Dermatology/Genital irritation


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I have been having irritation in my vaginal region on and off the last few months. When the irritation started I had not been sexually active for three months. The irritation is on the labia and vulva and has a slight burning sensation and sometimes an itch (but more to alleviate the burning feel, not like a mosquito bite itch). Some parts of my vulva have almost a white colour to them and I also found a few spots that are red. I was thinking this could be from the irritation. I was wondering what the irritation could be from and thinking the possibility of a yeast infection but am unsure if it is something much more serious.

The main vulvodynia symptom is pain in your genital area, which can be characterized by:
Painful intercourse (dyspareunia),
The pain you experience may be constant or occasional and can last for months or even years, but it can vanish as suddenly as it started. You may feel the pain in your entire vulvar area (generalized), or it may be localized to a certain area, such as the opening of your vagina (vestibule).
A similar condition, vestibulodynia, may cause pain only when pressure is applied to the area surrounding the entrance to your vagina.
Vulvar tissue may look minimally inflamed or swollen. More often, your vulva appears normal.
Doctors don't know what causes vulvodynia, but contributing factors may include:
Injury to or irritation of the nerves surrounding your vulvar region,
Past vaginal infections as bacterial or yeast,
Allergies or sensitive skin,
Hormonal changes.
Vulvodynia treatments focus on relieving symptoms. No one treatment works for every woman, and you may find that a combination of treatments works best for you. It may take weeks or even months for treatment to improve your symptoms noticeably. Treatment options may include:
Medications. Steroids, tricyclic antidepressants or anticonvulsants may help lessen chronic pain. Antihistamines may reduce itching.
Biofeedback therapy. This therapy can help reduce pain by teaching you how to control how your body responds to the symptoms. The goal of biofeedback is to help you relax to decrease pain. To cope with vulvodynia, biofeedback can teach you to relax your pelvic muscles, which can contract in anticipation of pain and actually cause chronic pain.
Local anesthetics. Medications, such as lidocaine ointment, can provide temporary symptom relief. Your doctor may recommend applying lidocaine 30 minutes before sexual intercourse to reduce your discomfort. If you use lidocaine ointment, your partner also may experience temporary numbness after sexual contact.
Nerve blocks. Women who have long-standing pain that doesn't respond to other treatments may benefit from local injections of nerve blocks.
Pelvic floor therapy. Many women with vulvodynia have tension in the muscles of the pelvic floor, which supports the uterus, bladder and bowel. Exercises to relax those muscles may help relieve vulvodynia pain.
Surgery. In cases of localized vulvodynia or vestibulodynia, surgery to remove the affected skin and tissue (vestibulectomy) relieves pain in some women.


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Michael S. Fisher, <B>Ph.D., M.D.</B>


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