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Dr. Andrew Rynne

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What causes burning sensation, severe stinging pain and itching in vulva area?

Answered by
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Dr. Ramadevi Wani

OBGYN

Practicing since :1985

Answered : 1280 Questions

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Posted on Fri, 11 Sep 2015 in Women's Health
Question: I have been having a problem in my vulva area for a few months now. \it started with an uncomfortable feeling as if I had a slight burning down there but there was no inflammation. I have visited several GPs, the first did a thourough examination, swabs tested and urine sample, all came back clear, she suggested it may be nerve pain and prescribed 10mg amitriptilyne. Then had full pelvic scan which also came back clear. Pain then went away totally for 2 weeks. Completely baffled I did some internet searching on interent and came up with the condition "Vulvodynia". In the meantime the pains started to creep back, stabbing like needles, feeling like sitting on glass and an unbearable itch, feels like someone has used sandpaper on my vulva. Was getting me very down as doctors would not diagnose anything. Went to another GP last week just told me to up the dose of amitriptilyne to 20mg and use Lanacane bought over the counter. Should I be a little more patient? I see on the internet sites I have visited that this condition can last for years. Any advice would be greatly appreciated as I am a very active person and it is difficult at the moment to continue with the things I enjoy. Also I do not want to become depressed about it never going away. Please help!!
doctor
Answered by Dr. Ramadevi Wani 1 hour later
Brief Answer:
Details below.

Detailed Answer:
Hi,
Welcome to Healthcare magic.
I am Dr Ramadevi Wani. I will be answering your concerns today.

From your notes it appears that you have vulvodynia.
Do you have any white /purplish /red patches on the vulva? In that case it is important that vulval skin biopsy is done to exclude lichen sclerosis and lichen planus.

Consult your doctor and gradually increase the dose of Amitriptilyne until the pain totally disppears. You may need these medications for 3-6 months.

follow these tips too:
- Wear cotton undergarments
-Wear loose trousers
-Use dermatologically tested detergents
- Practise relaxation techniques like yoga/ meditation.
-keep the vulva clean and dry

Be patient and be positive.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Ramadevi Wani 19 minutes later
Many thanks for your reply. I have no discoloured patches on vulva, just recent irritation slightly red where I was scratching recently. I will follow up with the doctor about increasing the dose and I will try some relaxation exercise. I maybe make it worse by worrying that it will never go.As you can see from previous notes, it was something that came on gradually. In your experience do people usually get over this? I am quite good at managing the discomfort but struggle sometimes and get rather down.
doctor
Answered by Dr. Ramadevi Wani 6 hours later
Brief Answer:
Details below.

Detailed Answer:
Hi,
I am sorry for the delay in replying.
Got busy with the duty.

I like your positive attitude.
Yes please consult your doctor to increase your medication.
Yoga/meditation definitely helps not just for the pain but for your general wellbeing.

In my practice I have seen it being resolved/drastically reduced frequency of episodes in more than 80% of cases.
Are you sexually active? If so, if sex is painful, apply 5% lidocaine ointment on the vulva 20 minutes before sex.
You can also try physiotherapy with TENS or acupressure.
Talk to your doctor and get a referral for cognitive behavior therapy. In these sessions the therapist will educate you regarding how best the pain can be managed by changing your outlook to this pain.
Believe me, women like you with positive attitude can definitely get over it.

If you have further concerns, do write to me. I will be happy to answer.
Best wishes,
Dr Rama
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Ramadevi Wani 14 hours later
Thank you that is encouraging after reading all the doom and gloom of people being disabled for life and nor being able to do anything!!! I know the internet can be fatal for things like that but you come across it sometimes by accident when you are searching for advice.
I had a terrible episode of itching last night that woke me up, I tried so desperately not to scratch, cold water compress ect, but I awoke this morning with my vulva raw and rather swollen, any ideas on how to stop the itch at night??
Also I am in UK I dont think we have lidocaine 5% over the counter only Lancaine 3% can the GP prescrible a higher dose of anasthetic cream??
Thank you for your patience XXXXXXX (Scotland. UK)
doctor
Answered by Dr. Ramadevi Wani 51 minutes later
Brief Answer:
Try antihistamine like Zyretec and estrogen cream

Detailed Answer:
Hi Miss XXXXXXX
Welcome back.
Discuss with your doctor and try the following:
-Try taking antihistamine like Zyretec at night and see if it helps to itching. Keep a gap of 4 hours between this tablet and Amytryptiline.
-Some people get relief with estrogen cream too. Initially for a week you can use daily and later twice weekly and weekly.
Yes, the GP can prescribe higher dose of anaesthetic cream.
If you have further concerns do write to me.
Best wishes,
Dr Rama

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Ramadevi Wani 5 minutes later
Thank you, you are very helpful, I will see GP for prescription XXXXXXX
doctor
Answered by Dr. Ramadevi Wani 6 minutes later
Brief Answer:
Thanks for trusting Healthcare Magic.

Detailed Answer:
Hi Miss XXXXXXX

You are welcome.

Wishing you good health always,
Dr Rama
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Ramadevi Wani 2 days later
Good Morning

I went to see the GP on Wednesday, I told him the irritation had got worse and was very painful and itching day and night. He has put me on 30mg of amitriptilyne and prescribed on ointment called Uniroid _ HC Hydrocortisone, cinchocaine hydrochloride. I applied it last night as my vulva and surrounding skin was broken and inflamed and very sore to sit. This morning the inflammation had gone almost completely, the itching very minor and no sign yet of nerve pain ( a bit early I know and it may appear later today) but right now I feel more comfortable than I have in weeks. The GP said it is an ointment for hemmarroids, but it is so much more effective than the lidocaine. I will continue to be patient and try not to focus on any pain and hopefully it will disappear!
best regards XXXXXXX
doctor
Answered by Dr. Ramadevi Wani 8 hours later
Brief Answer:
Good to know Conchocaine is working

Detailed Answer:
Hi Miss XXXXXXX

Welcome back.
Great news. Very happy to know that you have good response with Conchocaine.
Use it as and when required.

I hope this pain responds to 30 mg of Amytryptiline. If not the dose can still be increased further .

wishing you good health always,
With regards and best wishes,
Dr Rama
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Ramadevi Wani 3 days later
Hi Dr XXXXXXX

I have had 3 good days after using the Conchocaine. Only really using it twice a day. The stabbing pain has gone for now, so I guess the amytryptiline has started to work. Getting a peculiar sensation down below though, as if everything is sticking together and now had again the feeling that something is cutting into me. I would describe it more as irritating as opposed to painful, it also feels slighty tingly like pins and needles, not all the time but intermittently. Is this quite normal or should the drugs cut out the abnormal sensations completely? Should this all disappear quite suddenly or more over a period of time?
Many thanks XXXXXXX
doctor
Answered by Dr. Ramadevi Wani 11 minutes later
Brief Answer:
Yes, Amytryptiline has started acting.

Detailed Answer:
Hi Miss XXXXXXX

Yes, Amytryptiline has started acting.

With medications the symptoms take some time to disappear. They don't disappear suddenly.

Miss XXXXXXX I suggest you discuss with your doctor regarding cognitive behavior therapy and get a referral for the same

I suggest you practice yoga and meditation too. Please join a good yoga class for 6 months. It really helps in managing this pain and improves your general well being. If you do not like it, you can always discontinue after 6 months.

Wishing you the best health always,
Best wishes,
Dr Rama
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Ramadevi Wani 18 minutes later
Thank you,

I am a very positive person, not someone who worries. I don't have to see the GP for a week or two yet as he wants to see if this prescription works which is fine. It is great to speak to you as I know you are a specialist. The discomfort is so much less than before and I have been to a CBT who gave me a lot of pelvic floor exercises so maybe that has helped. I would love to go to a yoga class but we live quite far from the town so is difficult. Maybe I will get a DVD and do it at home. Thanks for your continued support, so much better than remembering the 20 questions to ask the GP.

Best wishes XXXXXXX
doctor
Answered by Dr. Ramadevi Wani 7 hours later
Brief Answer:
Check yoga and meditation in you tube too.

Detailed Answer:
Hi Miss XXXXXXX

Being positive is extremely important in life.
Happy to know that things are working positively for you.
You may check on you tube for yoga lessons or Google regarding which DVD's to buy. Please check on you tube regarding meditation too. It helps.

I am not aware which ones are good sites as I do yoga under Gurujis ( teacher) guidance.

If you have any further concerns, I will be happy to answer.
Wishing you good health always,
Best wishes,
Dr Rama.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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