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A few questions first to clarify your concern:
1. For how long has this been going on?
2. Have you had a biopsy of the vulvar done?
3. When the pain started were you having any accompanying irritation, itching, discharge? if so describe?
4. What medical conditions do you have?
5. Did the onset occur after a new medication was started, i.e 3-6 weeks before onset? if so what is the medication?
Thank you for your response.
So as I understand your responses, no biopsy has been taken to date. This would help arrive at a diagnosis & I strongly recommend you ask for one as t might pinpoint the underlying cause. The vulvar area can get irritated from normal activity as we get older because the tissues become fragile as the amount of estrogen decreases. For women after menopause this can be an ongoing problem. Vulvar pain can be due to irritations on the surface of the skin but also underneath. I strongly advise a skin biopsy to make sure there are no underlying abnormalities (aka dysplasia) that can be contributing to your discomfort.
Since the duration is considered to be chronic, it would be helpful for your to take some time to think about what was going on in your life before or around the time of onset. To see if there was anything that could have triggered these symptoms, and then possible help to understand what might relieve them. Triggers can include dietary changes, physical activity changes, change in residence/living, new medicines/cosmetics/other chemicals. While anxiety can cause pain, it is quite possible that the vulvar pain is related to a psycho-social cause. This may be difficult to determine initially and only may truly come to light as you continue to think and ponder about this time 5 years ago.
Finally, if no other cause can be found then the condition of fibromyalgia needs to be entertained. In the evaluation for fibromyalagia a very thorough history needs to be obtained, including the discussion of many of the factors mentioned in the preceding paragraph. A thorough physical examination is also conducted to include nerve and sensation identification. This is often a diagnosis of exclusion and should be treated by a pain management specialist.
Let me know if you have any further questions regarding this question as my goal is to make sure you are completely satisfied with your answer.
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