When I went to the head of dermatology at the Civic hospital in Ottawa Ontario for the problem with my vulva the first thing she asked me was whether there was any asthma in my family, and I thought she is not talking about the right part of my body problem but I agreed there was asthma in my family. The second question was whether there was any eczema in my family, and again I agreed there was. Third question was whether I had ever had any surgery on the vulva and I agreed that there was because some parts of the labia had sort of grown together and had to be stitched back. Then she examined me and told me that I had a condition callled Lichen Sclerosis that was causing the pain in my vulva.It is an autoimmune disease that is most likely inherited. She told me it was incurable but medication could help. We tried lower doses of Lyrica but they were not sufficient. Seems only the higher dose worked for me. Also, if I try to lower the dose the pain comes back. Maybe you should try that along with the amitriptlyine and clobetasol. I know how miserable it is to have pain in the vulva. Is also tough on the married life! I used to be so exhausted from suffering the pain all day that by the time I got into bed I just fell asleep with the pain. Now I have another chronic condition related to my ears that is also incurable (tinnitus) only this time there is absolutely nothing that has been developed to cure it or even reduce it in intensity. I do hope that things improve for you. Please let me know how things are going.