Neverending thrush

[Jenny1]

I feel like I have had thrush almost non stop for the past year. I have had swabs taken twice which confirmed thrush and have had several rounds of tablets,creams and pessaries.I am careful about soap,cotton underwear,low sugar intake.It definitely gets worse around ovulation and periods.That itchy feeling is always worse in the morning and evening when I walk to and from work,like the movement is irritating me. Can I get rid of this and is it all down to thrush?

[Mr Peter Greenhouse]

If you've had symptoms for a year and only had swabs taken twice, then your problem hasn't been properly investigated. Yes - it's probably thrush, because thrush typically gets worse before menstruation - but there may be several more things going on, given that it doesn't seem to cause you too much grief during most of the day. If it was all down to fungal infection, you'd expect to have symptoms at times other than when you're walking to & from work, and to get discomfort with intercourse, and to feel things most while you're trying to get to sleep.
I suggest the following:
Keep a daily symptom score chart where you score your itching / genital symptoms out of 10 and also score breast tenderness and mood - 0 is nothing wrong, 10 is the itchiest, tenderest & moodiest possible. Alongside the dates, number the days counting day 1 as the first day your period bleed starts & repeat for each cycle. Then go to your local sexual health clinic when the itch score is more than 6 to get a proper immediate diagnosis with microscopy confirming which bugs are present in the vagina. They will need to confirm that this is Candida albicans (the usual cause of thrush) and not one of the rarer strains, which may not respond to the typical anti-fungal drugs.
If it is 'typical thrush' then the Detroit regime http://www.ncbi.nlm.nih.gov/pubmed/15329425 followed by fluconazole 150mg taken a couple of days before the symptoms are about to occur (as shown by your chart), should fix the problem. Alternatively, the clinic may find something else, not thrush, & will then sort it out.

[Mr. Hugh Byrne, MRCOG]

I agree, and would like to add that thrush is naturally carried in the bowel. It is important to treat your partner, and to use the cream to eradicate it from other sites on the body such as between the buttocks/groin folds/belly button and under your breasts.
In case it is not thrush, ask a doctor to outrule conditions such as lichen sclerosis.

[Mr Stelios Doumouchtsis]

Cases of chronic thrush usually require oral medication for at least 6 months to eradicate.

Also the lab should undertake investigations to identify the exact type of the candida and possible sensitivities.