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Swollen and painful clitoris. How to get relief?

Mar 2013
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Practicing since : 1998
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My clitoris is swollen and painful. This resulted from masterbating on Saturday. It was somewhat discomforting Sunday but has progressively gotten worse Tuesday and Wednesday in terms of pain. I plan on calling my obgyn in the morning, but am greatly concerned and wanted to know if there is anything I can use now to help w the swelling and therefore the pain. I am a 3rd shift pharmacist and have several OTC meds available to me now
Posted Sat, 9 Feb 2013 in Vaginal and Uterus Health
Answered by Dr. Aarti Abraham 2 hours later
Thanks for your query.

The cause for your clitoral swelling could be one of the following.

1. Allergic reaction to some kind of substance, fabric, scented or coloured toilet paper, local cleanser, lotion, gel, soap or bathing product.

2. An infection, due to the nails or a nearby infected hair follicle, which could be causing a developing abscess. If you have accompanying urinary symptoms, it could be UTI ( genital infection in the area, such as fungal infection or bacterial infection, could have been worsened by abrasion during masturbation.

3. It is common for the clitoral area to be sore and swollen for a day after vigorous intercourse/ rubbing during masturbation. If it is very painful and troublesome, there could be a minor blood vessel which bled inside the clitoris, leading to a hematoma ( blood clot ).

4. A rare condition is clitoral priapism. Priapism is defined as a persistent and painful erection of penile or clitoral tissue with a duration of more than six hours and is not associated with sexual arousal. It leads to pain and swelling in the clitoral area, particularly if you failed to have an orgasm.

As you already guessed, you need to consult a gynecologist for exact diagnosis and treatment.
For the time being, please use ice packs, soothing gels like aloe vera and if itching is a problem, you can use Vagisil anti itch cream
Also avoid abrasion and friction, excessive washing or rubbing of the affected area.

Take care and feel free to ask for further clarifications.
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Follow-up: Swollen and painful clitoris. How to get relief? 17 hours later
Today my obgyn called in a prescription for Nystatin/Triamcinolone cream. Sig: to affected area top bid. I first administered it today at 1 pm. I am still in a lot of pain and have to work 12 hours tonight with very little sleep, so I am a bit emotional. Do you think there is anything otc i can use for pain? i am a pharmacist and have several otc meds available to me. My expertise is not in women's issues, so i dont want to go just try anything. Also, do you think the nystatin/triamcionolone cream is a good product for my medical problem?
Answered by Dr. Aarti Abraham 19 minutes later
Without examining you, it's difficult to say I'd the nystatin/ triamcinolone cream is the right prescription.
Am sure she found some yeast infection to go by, because of which a local anti fungal was prescribed.
You could try a local anaesthetic gel, if the pain is too severe.
Am sure cold compresses would work too.
All the best.
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Follow-up: Swollen and painful clitoris. How to get relief? 10 hours later
Good Morning,

Actually this medication was called in over the phone. I've only used it twice, and after each time that area becomes so painful that I burst into tears. The first time I thought it was just due to the sensitivity of the area, but since it happened again (each time around 2 hrs after the cream was applied) I'm leaning towards it's the strength of the steroid. I will be calling my OBGYN again this morning to see if she'll see me today. Wish me luck.
Answered by Dr. Aarti Abraham 2 hours later
Since you are in so much agony, please do not delay an examination.
This sounds very much like an abscess, since it is so painful.
Have you tried cold compresses yet?
And also a local anesthetic gel .. that could help till you get a check up.
If the current medication is worsening your symptoms, please do not use it.
All the best, dear.
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Follow-up: Swollen and painful clitoris. How to get relief? 23 hours later
Good morning,
Going to see my OGBYN was an experience. During the examination, she mentioned how inflamed the area was and that she did notice a small lesion at the top of my clitoral hood. She squeezed the area to see if it produced pus or blood. Neither which emerged. She took a swab and is having it tested for all sorts of STDs. She thinks that I may have herpes, which I really don't understand. She said that if it was trauma to the area (which I had expected) that the swelling would have gone down in 24-48 hrs. So she gave me prescriptions for Valtrex 1gm po bid x 10 days, Diflucan 150mg po x1 and Zovirax cream. I had them all filled but the cream and only because it was not in stock in two different pharmacies.
After my appointment i went to bed and woke up in horrible pain, I assume from the examination. I took your advice and got some Dermoplast spray. While I was on my way to Walgreens to pick it up, I called my doctors office to get their okay. She said it wouldn't hurt but may not help too much. I bought the Dermoplast and one of those donut pillows to sit on. When I got home, the spray helped a little but my clitoral hood was still in pain, so I called my doctor back and she prescribed me lortab 5mg-500mg. Never have taken an opiate before and with such a lack of sleep, I was in bed for about 14 hrs.
I have a follow up appointment on Friday. The tests should come back within 3-4 days. I've been w my husband for 6 yrs. Never had an outbreak before. Did not exhibit flu like symptoms before hand. It just seems much of a coincidence from me using the magic bullet (pretty intensely) to being sore on Sunday and it progressing this much. I can't imagine it'd be herpes. What are your thoughts?
Oh and to answer your question from before i did use a cold compress when I got home from work yesterday it did make it feel so much better during the process but was very painful when the area rewarmed. Also I thought that lesion may have been a friction burn from when i used my silver bullet. There was no lubrication used and I had the silver bullet over my underwear and pretty much on that very spot. I don't ever use it directly on my clitoris. Wanted to give you the whole story. Thanks for being such a good listener.
Answered by Dr. Aarti Abraham 3 hours later
Hi again,
I appreciate your detailed feedback, and thanks for confiding in me.
It is my constraint, that without examining you, an opinion on the lesion and swelling is next to impossible.
Genital herpes has a variety of presentations, and if she did notice a small lesion on the clitoris, herpes is well among the possibilities. Also, a monogamous relationship lessens the chances of, but does not rule out, genital herpes. You need not always have prodromal symptoms like flu etc to have genital herpes.
Only the tests will tell you whether you actually have it.
Kindly get the cream also, because topical application will have maximum effect if you indeed have herpes.
Also, as she pointed out, trauma would have subsided by now, but not if it was superimposed on some underlying infection.
Also, taking painkillers for a few days is a good idea, since you are in such agony.
Using the stimulatory device over the clothes, and not directly on the clitoris, could not have given rise to such severe symptoms. Also, the burning would be pinpoint, and not swollen as it has. There is definitely an infective pathology going on somewhere.
Kindly go by the prescription, await the tests, and meanwhile if compresses and painkillers help you take the pain better, go ahead and use them

Take care and hope you get well soon enough.
Would love hearing from you anytime
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Follow-up: Swollen and painful clitoris. How to get relief? 19 hours later
Good Morning,
I called around town and did get the Zovirax cream and a box of gloves to apply to medication per the information handout yesterday afternoon.

So I don't know if I told you, but the morning after I took Diflucan and two doses of Valtrex the swelling of my labia had gone down completely and my clitoral hood had decreased in size. The only alarming thing was that the lesion had ruptured, and it's been leaking bodily fluid since; a combination of blood and clear fluid. Sexy right? I did not see any puss, but it did rupture in the middle of the night. The only time I did note any white discharge was Wednesday night. I found some crusted by my labia and some in the crotch of my pants.

Today the swelling has gone down even more, so I feel like I am healing and that's good news. I am applying the Zovirax every 3 hours. I wash my hands before and after and do wear the gloves I bought.

I know there is the possibility of this all being an abscess that has ruptured and draining, but to brace myself for the worst case scenario I'm trying to wrap my head around the likelihood that my condition is indeed herpes. So here is my follow up question:

I am terribly concerned that I will spread this infection to other parts of my body (i.e. mouth, eye, nose, etc). I'm washing my hands and trying to only use my pinky fingers to scratch anything that may itch. It's kinda like now that I'm afraid to touch my face, it itches all the time. I know it's just in my head. What can I do to decrease that likelihood.

My husband is convinced that what I am going through is not genital herpes. He thinks it's a yeast infection gone terribly wrong. Which is great because I need the support and I REALLY don't want that virus in my for the rest of my life. Since we've been together for 6 years and none of our previous partners have ever contacted us about herpes, we are crossing our fingers and toes that it is something else.

Just stinks that it takes so long to get test results back. The first panel (other STDs, yeast, etc) will come back in 3 days but the HPV will take an additional 1-2 days.

Anyway, I'll keep you posted.
Oh the other thing I forgot to tell you was I did take two hot baths on Friday. I found that to be more of a relief than the cold compresses. And since my lesion, abscess, what have you ruptured Friday night/Saturday morning, I have not been in much pain, so I haven't had to use anymore lortab. I can actually close my legs and walk like a normal human being. The open sore is a little sensitive, so there is mild discomfort when I am applying the Zovirax cream. I plan on wearing loose fitting clothing until my sore heals completely.
Thanks for all your help.
Answered by Dr. Aarti Abraham 1 hour later
I am glad you are out of pain.
Well, the conundrum will only be solved with the results.
It could be a drained abscess that provided obvious relief after rupturing, particularly since you noticed the pus, but the sore lesion is still there, and the fact is that it responded to anti herpes medication.

Discuss genital herpes with your partner and decide together on the precautions that suit you best. When you have symptoms of genital herpes, avoid skin-to-skin contact with the affected area until all of the sores have healed.
Use condoms. Condoms provide good all-round protection from STD's. They also offer useful protection against asymptomatic shedding, by covering and protecting the parts of the body that are the most likely sites of transmission. Latex Dental dams reduce transmission during oral sex.

Although the chance of transmitting HSV-2 to areas other than the sacrum, thighs, buttocks and genitals exists, it is not very common. However, HSV-2 can spread to non-genital regions of your own or someone else’s body. The virus can spread by touching the infection and then transferring the virus particles. Besides the genital region, the mouth, fingers and eyes seem to be the most vulnerable. This risk increases:
When the recipient’s immune system is compromised
If there is a tear or break in the skin allowing easier access for the virus to gain entry
During the first herpes outbreak, before the body has time to build up sufficient antibodies . Till you get the results and till the antiviral medications clear up the current infection, it is best to use gloves if possible, while touching the area, engage in frequent hand washing , and avoid touching other areas of your body, face etc. without vigorous and thorough hand washing.
Herpes virus, when shed, is a very hardy one, and can survive outside the body for upto a week. Please ensure complete sterilization and isolation of bed linen, face tissues, hand towels etc.
Take care, and lets hope you turn out to be alright.
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