Hi, @harper2018 - that sounds very uncomfortable with the vulvar varicosities. Here is a Mayo Clinic article on that topic that may be useful. Though it says that these occur primarily in pregnancy, the information and information on relief would be relevant.
https://www.mayoclinic.org/healthy-lifestyle/pregnancy-week-by-week/expert-answers/vulvar-varicosities-during-pregnancy/faq-20419426.

I'd like to introduce you to @dawn_giacabazi @growyourflow and @predictable, who may have some thoughts for you.

I'm wondering when you mentioned you have chronic fissure, are you referring to chronic anal fissure? You also mentioned that you initially thought the ache in the vulvar region and pain in the back of the thighs may have been due to a herpes outbreak, and that the antiviral that can be used for herpes-related infections, valacyclovir (Valtrex), was not providing relief. Has herpes now been ruled out by your nurse practitioner?

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