Burning stinging vulva, what to do
July 15, 2012 9:24 AM   Subscribe

I have had a burning/stinging vulva on and off for over a year and it's driving me crazy. I've seen lots of different healthcare professionals and none of them have been able to identify it. I've finally got an appointment with a specialist (thank you NHS) in chronic women's health conditions in a couple of weeks and I want to be prepared when I see her, so has anybody suffered anything similar?

Very long, sorry, but I want to give all the details in case anyone else recognises the symptoms. I've had a look through past questions and couldn't find anything similar. I've already read through this guide to vulval problems.

Early last year, I got a new boyfriend and, as I am unfortunately prone to, had a series of UTIs followed by a few bouts of thrush from the antibiotics taken to cure them. I also started taking the pill (Marvelon and then switched to Yasmin due to skin problems) around this time. Soon after, my vulva began to feel very inflamed and would sting, burn and occasionally itch at random times, sometimes more, sometimes less. I went to the doctor who tested me for STDs, thrush, etc. and didn't find anything. Finally I saw a nurse who suggested it could be the hormones from the pill that I was reacting to and when we checked the less common side effects of Yasmin online, 'non-specific vaginitis' (i.e. plain old inflammation) was listed as one.

So, I immediately stopped taking the pill and it went away entirely for several months until early this year, when the same symptoms mysteriously returned. I had broken up with that boyfriend in the meantime and am no longer seeing anyone with any regularity.

I went back to the doctor who suggested it could be eczema or another skin condition, as I do have eczema on my legs, and suggested using only Diprobase (an emollient cream) to wash with and applying 1% steroid cream a couple of times a day. That was a couple of months ago. The moisturiser has helped a bit but the steroid doesn't seem to make any difference and can make it feel worse if I apply it regularly. I'm also worried that using steroid creams over the long term will thin the skin. If I'm having a bad day it does seem to help calm it down though.

Possibly pertinent details:

- Random stinging and burning just around the vulva and entrance to the vagina, but not inside.
- Worse after drinking alcohol and sweating.
- Some pain during sex a few minutes in, but it feels more like chafing as it's already inflamed rather than any vaginismus/muscle spasm issue.
- Not painful to the touch at all, which would seem to rule out vulval vestibulitis and related conditions
-Slightly worse just prior to and after my period
- Tampons and sanitary towels are very irritating
- Not taking any other medication
- Recent pap smear - all fine
- No STDs or yeast (thrush)
- Not having sex with any regularity at the moment
- Not on any contraception
- Very careful to only use diprobase to wash with and sensitive detergent to wash my clothes

Has anyone experienced anything similar and did it ever go away? The second bout has lasted for 6 months now and it's really making me miserable.

Thank you.
posted by anonymous to Health & Fitness (11 answers total) 5 users marked this as a favorite

Have you tried going entirely off yeast and gluten and sugar for a couple of weeks? I know it's not an STD or a yeast infection but it sounds enough like problems with yeast that if I were the one itching I would try this to make sure. What are your triglyceride levels like? Have you been tested for diabetes?

Do your natural secretions help or make it worse? Not sweat - the other sort, like you produce when you are aroused.

Can you find your bartholin's glands? (Scent glands near the opening of the vagina.)

Do you smell and taste normal? Are you more acidic than you think is normal?

From the symptoms except that you tested negative for yeast, I would really think it was a case of catching an unfamiliar yeast from a sexual partner, and having it come and go depending on your hormones and the drying effect of tampons. If you are at all starting to tend towards diabetes that could easily exacerbate it if so, and the amount of yeast and itchiness fluctuate along with your blood sugars.

Have you tried using the cup when you are on your period so as to reduce the use of sanitary towels and tampons? Does introducing anything into your vagina tend to trigger a bout of it, or make it worse? I know someone who is fine withlving with an ongoing floral imbalance until anything whatsoever is introduced into her vagina and then that triggers a bout of the itchies.

Does using petroleum jelly liberally provide any relief?
posted by Jane the Brown at 10:06 AM on July 15, 2012

Oh man. I had a vulvar issue like this, which we suspected was fungal in nature, and I tried freakin' everything: over-the-counter antifungal cream, plain yogurt internally and externally, raw garlic internally and externally, aloe moisturizer, cutting back on sugar, avoiding latex condoms, using paraben- and everything else-free lubricant, multiple weeks-long courses of Diflucan, changing to "free and clear" detergents and fabric softener, using a cup rather than pads (which seemed to actually make things worse), washing with tea-tree oil face wash (also made things worse), not shaving or trimming for a while...

What finally worked was getting a prescription for nystatin/triamcinolone ointment, which includes both a mild steroid and an antifungal. I had to use it at least a few days each month, usually leading up to my period (it seemed to be at least somewhat hormone-related in my case, too), but sometimes occasionally in between, and after about a year, I stopped having to use it at all.

Oh, and keeping my nails trimmed also helped a lot - when everything was itchy and irritated, using my hands to wash there often made things worse, 'cause I was inadvertently scratching myself a lot. I would definitely recommend keeping your nails trimmed close at all times while you're figuring this out.

It's interesting, thinking back on that whole episode in light of my other recently uncovered skin issues. After a bout of uncontrollable skin itchiness everywhere else on my body this winter (and trying a whole new set of skin products and potential solutions that largely didn't work), I learned that contrary to what my primary doctor thought, I probably don't have eczema - I actually have dermatographia, or dermatographic urticaria, which basically means that scratching makes me itch more and can actually give me hives. And I turned out to have an allergy to formaldehyde resin, which means a lot of moisturizers, cleansers, makeup brands, sunscreens, glues, furniture coatings, corduroys, unwashed new clothing, etc. are off-limits to me.

If all else fails with the gynecologist, you might consider getting allergy testing done by a dermatologist for contact dermatitis and/or seeing an allergist to rule out a food allergy (which can often manifest vaginally due to food proteins coming out in secretions and sweat). Each specialist can test for different things - the dermatologists' patch test and allergists' pin-prick tests each cover a different set of potential allergens.

I wish you luck figuring this out - it definitely is possible to overcome this!
posted by limeonaire at 10:54 AM on July 15, 2012 [1 favorite]

I was going to suggest the derm route too. Could be a ladybits problem as such, but it could also just be a more general skin problem. Consider asking for a referral to a dermatologist. Your gynecologist is going to treat this like a gynecological problem, but it might not be.
posted by valkyryn at 1:27 PM on July 15, 2012

Be careful using steroid creams on your genitals, without being under supervision of a dermatologist (or specialist)! some who knows their stuff, not a generalist. thinning of skin and weird stretch marks are serious, and permanent problems. don't use steroid cream made for your eczema (which I assume is in other places on your body) for your vagina!!!!!! <>
a dermatologist is a great start, preferably someone who knows their way around the vulva/vagina. not all gynecologists are comfortable treating skin stuff and not all dermatologists are great with genitalia. but if you're seeing a specialist in chronic women's health issues, that's great, because this type of irritation/pain is unfortunately really common as a chronic issue, so they should be experienced in this.

i really recommend people generally don't use any product on the vagina, inside the labia minora, etc, unless under advice of a specialist (with a couple of exceptions). i always appreciate the advice, don't put anything on the vagina that you wouldn't put in your eye...

you probably have heard the list and are doing this already - i wouldn't use pads, change your underwear ASAP after you get sweaty, don't sleep in your underwear, don't wear tight snug jeans/tights for a long time, dry yourself out well after a shower or bath.

FYI, it's unlikely but a possibility that the doctor may want to do something like a tiny skin sample if they noticed any areas that might indicate certain types of rashes like mild lichen planus or something (uh, please be real careful googling anything that's a rash on a vagina).

i will share my own experience here, though - i also developed cyclical itching/scratching/discomfort (like, am i about to get a yeast infection?? ugh) that really worsened around my cycle. i ultimately went on continuous monophasic birth control to just stop cycling, after the merry-go-round of thinking i had yeast infections, thinking i had BV, trying everything under the sun and then some. not having a period has been what stopped all the problems... stupid hormones. so, good luck with your appointments, i hope you can get a more definitive or helpful answer!
posted by circle_b at 3:01 PM on July 15, 2012

Consider taking probiotics to help increase your healthy vaginal flora. I don't what's available where you are, but Fem-dophilus and Florajen are two brands I am aware of. Both should be refrigerated, so you need to ask for them at the pharmacy counter. Both can also be bought on Amazon.
posted by TrarNoir at 3:48 PM on July 15, 2012

I have this exact same problem and my gynecologist is of the opinion that it is due to a food allergy. She even had a pamphlet about it which I have misplaced that had a bunch of information about food allergy caused lady issues. It's apparently somewhat common. Try to see if your dietary habits effect the severity at all, I think mine is a wheat allergy but I can't actually bring myself to give up wheat so I just eat it in moderation. I also just use hydrocortisone cream, and I have a prescription steroid cream from the gynecologist for days when it is particularly bad. Definitely ask your gynecologist about all this, but your symptoms EXACTLY match mine and I could've written this exact question 3 years ago when I was going through the same process as you.
posted by internet!Hannah at 5:57 PM on July 15, 2012

I had this problem a few years ago; for me, it was an allergy or irritation caused by toilet paper and other products. I have found that the only toilet paper I can use consistently is Seventh Generation. I can use other brands a few times (if I'm away from home for the day, say), but after that I start to get irritated. I have very, very sensitive skin everywhere and get rashes from all sorts of things. I also use Seventh Generation unscented laundry detergent (and no fabric softener or other laundry additives) on my clothes and wash my ladybits with Cetaphil Sensitive Skin Cleanser; during my periods, I use Seventh Generation pads (still irritating, but much less so than the regular ones).
posted by WorkingMyWayHome at 6:17 PM on July 15, 2012

I had a case of itchiness for a while. I found a place where I could happily sunbathe without pants and that helped a great deal. I also used cornstarch to help keep things drier and less chafe-y.
posted by theora55 at 8:51 PM on July 15, 2012

Mod note: From the OP:
Thanks to all for your very helpful suggestions. I haven't seen a dermatologist or had a biopsy, getting a referral here in the UK is a nightmare and takes months. I will try to get the chronic doctor to refer me though. To those who suggest it is a skin problem rather than a gynaecological issue, I think you're right. I am generally kind of an allergic person - no known specific allergies but as I say I do have mild eczema and hayfever and my skin gets easily irritated.

Jane the Brown: When I was a child my parents were concerned I might be tending toward diabetes but it turned out not to be the case, at least then. I am fit and not at all overweight so it seems unlikely to be type 2 diabetes. I will bring this up though.

Secretions don't seem to make any difference. As far as I am aware they have the same smell/taste as normal but to be honest I didn't pay much attention before this! Using the emollient moisturiser does help a bit. I should reiterate that the problem isn't really itching, only very very occasionally, it's more the burning feeling.

To limonaire, internet!hannah, and workingmywayhome it's good to know other people have suffered with things like this and that you managed to figure it out! Whenever I go to the doctor (always different ones as I've moved around) they don't seem to believe me or are just stumped.

@circle_b - Sorry, I should clarify that the steroid cream (hydrocortisone) was given to me by a doctor at a specialist sexual health clinic and is very mild. I also asked my mother, who conveniently is a GP and specializes in sexual health, and she didn't think it was a problem. I have stopped using it now though as it doesn't seem to make any difference anyway. And too late, haha, I have already googled all the horrible degenerative diseases one can get like Lichen Sclerosis - I don't have any of the white patches they describe as early symptoms, though, thankfully.

Thanks again.
posted by taz (staff) at 3:22 AM on July 16, 2012

Another possibility to tuck in the back of your mind: Sjogren's syndrome, which is an autoimmune disease that attacks the moisture-producing glands throughout the body, most famously the eyes and mouth, but elsewhere too. It can cause symptoms just like you describe, long before the more typical symptoms become obvious. Don't ask me how I know. It took 20 damn years to get a diagnosis. I hope your luck is lot better than mine on that one!
posted by Corvid at 6:47 PM on July 16, 2012

OP, I should have mentioned this in my comment earlier, but I was in a bit of a hurry; if it IS a skin issue, I wouldn't be surprised if you're going to have to be the one to figure out what's causing it, with little help from your doctors. I have problems with rashes from all sorts of products--toothpastes, soaps, lotions, chemicals used to treat fabrics, detergents, etc., plus things like the adhesive on bandages and rough fabrics like linen--and neither my dermatologist nor my allergist have been any help, I'm sorry to say. And they don't seem to see it as a serious problem, which it certainly is. If I were you, I would eliminate as many products as you can that come in contact with your bits and see if you get any improvement. If you do, then you can start re-introducing products until you find the culprit or culprits.

Hang in there and know that you aren't alone in this. Good luck to you.
posted by WorkingMyWayHome at 9:13 AM on July 18, 2012

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