looking at that would be like, “Oh, it’s because they sleep around,” and it’s like, “No, it’s not, it’s not at all, they're just bold... like bold enough to say what they've got because more women that we realise have this problem and none of them are confident coming out and if you don't stop talking the way you are, then it’s going to keep getting like this,” but you know there’s a lot... a lot of rubbish online that’s inaccurate.

Harry worried about starting a restrictive diet, and the impact it could have on an already difficult relationship with food and body image.

I'd signed up to some like chat forums. At one point I looked at doing the low candida diet. I've looked at all sorts of things; I mean the theories out there are wild. I don't know... sure... I'm not sure how many of them are accurate, but I did genuinely consider changing my diet to see if that would help, and as someone who... I've had a very interesting relationship with foods throughout my life, it’s probably not a good idea for me to do that, but you know when you get to that point of desperation you're like, ‘I just want something to fix this because I can't keep living how I'm living,’ so I've looked into a few.

Harry found long-term antifungal medication effective but remained unsure about whether it had “broken the cycle”.

They were effective: I haven’t had thrush for five months now, so they have worked. I just don’t know how long they’ll hold it off because they’ve worked because I’ve consistently taken them, I don’t know whether that’s broken the cycle, which I’m hoping it has, because I’m hoping what happened is I just never quite cleared the cycle whenever I took them. But it came out of nowhere when it first started, I wouldn’t be surprised if it comes back, is my concern with it.

Harry was not convinced that applying yogurt topically was going to help.

Like I saw someone the other day talking about putting the Greek yogurt down her pants because it’s natural and I'm like, ‘that doesn't do anything, it won't help, you need to get treatment properly because it’s not going to go away with some Greek yogurt,’ and people... but people do still really believe in it. And my probiotics, if you eat them and ingest them, probably help, but I don't think putting it on your skin is going to do masses because it’s not being digested and broken down in the way you need it to be.

Harry encouraged others to advocate for themselves.

I’d say don't be ashamed of it, it’s not anything that you can control, it’s something that is just happening to you and you've been unlucky and had it, it’s not because you're dirty, it’s not because you've caught anything, it’s not because you've had too much sex or not enough sex, it’s just... it’s just one of those things. But I'd say advocate your own right because you know your body better than anyone else, you know if it’s going to come back, you feel it before you really get symptoms, you kind of... you get a niggle and you're like, ‘I know what this is, it’s coming,’ as soon as you get that: don't wait till it develops, just take something anyway. It’s not going to harm you if it wasn't going to be it, because they put me on it long term, so obviously it’s not a detrimental to my body, just take it and push for something you think is appropriate, say it comes back every month, be very clear with your expectations and make sure they... they listen to you, I suppose.

Harry hoped for quicker diagnosis and a clear treatment plan.

I’d hope that they diagnose it quicker for people. Take it more seriously and understand that it’s a... it’s quite a traumatic like horrendous experience to have, and if they can't cure it, make a very clear treatment plan for the ongoing time with clear expectations and clear conversations around how it can... how it will affect you, what the side effects are in your body, what’s the implication of taking it long term, with the hope that we someday get to a cure would be my ultimate aim, and just don't just... and like for them to not just try something to see if it works, like as in don't go... if you know someone’s got recurrent thrush don't just go, ‘oh, just take it for a month and see what happens,’ because nine times out of ten it’s not going to work: just go in with a proper treatment plan, or if they know it might not work: give that expectation. I think just be clear, and be honest with it, because I think the most disappointing thing is knowing that there... at the moment there isn't much out there to cure it or to stop it. I think that would be... and educate more people on it, which is I suppose your aim is to educate more people on it.