Thrush and vulval nerve damage: lack of information and knowledge puts patients at risk (a blog by Philly Baines)

Summary

Philly Baines is a patient advocate and Founder of Thrush Support. She is living with chronic pain following recurrent thrush infections and vulval nerve damage. 

In this opinion piece, Philly shares her experience and calls for action to make sure patients and healthcare professionals are more aware of the risk of thrush-associated nerve damage. She highlights the devastating impact chronic vulval pain has on people’s lives and why prevention is key. 

Content

Experience of thrush in my 20s

From the age of 22, I experienced one episode of thrush almost every year. Thrush is not taught in schools or universities, so when I had my first infection, I relied on my mother’s knowledge and over-the-counter treatment. This lack of education is striking given that around 75% of women will develop thrush at some point in their lives.[1]

Throughout my 20s, my thrush infections were short-lived and typically resolved within a week. I never met the medical definition of “recurrent thrush”, which is four or more infections in a year,[2] and therefore was never eligible for specialist referral . 

By the age of 32, my go-to treatment - clotrimazole pessaries - stopped working. This was due to candida albicans (the fungus associated with thrush) developing resistance from repeated over-the-counter use. NHS guidance[3] advised that it was safe to drink alcohol while taking antifungals, so I did. Now I know that alcohol floods the body with sugar, feeds yeast, and lowers innate immunity, increasing the likelihood of treatment failure.[4]

This resulted in a severe thrush infection that lasted two months. During this time, inflammation caused nerve damage and pain in my vulval vestibule (where the vulva meets with the vagina). 

Harmful lack of knowledge 

In October 2022, after two months of treatment, I tested negative for thrush, but the burning pain in my vulval vestibule persisted. 

The NHS thrush clinic treating me had no clinicians trained in vulval pain, so my ongoing symptoms were not recognised as vulvodynia (vulval pain) or vestibulodynia (pain at the vulval vestibule). I was never diagnosed with nerve damage. 

Over the following six months, the pain gradually subsided but in October 2023, I developed thrush again. 

This time, the pain never went away

A gynaecologist misdiagnosed me with a controversial condition, 'cytolytic vaginosis' (overgrowth of good bacteria) and I was prescribed an antibiotic called co-amoxiclav.I was prescribed an antibiotic called co-amoxiclav to ‘knock down the good bacteria’ in my vagina. This triggered recurrent drug-resistant thrush and worsened the existing nerve damage. 

My pain went from 2/10 to 7/10.

The gynaecologist had no vulval training and unfortunately the treatment I was given has caused me to become disabled by pain. 

Key areas for change: information and training

NHS information: The NHS thrush webpage should include the information from the Vulval Pain Society[5] and British Association of Dermatologists[6] and warn women of the link between thrush and vulval nerve damage. This way women can be supported to take recurrent or severe thrush seriously. I am calling for their webpage to include the following two sentences:

“There is an association between thrush and vulval nerve damage, a chronic pain condition called vulvodynia. Women prone to thrush should take all reasonable measures to bring their rate down and consult a vulval clinic if they have any concerns.”

The webpage should also direct women to vulval clinics[7], as these are the services where people will be trained in vestibulodynia. 

Training: Healthcare professionals working in thrush services inside sexual health clinics should have training, so they are aware of the link between thrush and vulval nerve damage, to reduce diagnostic delays. GP services need women's health experts who know the difference between vulval clinics and gynaecologists, as gynaecologists are not typically taught about the vulva in sufficient depth. This would help people get appropriate treatment sooner. Early diagnosis improves outcomes.

Impact on my life

If I had been given more information about the risk of vulval nerve damage associated with thrush and how to minimise infections, I would have been better empowered to protect myself. 

I cannot work full-time now. I cannot consider having children because I struggle to care for myself. My income has halved, while my outgoings on private healthcare are substantial. I live with severe medical trauma.

As one of the few patients speaking publicly about vulval pain, I have been inundated with messages from women living with vestibulodynia in silence. Many have 9/10 pain. Many are suicidal and desperate for help. Thrush was often the precipitating event. 

Women cannot take their health into their own hands if the medical system withholds vital information.

Support resources

• The Vulval Pain Society
• British Association of Dermatologists (information on vulvodynia and vestibulodynia)
• Thrush Support

References

[1] InformedHealth.org. Cologne, Germany: Institute for Quality and Efficiency in Health Care (IQWiG); 2006. Overview: Vaginal yeast infection (thrush). [Updated 2022 Apr 4]. Accessed online 2 February 2026.

[2] NHS website. Thrush in men and women. Accessed online 2 February 2026.

[3] NHS website. Common questions about clotrimazole cream, spray and solution -Brand name: Canesten. Accessed online 2 February 2026.

[4] Myers, A. Candida and Alcohol: The Perfect Storm. AM MD. 21 November 2024. Accessed online 2 February 2026.  

[5] Vulval Pain Society. Vestibulodynia (formerly vulval vestibulitis). Accessed online 2 February 2026.

[6] British Association of Dermatologists. Vulvodynia and vestibulodynia. Accessed online 2 February 2026.

[7] The British Society for the Study of Vulval Disease. Clinic Map. Accessed online 2 February 2026.

Share your experience

Have you been affected by any of the issues raised in this blog? Perhaps you are a patient too, or a healthcare professional working in women's health? Comment below (sign up first for free) or email [email protected]