Support
Finding a Doctor
Less than 5 thrush infections, no other complications
Genitourinary Medicine clinic
Access timely thrush care at your local GUM clinic. If you have symptoms, relay them to the receptionist and ask for the next available appointment.
The Sexual Health website has a map of all available across the UK here.
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Your GP can also test for thrush and advise on treatments.
Phone 8am in the morning for an emergency appointment.
111​
If your local GUM and GP clinic are proving challenging to access, contact 111 and ask for a same-day appointment at an urgent care clinic.
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Gynaecology referral​
These are often a non-starter for most women as the wait lists are exorbitant. Once there, gynos are not trained in vulva pain syndromes (some are trained but this teaching is given ad hoc and not systemically.) They are unlikely to be of much timely help. ​
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Asking for a take-home swab​
You can ask your GP/ GUM clinic to give you an at-home swab and test when your symptoms flare up and returning it to the clinic. It is not available at all GPs or GUM clinics but it's worth asking for. Private gynos and vulva clinics are more likely to offer this.
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More than five thrush infections and or symptoms with no positive tests for thrush
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You will want to strike up a relationship with a consultant at a vulva clinic. Discuss your concerns about your propensity for thrush and risk of nerve damage. A list of clinics can be found at the British Society for the Study of Vulva Disease website here.
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The map below allows you to find a vulva clinic close to you.
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Wait times to see an NHS vulva consultant are around 6 months at the time of writing.
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Vulva clinics offering vestibulectomies
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Vestibulectomy surgery is highly specialised and only offered in a handful of clinics for a select group of patients who have provoked vestibulodynia. This is an operation to remove skin at the opening of the vagina that is packed full of nerves. There are many quoted success rates but leaders in the field have reported generally 80% success rate on well-selected patients.
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Those that have performed the most number of vestibulectomies: Bornstein (Israel), Goldstein, A. (New York) and Goldstein, I. (San Diego), all recommend a full vestibulectomy removing skin equivalent to a clock face from 13:00 around to 11:00.
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In Europe, at the time of writing, only Bautrant, E. based in France can perform a full vestibulectomy.
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UK providers all only offer a partial vestibulectomy from 15:00 to 09:00. These include surgeons at the Royal Free London Clinic (Boyle, D.) as well as Birmingham Women's Clinic (Byrom, J.).
See the provider map compiled by patients below (link here).
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Competency, Compassion, and Recommendations:​
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Competency:
The first challenge often within women's health is finding a competent doctor who is aware of the latest research on thrush, vulvodynia and vestibulodynia. A good clue to this is whether they have membership in relevant boards that promote discussion and research into the conditions.
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These include:
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ISSVD (International Society for the Study of Vulva Disease)
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BSSVD (British Society for the Study of Vulva Disease)
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ISSWSH (International Society for the Study of Women's Sexual Health)
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IPPS (International Pelvic Pain Society)
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Consultants specialised in the area often speak of their frustration in the state of affairs for women's health. Another good sign is that they are using their voice through reputable publications (The Guardian, The Times, The Telegraph and beyond) to raise awareness of thrush care, vulvodynia and other vulva pain syndromes. And or they have a profile online regularly discussing their work.
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Compassion:​
Doctors are not expected to have empathy with patients as if they constantly put themselves in their patients' shoes, they would take on an unsustainable mental load.
The focus should be on compassion, treating the patient with respect and validating their experience. A good doctor or consultant should see the relationship between them and their clients as a partnership – particularly if you are dealing with a chronic condition. You should feel safe in their presence and not leave meetings emotionally drained and hopeless. Do not settle for a consultant that does any of the following:
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Shows signs of medical gaslighting
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Medical gaslighting is when a doctor or any of their associated staff discredit or minimise the concerns of a patient. If you don't think a treatment is working, they should hear this and act.​
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Show signs of the 'trust gap'
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The 'trust gap' is when a doctor projects symptoms onto you that you have not reported to them. Many will try and make you fit into a particular medical model they've learned at medical school, even if you do not show textbook signs and symptoms. ​
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Show signs of stereotyping or racial bias
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Women of colour are less likely to be given adequate pain relief compared to their white counterparts. The medical system is structurally unequal with unconscious bias prevalent. Any hint of these kinds of behaviour should be reported via PALS (patient liaison service) and not accepted. ​
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Recommendations:​
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Many doctors rely on public review sites for new leads however, the reviews here are not necessarily to be trusted.
This is because doctors and their secretaries are in control of who provides a review and so there is positive bias.
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A better approach for finding a good clinician is to go onto Reddit or Facebook support groups and search for your doctor's name. No clinician will have a perfect record, but you should see that, on the whole, patients share positive stories.
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