vulva issues

Posted by unknownclock58 @unknownclock58, Feb 19 9:55pm

For the past 9 months I have been dealing with a persistent ulcer that recurs with some regularity. It seems to happen if I wear jeans or some pants that cut into my crotch, or I scratch my crotch (yes it itches a lot)
I am post menopausal age 65 and never had problems like this before. The ulcer will clear up usually after about 7-10 days then will pop up again after a week or so. The itching though never really stops. It's driving me crazy! I've tried every ointment from diaper rash (which works best when the ulcer first appears) When the ulcer is basically like a water blister it hurts a lot when I use the bathroom! To the point that i have to keep water streaming on it or keep a cool washcloth nearby. I have searched the entire web for this and it seems to be one of 4 things, Herpes, lichen sclerosis, or vaginal atrophy, or worse cancer.
Anyone else have this happen or any experience with this, any help is appreciated!

Interested in more discussions like this? Go to the Women's Health Support Group.

Possibly Lichen Sclerosis. Check the symptoms. It should be monitored by your doctor. Thr Dr. Prescribed... Taro Clobetasol 2 x per week. There is a very informative Facebook support group. Also check on Instagram for specialist in this skin condition Dr Jill Krapf

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@blrdot

Possibly Lichen Sclerosis. Check the symptoms. It should be monitored by your doctor. Thr Dr. Prescribed... Taro Clobetasol 2 x per week. There is a very informative Facebook support group. Also check on Instagram for specialist in this skin condition Dr Jill Krapf

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Yes, I just joined this group too. They seem to have frequent Zoom calls (2x/week at least?), though I haven't done that yet. (lssupportnetwork.org) Also, the Women's Gynecological Cancers Support Group here on Mayo Clinic Forum (1x/month Zoom call - just register here through main Mayo Clinic Connect under Support Groups, or search for this group on Mayo & register to get notice of monthly calls where you can remain anonymous, if preferred)

I've tried to research this a lot too - credible research sites, government and higher education sources. NIH.gov (National Institutes of Health - e.g. https://pubmed.ncbi.nlm.nih.gov/35285455/), Mayo Clinic, Cleveland Clinic, professional publications such as the Journal of Lower Genital Tract Disease (may require purchase of articles - not inexpensive - read the Abstracts when available for a summary of the findings), and more.

If I can provide more, please let me know.

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@emo

Sure. My cysts come and go; I have one that lingers and changes sizes. They can be painful if irritated by my clothing or when they swell up, but it sounds like not as painful as yours.

My gynecologist did tell me cysts like the one I have that lingers is common and can be a response to any kind of “trauma” to the skin. She said there’s not much she knows of that I could do except have it removed, but I decided to observe it to see if it improved, which it did. I’m going to have my dermatologist look at it.

So this sounds similar to what your physician said.

The thing is it’s hard to tell if it is or isn’t caused by steroids. For the fluid-filled type of cyst I just described that I have, I don’t thinks that’s associated with steroids. I thought that acne-like lesions are more associated with steroids and even then it’s more with oral steroids than topicals (I know this because my dad is on long term oral steroids for a different condition).

Even if they are or aren’t related to the steroids or the LS, clearly they’re very painful for you. Were they able to recommend anything to help you with the pain, or do you think it would be better to talk to a dermatologist with experience in vulvar skin conditions? I can understand how it would be frustrating if they’re just saying: “It’s not this thing or the other and usually it’s not painful.” Except you’re you, and they are painful!

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I finally have an appointment, unfortunately not until June, with a gynecologist who specializes in painful, more unusual vulva problems. Will check for cancellations she may have before then. I'm hoping she will have some answers about this. Doctors are much too quick to diagnosis a condition based on what is most familiar to them. But when 15 minutes is all the time you get with doctors, in todays environment, there's no time for a much more. I was insistent the doctor I saw last month listen to what I was saying. They just don't listen or discount what is being said to them too often. So irritating..

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@brandysparks

Hi! I was advised to use the Clobetasol to manage the LS when it flared up (often related to increased stress levels). I think pretty early on I was also advised - in so many words - there was no cure to remove LS, and the words became clearer after decades with this condition.
Now I am 3-1/2 weeks into recovery from a surgical procedure called "laser ablation (with plasma jet)" to remove the 1st layer of skin in the vulva, due to the diagnosis of "vulvar intraepithelial neoplasia" (VIN II/III), a precancerous condition, with another, slightly deeper biopsy to be taken in < 3 weeks for a more troubling spot, but hopefully not cancerous!
So, in summary, at least from my journey, the Clobetasol propionate 0.05% ointment is for managing, and is not a cure.
Best wishes.

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You are so brave, that sounds incredibly painful. So far, I've refused to even have a biopsy, but think that is what I'll be doing next .

Best wishes to you on the next biopsy.

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@alju

I finally have an appointment, unfortunately not until June, with a gynecologist who specializes in painful, more unusual vulva problems. Will check for cancellations she may have before then. I'm hoping she will have some answers about this. Doctors are much too quick to diagnosis a condition based on what is most familiar to them. But when 15 minutes is all the time you get with doctors, in todays environment, there's no time for a much more. I was insistent the doctor I saw last month listen to what I was saying. They just don't listen or discount what is being said to them too often. So irritating..

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Totally agree, this is why I have been actually trying to diagnose this myself. Vulva issues are notoriously hard to diagnose. I'm going to get the Herpes test and I now have a RX for Valtrex. But the longer I stay on this Vagifem the better my issues are getting I'm nearly 2 weeks symptom free, been using Vagifem for a little over 4 weeks, and I am splitting the pills in half so I'm only using 5mcg per does. Things are happier down there!!!

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@vlharvey

Hi, Thank you for being open about this, it's helpful, and I don't have contact with doctors who want to help. What is the Loratadine? and what is it used for? It seems like youre saying it's an antihistamine. I take oral estrogen and have for 20 years, but don't know about a vaginal estrogen. is it a prescription, and what is it called?
I contracted herpes in the late 70's and haven't had many outbreaks. I can guess when my stress level is high enough to bring it on, like a move across country. But being familiar with the dease doesn't make me sure that's what this first commentor has.
The first time I was told I had vaginal atrophy I told the doc he was sexist, lol. Now I have more information but it is a terrible name. Having atrophy doesn't necessarily mean there is a itching symptom. When I have had itching, or irritation, I have been tested for a infection (not sexually transmitted) and treated with antibiotics. It is hard to get rid of completely and many older women live with a bacterial infection without being treated. That is sad to me, it doesn't have to be tolerated if we can find doctors who will keep looking for answers too.

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Are you on estradiol vaginally? A lot of what you describe may be dead cells sloughing off. My discharge requires a pantry liner. And then if you get an additional vaginosis it’s hard to detect. Because it seems your ordinary discharge is a bit more. I use Vagifem twice a week. Kind of pricey but I loath that icky cream.

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@pb50

Are you on estradiol vaginally? A lot of what you describe may be dead cells sloughing off. My discharge requires a pantry liner. And then if you get an additional vaginosis it’s hard to detect. Because it seems your ordinary discharge is a bit more. I use Vagifem twice a week. Kind of pricey but I loath that icky cream.

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Yes, I use Vagifem I still have a ton left from last year. They told me to stop using it when I was diagnosed with breast cancer. Then hey put me on estradiol cream over the summer but i quit using it because it also burned. I actually split the pills and I am using 1/2 the dosage. As far as price I get my vagifem through canada and i get name brand for less than the generic here. I get 36 tablets for about 70.00.

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@alju

I finally have an appointment, unfortunately not until June, with a gynecologist who specializes in painful, more unusual vulva problems. Will check for cancellations she may have before then. I'm hoping she will have some answers about this. Doctors are much too quick to diagnosis a condition based on what is most familiar to them. But when 15 minutes is all the time you get with doctors, in todays environment, there's no time for a much more. I was insistent the doctor I saw last month listen to what I was saying. They just don't listen or discount what is being said to them too often. So irritating..

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Definitely irritating. I hope that the dermatologist will be more helpful and a better listener.

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@alju

You are so brave, that sounds incredibly painful. So far, I've refused to even have a biopsy, but think that is what I'll be doing next .

Best wishes to you on the next biopsy.

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@alju Appreciate your reply and your well wishes!

May I recommend that you request your doctor use a numbing cream BEFORE the pre-biopsy injection to ease the pain of the injection - which for some of us is the only painful part of the very important process?

I'd ask you to verify the actual name, but as I was lying there I heard my kind GYN ask her assistant to get out the "HurriCaine" gel to numb the area. I see that is a name for an oral gel, but whatever the name, the numbing gel is both a psychological and physical balm.

It is over quickly, and communicate with your doctor during the process, as she/he should expect, to gauge how the numbing is going, and making sure you are at minimal discomfort, if any.

I hope this may help, and let us know if you'd like to follow-up with us here to see how it goes. Staying ahead of these things is calming, as is reading reputable sources (*.gov, *.edu sites, and *.org sites that are for professionals in the field).

Hugs, too!

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@brandysparks

@alju Appreciate your reply and your well wishes!

May I recommend that you request your doctor use a numbing cream BEFORE the pre-biopsy injection to ease the pain of the injection - which for some of us is the only painful part of the very important process?

I'd ask you to verify the actual name, but as I was lying there I heard my kind GYN ask her assistant to get out the "HurriCaine" gel to numb the area. I see that is a name for an oral gel, but whatever the name, the numbing gel is both a psychological and physical balm.

It is over quickly, and communicate with your doctor during the process, as she/he should expect, to gauge how the numbing is going, and making sure you are at minimal discomfort, if any.

I hope this may help, and let us know if you'd like to follow-up with us here to see how it goes. Staying ahead of these things is calming, as is reading reputable sources (*.gov, *.edu sites, and *.org sites that are for professionals in the field).

Hugs, too!

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Thank you for the suggestion. It's very likely the first thing I'll want to discuss is the anesthetic , etc. I am not a very stoic patient, unlike some of you ladies who are amazing. Best to you.

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