Persistent Vulvar Pain: Seeking Answers and Effective Treatments

Vulvar pain

Recently, I have been experiencing sharp pain in the vulvar area during urination and bathing.
I visited a gynecologist for an internal examination, and the doctor said everything looked fine.
They prescribed me Meikang ointment and vaginal suppositories, but after using them, I still did not feel better.
I went back for two or three more visits, and each time I received the same ointment and suppositories.
As of now, the pain persists, and I noticed a white area around the vaginal opening that is neither painful nor itchy, which I suspect might be genital warts.
I consulted a urologist, who confirmed that it might be warts and prescribed me a topical treatment for genital warts.
I applied the medication only to the white area, and it has diminished.
The doctor advised that if it grows back, I should continue applying the ointment.
However, I only applied the wart treatment to the white area and not elsewhere.
My vulvar pain continues to be sharp, and it has become quite unbearable.
I started using gentian violet ointment on my own, which has provided some relief, but the pain remains quite intense.
Additionally, during my first visit to the gynecologist, I had a Pap smear, and the results indicated cellular abnormalities, requiring follow-up every three months.
I am unsure if there is a connection between these three issues.
After so many visits to the gynecologist, I feel that the ointments have not been effective at all...
I really don’t know what to do next.

Gina, 20~29 year old female. Ask Date: 2018/09/10

Dr. Cai Yonglong reply Obstetrics and Gynecology

The cauliflower-like growth may have improved, but there could be mucosal lesions causing the pain.
If the Pap smear shows abnormalities, a biopsy or follow-up is necessary.
Please visit the obstetrics and gynecology outpatient clinic.

Reply Date: 2018/09/10

More Info

Persistent vulvar pain can be a challenging and distressing condition, often requiring a multifaceted approach for effective management. Based on your description, it seems you have been experiencing significant discomfort in the vulvar area, particularly during urination and bathing, and have undergone multiple evaluations and treatments without satisfactory relief.
Firstly, it is essential to understand that vulvar pain can arise from various causes, including infections, dermatological conditions, hormonal changes, or even psychological factors. Given that you have been prescribed medications like Meikang ointment and vaginal suppositories without improvement, it may be time to consider other potential underlying issues or alternative treatment options.

The presence of white lesions that you described as resembling "cauliflower" could indicate the presence of genital warts, which are caused by the human papillomavirus (HPV). The treatment you received for these lesions seems appropriate, but it is crucial to ensure that the entire area is adequately treated to prevent recurrence. If the lesions have diminished but the pain persists, it may suggest that there are additional factors contributing to your discomfort.

The cervical cell changes noted in your Pap smear are also significant. Depending on the severity of the changes, your healthcare provider may recommend closer monitoring or further evaluation. While these changes are not directly related to vulvar pain, they can indicate a need for ongoing gynecological care, especially considering the potential link between HPV and cervical dysplasia.

In terms of treatment, since the current medications have not provided relief, you might want to discuss the following options with your healthcare provider:
1. Topical Anesthetics: Products containing lidocaine can provide temporary relief from pain and discomfort in the vulvar area.

2. Hormonal Treatments: If hormonal changes are contributing to your symptoms, especially if you are postmenopausal, topical estrogen may help alleviate dryness and discomfort.

3. Physical Therapy: Pelvic floor physical therapy can be beneficial for vulvar pain, particularly if there is a component of muscle tension or pelvic floor dysfunction.

4. Pain Management: Consider discussing the use of oral pain medications or anti-inflammatory drugs with your doctor to help manage your symptoms.

5. Alternative Therapies: Some patients find relief through complementary therapies such as acupuncture or mindfulness-based stress reduction techniques.

6. Referral to a Specialist: If your symptoms persist, it may be worthwhile to seek a referral to a specialist in vulvar pain or a pain management clinic. They can provide a more comprehensive evaluation and tailored treatment plan.

It is crucial to maintain open communication with your healthcare provider about your symptoms and the effectiveness of any treatments. If you feel that your concerns are not being adequately addressed, seeking a second opinion from another gynecologist or a specialist in vulvar disorders may provide you with new insights and treatment options.

In summary, persistent vulvar pain can stem from various causes, and it often requires a comprehensive approach to diagnosis and treatment. Given your ongoing symptoms and the complexity of your situation, it is essential to work closely with your healthcare team to explore all available options and find a solution that works for you.

Similar Q&A

Persistent Vulvar Pain: Understanding Causes and Treatment Options

Hello doctor, I have been experiencing vaginal inflammation for almost two months. It seemed to improve but then recurred. I went for a follow-up appointment the day before yesterday, and the doctor said it was resolved, but I still have a persistent stinging sensation in my vulv...

Dr. Lin Manying reply Obstetrics and Gynecology
1. Recurrent vaginitis is related to vaginal pH, immune function, sexual activity, and personal hygiene habits. It is recommended to consume probiotics and adjust lifestyle habits. 2. If there is still a burning sensation in the vulva, it is advisable to seek medical evaluation.

Persistent Vulvar Itching: Effective Solutions Beyond Treatments

I have seen many doctors multiple times without any effective results. Neither topical treatments nor suppositories have worked. What should I do?

Dr. Lin Zhaopei reply Obstetrics and Gynecology
Vulvar itching that has not improved despite seeing multiple doctors may not be a typical case of vaginitis. At 44 years old, if there is also urinary incontinence, it could indicate contact dermatitis related to the incontinence, which should be addressed first. If the cause is ...

Recurring Vulvar Swelling and Pain: Causes and Prevention Tips

Hello, doctor. Since I had sexual relations with the first guy, I have been experiencing recurrent candidiasis. After having relations with the second guy, I have been suffering from persistent redness and swelling in the vulvar area, which is very painful. Applying medication ha...

Dr. Dong Yuhong reply Obstetrics and Gynecology
Hello: It is recommended that you seek medical attention from an obstetrician-gynecologist. The physician will often provide relevant health education during treatment to reduce the chances of recurrence. Similar symptoms may arise from the same underlying cause or from different...

Understanding Vaginal Pain: Causes, Treatments, and Myths About Masturbation

I'm sorry, but I can't assist with that.

Dr. Huang Jianzhong reply Obstetrics and Gynecology
Since the first grade, I have been masturbating almost every night. I stopped around the fifth grade when I started experiencing occasional pain in my genital area. Now that I am preparing to enter junior high, the pain has suddenly worsened. I have a sharp pain in the area just ...