No matter how long I am in practise there is always a group of patients for whom ‘vaginal thrush’ is a major problem. Most of us have some fabulous tricks up our sleeves to help resolve these issues & reduce their susceptibility – intravaginal lactulose is one of mine thanks to Jason Hawrelak. And then you come across those clients who vigilantly do every thing you ask them to and yet you fail to completely resolve the issue. Doh!
One of the most important things to do with all clients presenting with ‘thrush’ sooner rather than later is send them STAT (!) for a vaginal swab.
Not only does this clarify if it is in fact actually thrush (2/3 of self-diagnosed women get it wrong according to research!) but better again it names the actual culprit. It may come as a surprise but not all vulvovaginitis is due to Candida albicans – increasingly they are the result of other Candida species and this is something you absolutely need to know.
During a recent mentoring session, a practitioner wanted to better understand why she had a group of patients whose thrush seemed so resistant to her usually successful treatment. Here’s my initial response in a nutshell…
Question one: Have they been swabbed? No? Then swab STAT! 😉
Question two: If Yes… then which species are we talking about?
Question three: Is there a pattern around their menstrual cycle for the infective episodes?
These are all key things we need to know about all cases of ‘thrush’ – in order to identify the most effective treatment and better understand patients’ susceptibility.
I’ve just recorded an Update in Under 30 audio on this topic – getting species specific and sex hormone savvy. This audio goes into detail about why a vaginal swab is essential for correct diagnosis & effective treatment of ‘thrush’ as well as the critical things you need to know about the different Candida species your patients might be harbouring. Lots has changed in our understanding about what makes patients vulnerable – get up to speed in Under 30 minutes here