Julia
Julia has had recurrent thrush since she was a teenager. Her symptoms occur on a monthly basis. She was able to get relief from thrush during a long-term course of antifungal medication and during pregnancy and breastfeeding. However, since going on antibiotics for a UTI her symptoms have returned and she is unsure about the next steps.
Julia is a straight woman. She has two children, a 3-year-old and a 7-year-old. She works as a social worker. Her background is white British. Interview clips read by an actor.
More about me...
Julia has had recurrent thrush since she was a teenager. Her experience began after taking antibiotics for recurrent urinary tract infections (UTIs). As a teenager, Julia was embarrassed by thrush and found using pessaries “traumatic”. From then, Julia recalled, "I just kind of began to notice that it happened quite a lot”.
As Julia got older, she recognised a hormonal aspect to recurrent thrush. She experiences thrush the week before her period on a cyclical basis. During pregnancy and breastfeeding, while having no periods, she did not experience thrush. Once her period came back, so did the recurrent thrush.
Julia was hesitant to seek medical care and worried about bothering her doctor over a “minor problem”. When she did consult her GP, she did get help and was given a six-month course of weekly antifungal tablets (fluconazole). This treatment helped her for a year until Julia took antibiotics for a UTI and recurrent thrush returned. When Julia followed up with the GP, she said that the medication should have resolved the issue and did not offer next steps.
At a consultation about getting the contraceptive coil, Julia brought up recurrent thrush with the GP. Unlike her past experience where she was taken seriously, this GP seemed embarrassed about the issue and brushed it off. Julia was unsure whether the coil would make thrush worse as she had read this was some people’s experience online.
In terms of treatment, Julia has been self-managing. Julia takes antifungal medication monthly the week before her period and does not wait until thrush gets bad to take action. She sometimes takes antifungal medication pre-emptively if she has a weekend away planned with her husband. Getting over-the-counter medication could be difficult as Julia had to visit different pharmacies to avoid being denied medication and told to see a GP to address the recurrence. Julia buys antifungal medication from online pharmacies as well.
To manage recurrent thrush, Julia avoids sugar, wears cotton underwear, and avoids leggings. However, she feels these lifestyle changes make no difference. Julia said "I feel like it's too small a problem to worry a GP over”. However, she would consider seeking longer-term prescription again in the future.
To get support, Julia talked to her friends and mum. She said “I don’t feel shame at all. I'm very open with my girlfriends”. This support helped her manage the annoyance and frustration that thrush caused. Julia had a supportive husband but was anxious about passing thrush onto him as this had happened a few times.
Looking forward, Julia encourages patients to take recurrent thrush seriously and explain to healthcare professionals that it is a long-term issue that deserves attention.
Julia recalled feeling “disgusted” as a teenager dealing with recurrent thrush (read by an actor)
Julia recalled feeling “disgusted” as a teenager dealing with recurrent thrush (read by an actor)
I was probably a bit disgusted by it as a teenager. I didn’t know what was going on with my body. I was probably quite frightened because I didn’t have the knowledge and understanding that I have now, and I think oral capsules are reasonably new, I don’t think... I can’t remember... I certainly can’t remember them being available when I was a teenager, and so you had to go through that pessary which meant like... and I did find it really quite disgusting, we... all the kind of... and because it kind of comes out over days and that was... at first, I was quite shocked by that initially; I was only little. But now I’m not... I’m not... I’m not... I’m not going to say I’m not bothered because it’s... it’s annoying, but I’m not disgusted or... or any of that. I’d say... I mean it’s annoying and frustrating more than making me sad or making me not like my body or any of those things.
I guess teenagers... I guess they’re sensitive, aren’t they, and I think I don’t have the shame and stigma, but I can understand why they would, and I... I guess it would have helped to know that this is just something that happens for some women and it’s nothing you’re doing wrong, it’s just something that happens to some women and it’s nothing to be ashamed of, there’s nothing to be frightened of.
For Julia, pregnancy and breastfeeding temporarily stopped her symptoms (read by an actor)
For Julia, pregnancy and breastfeeding temporarily stopped her symptoms (read by an actor)
I found like... so after I had kids, I didn’t have it when I was preg... I think it must be a... and I don't know, because obviously I can’t... really don’t really feel like I can explore it with anyone, but I feel like it must be a hormonal thing given that it comes the week before a period, and I also think when I was pregnant, I didn’t get it, and I breastfed both kids for two years. So, after both kids I didn’t get... because I was breastfeeding, I didn’t get my period back for like 14 months, and in that period, I didn’t get it at all, and then as soon as my periods returned and the hormone... like back to normal cycle, then I started getting it a week before each period.
Julia preferred to pay for over the counter treatment instead of waiting a week for a GP appointment to get a prescription (read by an actor)
Julia preferred to pay for over the counter treatment instead of waiting a week for a GP appointment to get a prescription (read by an actor)
It’s a tenner, it’s still a tenner. But it’s not... like you said, it’s not a viable... like I don’t feel it’s a viable option because I suppose by the time you get to see a GP, like over a week later, and it’s just what you... [sighs] do you... don’t want to sit with it for a week, so it... the... the cost difference is marginal, £3 between a prescription and a... and buying it over the counter, but the difference is if you’re going to get a GP you’d have to wait forever and you’d have had it for a week by then, whereas if you just go and buy it at the pharmacy, it’s really good, you can get it at the pharmacy full stop, isn’t it? And if you get it from a pharmacy then it’s... you can get it that day, can’t you?
Recurrent thrush affected Julia’s decisions around birth control options (read by an actor)
Recurrent thrush affected Julia’s decisions around birth control options (read by an actor)
I am getting really anxious about getting the coil on Wednesday because I’m anxious that that will exacerbate the problem and the... the fact that... that the... there’s kind of at least anecdotal evidence out there that suggests that the copper coil... causes... or exacerbates thrush, has meant that I’ve delayed getting it for... I’ve delayed getting it since I took... since the little one was born, so three years I’ve kind of put it off, and put it off because I don’t want to be in this situation where I’m already getting it every other month and I don’t want to get in this situation where it’s even worse.
So, the thrush has affected my decision to get the coil because on the copper coil you can have more thrush, but I’m actually getting it because I can’t use any other birth control because I just can’t use the hormonal stuff. So, I went... so I’m getting it on Wednesday, and for my pre-coil appointment I went to the GP and I said, you know, “I’ve heard it causes more thrush, and I have recurrent thrush,” and they were just like, “Don’t worry about it,” and that was all I got really, “you’ll be fine,” and I don’t think I will, I think I’ll just get recurrent thrush and then they can take it out, but I’ll try, because it is just thrush, isn’t it, and they don’t really... I don’t really feel it’s taken seriously.
Julia said that buying tablets from the pharmacy was a better option than waiting to see the GP (read by an actor)
Julia said that buying tablets from the pharmacy was a better option than waiting to see the GP (read by an actor)
It’s a tenner, it’s still a tenner. But it’s not... like you said, it’s not a viable... like I don’t feel it’s a viable option because I suppose by the time you get to see a GP, [sighs] like over a week later, and it’s just what you... [sighs] do you... don’t want to sit with it for a week, so it... the... the cost difference is marginal, £3 between a prescription and a... and buying it over the counter, but the difference is if you’re going to get a GP you’d have to wait forever and you’d have had it for a week by then, whereas if you just go and buy it at the pharmacy, it’s really good, you can get it at the pharmacy full stop, isn’t it? And if you get it from a pharmacy then it’s... you can get it that day, can’t you?
Julia found it helpful to take antifungal tablets pre-emptively before important occasions (read by an actor)
Julia found it helpful to take antifungal tablets pre-emptively before important occasions (read by an actor)
So yeah, and like I guess I do take... really naughty, I do... very occasionally I’ll take a pre-emptive... like a... a just-in-case, if I’m going away with my husband or I just... and I know that it’s the right time and I’m just before my period, I’ll just take it without... take a capsule without symptoms because these are all things that now I’m thinking about it are quite naughty and you really shouldn’t do, but I would rather... I guess I... I guess... you can’t tell anyone, because, no, this has to be anonymised, [chuckles] but I guess I would rather lie to pharmacists, and be a bit sneaky, than get thrush: I’m sick of it, absolutely sick of it because we... it’s... you know, it’s 20 years like that... or more, yeah, that it’s just back, and back, and back, and back again.
Julia was happy to get longer-term treatment (read by an actor)
Julia was happy to get longer-term treatment (read by an actor)
I don’t go to the GP. I went to the GP once to say I want this sorted out and that’s when I got the... that’s when I got the kind of... I can’t remember, was it six months’ worth... I think it was, six months’ worth and it was one tablet a week for the first six weeks and then one tablet a month for the rest of the time, so I went there to say, ‘I’m just getting this every month, I want it sorted out,’ and to be fair, she sorted it out for me. Because she said what she thinks happens is that it’s always living inside me, permanently, and it just flares up, so I never really... with one capsule every time I get it, it doesn’t knock it on the head, it just reduces it to a level where it doesn’t cause problems, so she was really helpful in explaining all of that and was really kind of impressed that she went all the way and spoke to a specialist, and I was really happy to have got the treatment.