Marie

Age at interview: 61

Brief Outline:

Marie has had recurrent thrush for five years which has contributed to pelvic floor dysfunction. She has sought help from the GP, gynecologist, pain clinician, and pelvic floor physiotherapist. She has found support online and is considering seeking out private healthcare and visiting a vulval health clinic. 

Background:

Marie (she/her) is a straight woman who is married with two children (30 and 35). She is a retired trainer. Her background is white British.

More about me...

Marie has had recurrent thrush for the past five years after being on three types of antibiotics for a dental abscess. Her symptoms return every 2-3 weeks.

Recurrent thrush has “taken a toll” on Marie and affected her mental health. Her sex life has been impacted as she worries about passing thrush back and forth with her partner, as this has occurred before. She has also had oral thrush. Marie feels that recurrent thrush has contributed to other health issues, such as pelvic floor dysfunction and pudendal neuralgia (long-term pelvic pain).

Marie says that her GP is “wonderful”, but difficult to see. Yet, Marie has felt not taken seriously by other healthcare professionals. When her main GP was unavailable, Marie met with a nurse practitioner who made her feel small and told her, “This is in your head”, causing Marie to cry.

Marie struggled to get swabs taken while symptomatic, as it required promptly seeing a healthcare professional. When she was younger, she “hated” having swabs taken for thrush as the GP always felt rushed. Marie’s GP has taken swabs that have returned positive and negative for thrush. When it was negative, the GP explained that the culture had not had the chance to develop long enough. Marie recalls having smear tests done where nurses noted being able to see thrush. A GP also tested Marie for HIV without informing her beforehand, upsetting Marie. She wonders if there is a different type of yeast affecting her or an underlying problem.

During the COVID-19 lockdown, Marie was referred to a gynaecologist who recommended seeking more precise testing from sexual health clinics. However, Marie feels stigma as a 61-year-old woman going to such clinics.

Marie was also referred to a pain clinic and the doctor said that her pelvic floor dysfunction this was caused by recurrent thrush. This made Marie wish she had received help sooner. Marie attends ongoing pelvic floor physiotherapy.

Between GP appointments, Marie began self-treating and found pharmacists asked about her age and recent thrush episodes. Marie avoided disclosing that she had had more than 1 attack in 6 months, or was over 60 years-old, as she worried about being denied medication.

In terms of treatment, Marie has tried pills, pessaries, creams, and probiotics. She has also looked online but said the treatments looked “quite worrying and questionable”. The gynaecologist prescribed a six-month course of fluconazole, but the thrush kept coming back. Now Marie worries that this treatment could have caused another problem like cytolytic vaginosis which is an overgrowth of good bacteria in the vagina that causes symptoms similar to thrush.

To manage her symptoms, Marie avoids scented bath products, sugars, alcohol, reusing towels, sleeping in underwear, and wearing tights. She has tried bathing in bicarbonate of soda and drying herself with a hairdryer. Marie was on HRT patches, but stopped after learning that oestrogen can promote thrush. Stopping HRT helped make the thrush less “aggressive”. 

Marie has joined private online forums about the microbiome and pelvic pain for support. She could not find one specifically about recurrent thrush. Marie has looked into seeking private healthcare and reached out to a vulval pain clinic, but learned she needed a referral. Marie said that getting a referral from the GP can be difficult and is unsure if she will proceed with this process.

Marie believes women’s health should be taken more seriously. She urges patients to seek healthcare earlier and get to the bottom of the issue before it leads to other problems. Marie encourages healthcare professionals to treat patients with empathy and concern. 

Marie was nervous and stressed getting swabs but tries to self-advocate for them.

I was sent to the nurse practitioner, and I was a nervous wreck, I... I you know I was like shaking, you know and she got the speculum out to do the swab I said, “Please don't hurt me, I... you know, I'm really stressed about this,” because having been through... I think most of us who’ve had recurring thrush over a number of years, you've had so many swabs and so many examinations that you become white coat syndrome, terror of coming back.

Marie was surprised to be tested for HIV.

I should add as well that because I had a pelvic floor physio, she’d said to me, “It’s a good idea to go to sexual health [Clinic] because they do better tests down there, ”so I've been through the whole mountain of tests for everything, and at one point a GP, not my main GP, actually tested me for HIV, not that I have a problem with that, I understand they have to do a full flush of tests, but she didn't tell me, I found out when I rang up for my results, and they were negative, but I think you should be told about something like that, personally.

Marie felt that “nobody wants to talk about vaginas or sexual health”.

But generally, I think women’s health issues are not widely discussed. You know we've been through the things like breast cancer and prostate cancer, but you know let’s talk about women’s health as well because there’s so many different conditions and they're not openly discussed: nobody wants to talk about them. Nobody wants to talk about vaginas or sexual health.

Marie explained her post-bathing routine to prevent thrush.

I don't use the same towel more than once or twice, whether I... and one gynaecologist who I saw suggested that when I get out the shower I dry the area with a... a hairdryer rather than using a towel because he said it’s just... it’s just better for the tissues, so yeah, I've done that as well, so I'm just really fanatical about how I dry because if you've got an active infection and you pass it to the towel, and you use the towel, it gives you it back, so I'm fanatical about that.

Marie had heard about boric acid but said it “frightens her”.

But you know there are other things like I think they're called ‘boric acid pessaries’, I haven't tried those, but that frightens me, and so that you can buy these pessaries off the internet, and that worries me a little bit because things could go wrong.

Marie said that with the rising pressure on the NHS, patients needed to be their “own self-advocate”.

Yeah, and sorry part of the question is what about people like me who are you know a few years into this? I think it’s pretty much the same: you have to get determined about your health, and you have to... I think it’s... it’s... we all go on the internet and self-treat and it’s probably not a good idea, we need to get to the right person and push, because no one else will that for us. The NHS has got, what, seven million people working... waiting for procedures at the moment: it’s breaking at the seams, so I think we've got to, as you've said, be your own self-advocate.