Vaginal thrush cause of PN?

[Lorelei M]

My PN was caused by an out of control fungal infection in the bladder/vagina in 2015. Prior to that time I had no history of yeast infections or UTIs and perfect health all around. No pain of any type, healthy body regular yoga, low stress etc.

I had a mild lower UTI from intercourse (e coli) and was given basic antibiotics at a clinic. These worked immediately but in a few weeks felt pain deeper in my bladder. I asked if it could be fungal from the antibiotics. Over the course of several months the pain grew and I went to several clinics all prescribing more antibiotics and dismissing my requests about anti fungals and my claims that I have no history of bladder infections. Dip sticks were negative as fungal infections don't show well on those tests. Had I done DNA next gen testing at the time or a scope it could have helped. Over four months I dealt with a massive infection, frequency every 10 minutes, unable to sleep, so much bladder pain and distention I could not move much my life came to a halt. I went to the hospital begging for help and was given bladder numbing pills, denied a scope or antifungals and accused of anxiety. As a result of this experience I developed a mild PTSD about being dismissed by doctors despite my organs and tissues being harmed by a pathogen. Because I appeared young and healthy and because fungal bladder infections are rare I was not believed. Finally I was able to see my family doctor (he had been away) who knew my history (no anxiety, no infections) and got me on anti fungals immediately. I had to titrate up the dose to 600mg per day of fluconazole which is not healthy but it immediately stopped the bladder infection (I also had vaginal symptoms by this point but they were not as problematic). I stayed on the antifungals for many months and I had absolutely no pain. By the time I was able to get a scope it was 6 months post infection they said my bladder showed some signs of being raw/irritated as though I had been hodling my urine and they dismissively told me to make sure I don't do that.,even though I had been going every 10 minutes prior.

however sometime after stopping the antifungals I began having IC symptoms and PN symptoms. It took me some time to tease this out but I realized that I had IC (food related) symptoms and thus a new issue as well as sitting/position/tension related bladder pain/urgency. I figured this out with daily diary tracking of everything. I used the IC diet for about a year, 6 months strictly, along with many IC supplements and that helped IC immensely. As much as IC is depressing, it is somewhat easier to control in terms of what I ingest. I also had some periods of remission for the PN side of things with lots of activity (walking running) yoga, chiro, massage, physio..all to create space around the pelvis. My PN symptoms are classic--I cannot wear anything remotely tight, just very baggy pants with elastics taken out, underwear several sizes too big, I sit between two yoga blocks to avoid pressure on perinum, anything core tightening creates pain which is a crushing burning pelvic pain plus bladder pain/urgency. Also I flare about bowel movements if tight and spasm. biofeedback helped with that someone. Good pelvic physio was very hard to find and had to travel internationally but it helped a lot...they found many trigger points in rectum, would flare post, tightness in muscles leading into pelvis, potential adhesions or fibrous tissues vaginally but otherwise quite good there.

Unfortunately I have flare ups of yeast infections now quite frequently. I suspect there is some embedded biofilm or other going on which is on my bucket list to explore (next gen testing?) and any mild inflammation from yeast gives me bladder pain/frequency/burning and fires up the PN I believe. Any inflammation or clenching from an IC food related flare also fires up the nerve.

In my case I think the original large infection that got to dangerous levels of distention inflammation etc likely damaged/irritated the Pudendal nerve. I also created tremendous tightness in the pelvic floor muscles so the nerve gets further irritated by this tension which can easily snap in again if muscles are tight and I can feel the spasms, I also suspect some entrapment or adhesions slowing the healthy movement of the nerve after such a protracted infection as I feel sticky in other parts of my groin where pre-infection I was not so tight. The nerve is overly sensitive like something tight on my leg (and not my pelvis) will cause a flare. So I need to keep infections at bay and manage yeast carefully (yes there is a correlation with menstrual cycle) and I need to keep IC flares away and do gentle IC bladder care (helps) and I need to keep PN flares away via body rolling, heat therapy, physio, muscle relaxants etc.

It feels like a part-time to full-time job with periods of total remission. Anything I do which increases circulation helps PN: hot baths, walking. Sitting is bad, loads or tension or cold clenching or stress clenching in pelvis are bad. Pain stops with high circulation and heat..yay. But I can not maintain that as my work (psychology and academic research) involves sitting. Pain from IC or infection does not stop with circulation which is how I know when I have that..
anyway yes I do think 100% infection can cause PN. It is quite often documented that infection can be a source of nerve damage. In my case I think the nerve gets bothered from hypertonic pelvic muscles caused by the original infection and ongoing IC flares, as well as potential adhesions, as well as just general nerve irritation/damage.
Currently I am working on trying pharmaceuticals beyond suppositories such as mild dose oral baclofen. My next stops are Potter MRI and seeking perhaps a good urogyn with next Gen testing experience/chronic, as well as a good local PT. It has been exhausting and costly dealing with so many practitioners many of whom are dismissive and ignorant/arrogant about these conditions. I remain hopeful and determined by the great practitioners I do find, as well as by periods of near remission I have. I think I basically have to work my program and get back to the PT.

This forum as been a big help.

[faithwalker]

My PN began after 6mos of back to back yeast infections following a pretty straightforward partial hysterectomy. Even my gyn was mystified at why it kept coming back.

Maybe it has to do w the hysterectomy, but my gyn (obviously) carefully investigated that... It's impossible to know & who'd want to take responsibility for the ruination of someone's life? The infection is the only other weird event preceded the onset. Hmm.

The world may never know. Idk how either could lead to a solution or a more effective treatment..

[Lorine9]

Sorry to bump an old post, just wondering how you are going now? I’m in a similar position, thrush is all cleared but PN symptoms are still there months later