Vaginal thrush cause of PN?

[Jayhaych]

I recently discovered that i have pudendal neuralgia after years of on and off symptoms including constant urge to urinate made worse after urinating or a bowel movement, itching, burning and pain around my vulva and perineum, and an ache under my legs when sitting that feels as if i'm sitting on rock. Symptoms feel better when standing. I can have flare ups for 6 or so months and then they disappear. It happens almost every year, and i have been seen by doctors for 6 years being treated for urinary infections i did not have, and being treated unsuccessfully for vaginal thrush. However, i have had swabs positive for thrush that is a non albicans strain, which is rare and not susceptible to the usual anti fungal treatments. I have read online that chronic vaginal thrush can cause pudendal neuralgia, so i would like to know if anyone else has found this to be true, and did the pn go away once thrush was treated? I believe i actually have recurrent asymptomatic thrush that only causes symptoms when the inflammation affects the pudendal nerve, which is why i've had it so long untreated. I'm afraid that even when it's treated, the nerve inflammation will not disappear. I have also been suffering with undiagnosed vestibular migraine for about the same time, it waa only diagnosed last year, and i don't know if there is a connection. My pn symptoms actually ease during menstruation and flare up after ovulation and are worse the week before my period, which corresponds with vaginal thrush, so i hope once the thrush clears, so will the pn.But i'm so worried that the chronic thrush, because it's been recurrent for such a ridiculous long time (6 years) has caused serious damage or irritation to the nerve.

[April]

Welcome to the forum, Jayhaych. I'm sorry to hear about what you've been through. I don't know about this cause of pn, but I can see how such a thrush could irritate the pudendal nerve. Violet might know more about this. Are you currently being treated with an anti-fungal cream or oral medication? If so, have you noticed a decline in the pn symptoms?

April

[Jayhaych]

Thank you April. The thrush isn't being treated at the moment - my swab test revealed i have one of the rare strains of thrush which can't be treated with any easily available anti fungals. The lab results did reveal which medication i need but my gp isn't allowed to prescribe it, i have to wait for a referral to a gynaecologist, which could take over a month. Meanwhile i am suffering with constant urinary urge, pelvic discomfort, itchiness, pain when sitting etc. My urinary symptoms are the worst, my bladder constantly feels raw and i could sit on the toilet all day long. I have noticed however that my pn symptoms, including the urinary urge, ease considerably during the first days of menstruation, and then return afterwards. That corresponds with thrush, which can subside during menstruation.My pn feels worst the week before my period, which is what happens with thrush infections. Therefore i'm really hoping that once the thrush is gone, so too will the pn. I hope. Absolutely dreading the highly embarrassing, violating internal examinations and treatments that might be necessary otherwise.

[Violet M]

I don't know if that rare form of thrush you have could cause PN or whether it could cause permanent damage. I haven't heard of that happening but that doesn't mean it couldn't. Lots of women get vaginal thrust without getting PN which makes me wonder if there is anything else in your history that might also have contributed? Often there is more than one thing that triggers PN. The symptoms you described are typical of what PN patients experience. Have you tried any drugs for symptom relief until you can get treatment for the thrush? It sounds like your symptoms are related to your position, with standing being better. Is sitting bad? What about lying down?

Violet

[Jayhaych]

Hi violet, my symptoms are continuous all the time but are definitely worse when sitting, better when standing,and worse after bowel movements. They flare up for several months then disappear, always when i seem to have this recurrent thrush. There are several websites where i have read about recurrent vaginal infections causing pn, but they don't mention if it lingers after the infection or not. I can't think of anything else that has contributed to pn, no fall or anything of that nature. I just joined a facebook group for pn sufferers, and met a young woman who developed pn after having repeated urinary infections for 6 months.Theoretically, once the pressure has been taken off the nerve, after a while it shoupd begin to subside, and the pressure is coming from the inflammation caused by the thrush infection. (Yes, i'm talking myself into this positive outlook).

[Jayhaych]

Thought i would share this link which explains how chronic infections can irritate the pudendal nerve from tightening of the pelvic floor muscles in response to infection: http://www.blogaboutpelvicpain.com/?p=13

I hope that might help anyone in the same circumstances as me.

[Violet M]

Thanks for posting that. Yes, that is one of the theories as to how an infection can cause PN symptoms. Have you been evaluated for pelvic floor tension -- comparing the muscle tension during an outbreak of thrush compared to when you are feeling OK?

Violet

[Jayhaych]

No i haven't been evaluated for anything like that, the doctors are just concerned with treating the thrush first as that's the first step. But i am worried about how bad the pn could get while i'm waiting for more test results and waiting to see a gynaecologist, it' ll be at least 2 months. A gynaecologist I spoke to (not for official treatment, just for a quick query) told me that once the thrush has been completely treated properly the pn symptoms should resolve I really hope so. In the meantime i have ordered a doughnut cushion to sit on.

[Violet M]

Well, that does sound hopeful. Two months isn't that long in the world of PN although it can seem like forever when you are in pain, so I guess it's a matter of whether you want to just try one thing at a time and see if treating the thrush solves the problem or whether you want to get a pelvic floor PT evaluation in the meantime -- just to see if your muscles are in tension and whether you have tenderness along the course of the nerve when they press on it. Since you only have pain part of the time you don't want to do anything that would escalate the pain so maybe taking a conservative attitude would be smart. Unless you have the right type of PT it can make you worse so if you decide to try that, just make sure you go to someone who knows what they are doing.

Violet

[Jayhaych]

Thanks Violet, that's reassuring. I think i will try to tackle one thing at once at the moment, treat the thrush and then assess the situation from there, because like you said, i don't want to end up aggravating things even more. Thanks for your input.