Hello, As per your clinical history is concerned, please follow like this: 1) Do a clinical evaluation by your Doctor [Gyn] and do [Cotton swab test] to confirm it and if you have already confirmed by your Doctor then follow as below. 2) Discuss with your Doctor about antidepressant and if itching present then an antihistamine can be reconsidered and [Lidocaine cream during sexual intercourse]. 3) Discuss with your physio for specific exercise plan for pelvic floor muscles. Do follow lifestyle modifications like this: 1) Try cold compresses. Cold compresses placed directly on your external genital area may help lessen pain and itching. Soak in a sitz bath three times a day. 2) Try to avoid tight-fitting underwear. Tight clothing restricts airflow to your genital area, often leading to increased temperature and moisture that can cause irritation. Wear white, cotton underwear to increase ventilation and dryness. 3) Avoid hot tubs. Spending time in hot water may lead to discomfort and itching. 4) Try to avoid activities that put pressure on your vulvae, such as biking or horseback riding. 5) Wash gently. Scrubbing the affected area harshly or washing too often can increase irritation. Instead, use plain water to gently clean your vulva with your hand and pat the area dry. After bathing, apply a preservative-free emollient, such as plain petroleum jelly, to create a protective barrier, use lubricants. If you re sexually active, apply a lubricant before engaging in sexual intercourse. 6) Try an antihistamine at bedtime. This may help reduce itching and help you rest better. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Uday Nath Sahoo