Zoya

Age at interview: 33
Brief Outline:

Zoya has had recurrent thrush for three years which has had an impact on her mental health, self-esteem, and career plans. She has seen a GP and had multiple swabs taken confirming thrush. While pregnant, Zoya's symptoms went away, but returned a few months after she gave birth. She has been referred to a specialist gynaecologist and is awaiting an appointment. 

Background:

Zoya (she/her) is a straight woman. She is currently a stay-at-home mum who lives with her husband and two children (aged 3 and 1). Her background is British Pakistani.

More about me...

Zoya has had recurrent thrush for three years, which started after she took a course of antibiotics for a UTI. Her symptoms used to appear a few days before her period, but now last a “solid block of 9-10 days” before and also are “mild” during ovulation.

Her symptoms include a constant itching, soreness, and changes in smell and discharge.

Recurrent thrush has has had an impacton Zoya’s mental health, self-esteem, and intimacy. She expressed gratitude towards having a supportive partner to whom she could talk. Zoya feels comfortable discussing her thrush symptoms, but recognises it can be taboo in certain cultures and says her mum would not discuss it.

Some months, she feels okay managing her symptoms, but in others, she is “hot and flustered”. Recurrent thrush lowers her patience and can make her “a bit short”, which she finds difficult while caring for her children. Zoya said that if she worked a full-time job, being around others would be challenging, and she is grateful not to be working while having recurrent thrush. 

Zoya Googled her symptoms early on, and the research results suggested thrush. She visited her GP, who swabbed for thrush, and confirmed that she had it. Her symptoms persisted, and a GP provided swabs so she could self-test at home, which Zoya was happy to do. She remembers waiting for her symptoms to worsen every month to give enough “proof” of thrush. She would get medication from her GP or self-treat. It took Zoya 6 to 9 months to feel she was getting somewhere with her GP, but then she fell pregnant.

While pregnant, Zoya’s recurrent thrush symptoms resolved, but then returned a few months after she gave birth.

Zoya searched online for answers and was upset to read that there was “no cure”. Learning that others had symptoms for many years made her feel hopeless and worry about having recurrent thrush for the rest of her “menstrual life”.

When she returned to the GP, Zoya had to do more swabs to confirm recurrent thrush. She was frustrated the GPs would not look at her old records to confirm recurrence, and she found she had to explain her situation over again. Zoya found it difficult to make appointments since the GP receptionist continually recommended picking up over-the-counter medication. However, once she got an appointment, the GPs were understanding. Zoya always saw a different GP, which made it hard to follow up.

In terms of treatment, Zoya preferred oral pills to creams, she found creams worsened her thrush symptoms and caused inflammation. Her GP prescribed antifungal tablets for three days, which was then followed by a three-month course,  Her GP also performed a blood test to check her liver function due to the potential risks of taking long-term antifungal medication.  

Treatment has yet to be effective. Zoya has been referred to a specialist gynaecologist and has been waiting months to hear back about an appointment.

To self-manage, Zoya no longer uses panty liners and any hygiene products on her vulva, such as scented soaps or wipes. She takes probiotics, which lessen the “harshness of symptoms” but says they are expensive.

Looking forward, Zoya is thinking about returning to work. While she would love to return to her old office, she is uncomfortable working in person while symptomatic and hopes to find remote work.

Zoya recognises that women are often told to carry on and deal with discomfort, which leads them to think it is normal. She encourages patients to keep returning to their GP, believing in themselves, and pushing for help. Zoya advises healthcare professionals to lower the threshold for recurrent thrush diagnosis to prevent delays.

Zoya thinks that her symptoms are related to her menstrual cycle.

Zoya thinks that her symptoms are related to her menstrual cycle.

SHOW TEXT VERSION
PRINT TRANSCRIPT

So, before I think I used to struggle with symptom like two... a few days before my period that, ‘oh my gosh, I'm getting it a few days,’ and now it’s a good solid block of nine, 10 days, and I know that’s the thrush coming on and the period probably coming on at the same time, I don't know, but it’s about 10 days before my period I start getting all these symptoms. Yeah, so I'd say in a month I'd probably have thrush-related symptoms for about maybe half of it because I get it around when I'm ovulating as well, I get a few days of soreness and more than... more than usual because I... I know when you've got your cycle there’s all sorts of different things coming up, but I follow it on a... on my calendar and sometimes I note it down, but yeah, when I'm ovulating, obviously I've got ovulation symptoms, but then I also get mild thrush symptoms. You see that... I don't know if that’s related, I don't know, because sometimes I'm thinking, ‘oh, am I overthinking it just because I've got it all the time?’ but I'm always trying to make note of like where I am in my cycle and when I'm trying to feel it, but those are the days that I feel it, so sometimes I just think it’s almost half a month that I'm struggling with this, which is quite a lot, and now I think about it I'm also getting used to it now, but yeah, it’s... it’s not pleasant.

Zoya wondered if she has to wait until menopause for recurrent thrush to end.

Zoya wondered if she has to wait until menopause for recurrent thrush to end.

SHOW TEXT VERSION
PRINT TRANSCRIPT

It is quite difficult to read that there’s nothing for this condition and that I’m going to have to live with this till I... I guess I hit menopause I think, I think, in my head that’s my theory, I don't know if that’s correct, I don't know, because I don't know anyone else personally in my life that’s had it for so long. Obviously, you know, everyone’s had like a bout of it here and there due to either pregnancy or where it like really... where it is just like they've had it but they've not had more than one or two episodes, so... but they can understand and they can sort of be like, ‘oh my gosh, you get that every month,’ I'm like, ‘yeah, kind of for half the month actually,’ you know other things happen around it as well, but yeah, it... it’s quite difficult.

Zoya had not yet had enough swabs to identify recurrent thrush as she saw many different GPs and was often redirected to the pharmacy to self-treat.

Zoya had not yet had enough swabs to identify recurrent thrush as she saw many different GPs and was often redirected to the pharmacy to self-treat.

SHOW TEXT VERSION
PRINT TRANSCRIPT

It was six to nine months and then I felt like I was getting somewhere with them like to... you know, they were like, “OK, recurrent thrush,” and they gave... they gave me the swabs, and then I fell pregnant, so I didn't get any symptoms you know for those nine, 10, 11, 12 months until I got my period again, and then I went through it and I was like, ‘this is not something that I cured,’ and I went, and I was really like, “I... I... I am getting recurrent thrush, I've had it before,” and luckily I had a female GP that answered and she... I said, “You need to look at my old records how many times I'd been, look at my swabs, this is it,” and then I had to do more swabs again to get them to diagnose me as recurrent thrush, they wouldn't do... because I had to do the whole thing again and I had to wait I think a few months I think it was, they I needed a certain number of swabs or it had to be a... I... I don't know, they had some... a number of episodes that I had to have or a number of swabs that I had to have.

It was really difficult to even get an appointment because they kept saying, you can go to the pharmacy, go to the pharmacy and get your... and get your Canesten basically, get that, get that, and I was like I've had... I've spent a lot of money on... I have been. And, so yeah, it was getting... getting an appointment was quite difficult, but once I did, the GPs were sort of understanding but I had to have a real conversation with them and I could only do that when I was lucky enough to get through to a female GP, and they were quite reassuring, but it’s always a different one so I couldn't follow my case up with one person, then I felt like I had to go through it all again with the next one and explain my full situation and it... you know, trying to get on track and like you'll go, you know, “I have got recurrent thrush,” and then it’s like, oh yeah, we've got to swab again and it’s... I had to go through it all again with the next new one, does that make sense?

Zoya found herself feeling less patient and more flustered because of thrush.

Zoya found herself feeling less patient and more flustered because of thrush.

SHOW TEXT VERSION
PRINT TRANSCRIPT

It’s almost like I have to live with it now, and I don't know, I can't remember a time where I've not had it, and I'm... some months I'm really OK with it, other times I'm getting quite hot and flustered inside because it... there’s something going on down there, and I've got the little ones and I know when I'm... it... sometimes I'm a bit short with them and I'm... you know that isn’t my parenting style and I'm like, ‘oh my gosh, I need this to go,’ because my patience is really low because I know there’s something going on, and you know like if you've got anything that’s going wrong with it, you know and for me anyway I get really hot and flustered, and also because I'm obviously due on my period and it’s all sort of at the same time, it’s a lot all in one go and then trying to do everything, you know I've got a family nearly all the time and I want to make sure my water’s in the fridge, anything to try and cool me down and distract me a little bit because it is taking the toll of my life, and generally I'm a really up but... like upbeat person, I've got kids and I try and be the best I can for them and then sometimes I have this and it’s like [sighs] I don’t have the patience for this today because there’s... there’s a lot going on down there, and then obviously like I said it always... it’s around my period, so that’s... I think my period symptoms are a little bit worse than what... what I can remember anyway, I feel really... again the soreness and all the rest of it’s there but I also feel quite hot and flustered, which I never used to have before.

Zoya felt “lucky” to have an understanding partner.

Zoya felt “lucky” to have an understanding partner.

SHOW TEXT VERSION
PRINT TRANSCRIPT

Again, intimacy is... I am really open with my partner and we’re like, ‘oh, I’m getting onset,’ and he is so understanding, so I’m lucky in that sense as well, so it’s not... it does affect in the sense that I have to like, oh, this is... he... he knows what the situation... and I do describe to him, it’s quite... I feel sorry for him sometimes  because it’s like this is what it feels like and you’re trying to describe it and he’s like, “Oh right, OK,” and he’s really understanding so I’m so lucky that he does understand what it is, and that I can... I just tell him, “Look, this is... this is the situation, it is unpleasant, but this is what it is”.

Zoya said that talking about thrush and genitals was taboo in her South Asian family, but that she was not afraid to ask for help.

Zoya said that talking about thrush and genitals was taboo in her South Asian family, but that she was not afraid to ask for help.

SHOW TEXT VERSION
PRINT TRANSCRIPT

Some countries and some cultures it’s probably quite taboo and don't want to speak to anybody about it and... and definitely if it was like... if... if it was my Mum, I mean if she had this she would just carry on, she wouldn't speak to anybody about it, that... you know because she is from sort of the south Asian side and stuff, but she would never mention it, whenever she’s struggling, she will not... she would not mention it, but I think it’s a different... I'm in a different generation, I'd be like, ‘yeah, I am struggling with this, I need help,’ [chuckles] I'm not afraid to ask for help.

Zoya said she would rather spend money on her kids than on probiotics

Zoya said she would rather spend money on her kids than on probiotics

SHOW TEXT VERSION
PRINT TRANSCRIPT

My partner's just like, 'Go on, just get them if it’s helping,' and I was like 'they’re very expensive for a little bottle,' yeah, it’s just... well, because I was really struggling the last few months, I was like, ‘I need them, I'm going to see if it helps,’ and these ones have, but like I said it’s... it’s a very expensive... it’s just very expensive, [baby coos]  it’s not something I can do long term even though my partner’s like, 'Oh my gosh, it’s your health you know, you need it,' and things like that, but I'm just sort of like, 'No, I'd rather spend that money on the kids.' You know, there’s other things and I don't think I should be spending that much every month for something that I don't think I caused, you know it's the... it’s just... it's one of those things, it’s... yeah, the cost of it is not good.

Zoya found that the cream made symptoms worse.

Zoya found that the cream made symptoms worse.

SHOW TEXT VERSION
PRINT TRANSCRIPT

Yeah, so the first year was really difficult, I was just on Canesten, you know all the ones, and the cream actually made it a lot worse for me: I was more inflamed because it said to use that you know to help soothe, it... it didn't soothe it, it... it was so... it was a lot worse, and I remember just... when I used to get my packets I'd just use the... [baby coughs] the suppository, I'd not use the cream, I used to chuck the cream out because it was so bad.

Zoya described how probiotics helped but was unsure if they were a long-term solution

Zoya described how probiotics helped but was unsure if they were a long-term solution

SHOW TEXT VERSION
PRINT TRANSCRIPT

I did read up on all sorts of things like what was it... was it some sort of acid and all this? And all this crazy stuff, I've never tried any of that, I only started trying like probiotics and things like that just to see like the things that I... were verified and are actually made by actual people in you know proper scientific labs I suppose or whatever.

I've been taking these probiotics at the minute: that seems to have helped. I don’t know if that’s a long-term solution, I've no idea, but... and like I said, it has sort of... it hasn’t gotten rid of the symptoms and I don't think anything like that would, but it definitely... the intensity of it definitely reduced, but like I said, they are expensive and I bet if I stopped taking them, the intensity would come back, and I... I know that, but I... I need something when I've got the little ones, yeah, it is what it is at the minute.

Zoya was very concerned to read online that there is no cure for recurrent thrush.

Zoya was very concerned to read online that there is no cure for recurrent thrush.

SHOW TEXT VERSION
PRINT TRANSCRIPT

Well, this is the thing, you know what I struggle with the most obviously you... everyone loves to Google everything and when I knew it was recurrent thrush, I was looking... I was trying to find... I know this sounds really sad, I was trying to find the cure for it, and I was like, ‘Why isn’t there a cure?’ like it doesn't make sense, and it... it was quite upsetting because I think I read something where it said there is no cure, and I was like, ‘ohh...’ I took that... oh, oh my gosh I’m getting upset, because I took that really quite hard because I remember saying to my husband like, “There’s no... there’s no cure, there’s no cure, this... I'm going to have this for the rest of my menstrual life.” And it hit me quite hard, I think I was really down and out for about a week.

Zoya discussed the importance of having a support system.

Zoya discussed the importance of having a support system.

SHOW TEXT VERSION
PRINT TRANSCRIPT

Yeah, so mental health-wise it did affect me for a while but I'm quite lucky because I've got... like I said, I spoke to my partner, I spoke to my mum and my sister, so I have a support system and they're quite good, so I have that to... if I didn't have them to sort of offload, be like ‘oh my God,’ you know, and go through the process of and grieve [chuckles] or whatever, I probably would struggle more, but luckily because I have that and I can speak to them quite open, I'm not struggling that much with mental health if I'm honest.

Zoya said that the health system needs a change in direction to put more research into recurrent thrush.

Zoya said that the health system needs a change in direction to put more research into recurrent thrush.

SHOW TEXT VERSION
PRINT TRANSCRIPT

Well, I'm still going to... yeah, I mean if I could conduct research myself, I would love to do it. I think at the minute it is very short term, it’s trying to manage the symptoms every month. The long term is I'm going to keep trying looking out for studies and if there’s a research team that wants participants... you know... I said that to my partner and I was like, “If you ever see anything, sign me up,” you know like, “I'll go for it,” and I think it’s not just finding the cure and things like that, I do think that maybe the health system needs a bit of a change in direction and maybe had a look at prescribing things, maybe, I don't know, there’s... if I was in charge or if I had the resources, I would definitely put more research into this area.