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Good Morning, I Have Posted On Here Before But Could

Posted on Wed, 7 Nov 2018

Question: Good Morning,
I have posted on here before but could not find the answers and then accidentally deleted everything. About 4 years or so ago I have a severe burning, itching in my vulva area, the Gp 4 years ago did all the tests for thrush etc and came to the conclusion that it was possible nerve endings. She put me on 30 mg amitripilyne and gave me an anetstetic ointment. I made the mistake of googling the symptoms 4 years ago and came up with vulvodynia. However, after about 1 month all symptoms disappeared and I have not experienced anything until now, this last 2 weeks. The itcing is awful at night, but not everynight and I have only had 3 episodes of the burn and tingling pins and needles. I self diagnosed myself with vulvodynia and went on the internet to search for some advise. I became very scared and very down when I read that some people have had this for 20 years and some feel suicidal!!! I am thinking that maybe this is just a flare of symptom and that it will go away again. can you please help with my fear and with advice. thank you so much

Answered by Dr. Shinas Hussain (1 hour later)

Brief Answer:
It is just a flare up.

Detailed Answer:
Hello,
Thanks for the query.
"vulvodynia" present with intense pain in the vulvovaginal region, itching is very unlikely.
In your case, the symptoms are more likely suggestive of infective causes like yeast or vaginosis. Other possibilities are dermatological conditions like lichen sclerosis. As you said neurological causes affecting the nerve endings can also give rise to these symptoms.
As of now consult a gynecologist and get a vaginal swab done to rule out infective causes.
In your case, it is flare up and not a chronic cause( so suicide is unlikely!!)
As of now, you can take antihistamines like pheneramine for symptomatic relief. Lignocaine or other anesthetic creams can also be tried.
Wishing all the best.

Above answer was peer-reviewed by : Dr. Nagamani Ng

Follow up: Dr. Shinas Hussain (1 hour later)

Thank you very much for your opinion. I am awaiting an appointment with the GYnocologist. I am not a depressive person but should never have looked at internet, I got very worried that this could be permanent. silly as it went away before, I cannot see any sign of infection there is no discharge and it is not inflamed. I would say the itching becomes unberable at night and goes down to my inner thighs and buttocks. The burning can be bad as well but I don't appear to get all symptoms together

Answered by Dr. Shinas Hussain (20 hours later)

Brief Answer:
Do a swab anyway

Detailed Answer:
Hi,
Anyway better to go for a vaginal swab.
As the symptoms radiates to thigh, neurological causes can also be a possibility. In that case dris like amitryptilline will be helpful.
Wishing all the best

Above answer was peer-reviewed by : Dr. Remy Koshy

Follow up: Dr. Shinas Hussain (19 minutes later)

Hi thank u have u come across this before in yr practice and in yr experience can it come and go ?

Answered by Dr. Shinas Hussain (17 hours later)

Brief Answer:
Given

Detailed Answer:
Hi,
I have seen two cases during my residency.
One was a case of herpes zoster, that comes and goes without much complications.
One was some neurological causes and responded well with drugs like amitryptilline.
Wishing all the best.
Thanks

Above answer was peer-reviewed by : Dr. Nagamani Ng

Follow up: Dr. Shinas Hussain (4 hours later)

I take amitripilyne 20 mg I have the tingling pins and needles and the desperate need to itch every morning, the burning is not there st the moment but I am worried it may stay forever even though it went for 4 years

Answered by Dr. Shinas Hussain (22 hours later)

Brief Answer:
Given

Detailed Answer:
Hi,
Thanks for the followup.
It might settle by itself.
You can take amitryptiline when there is an exacerbation of symptoms,
Wishing all the best.
Thanks

Above answer was peer-reviewed by : Dr. Kampana

Follow up: Dr. Shinas Hussain (36 minutes later)

Is amitripilyne ok to take long term? I have been on for 4 years at 20mg even though symptoms were not there , I’m the fear of it coming back

Answered by Dr. Shinas Hussain (3 minutes later)

Brief Answer:
Long-term use can rarely cause side effects.

Detailed Answer:
Hi,
Long-term use may rarely cause delirium.
If symptoms are not that much severe, you can go for SOS basis rather than daily use.
However, it is a relatively safe drug and many patients using it for years without many complications.

Above answer was peer-reviewed by : Dr. Kampana

Follow up: Dr. Shinas Hussain (2 hours later)

That's good to know thanks you

Answered by Dr. Shinas Hussain (15 minutes later)

Brief Answer:
Thanks

Detailed Answer:
Thanks and wish you good health.

Note: Revert back with your gynae reports to get a clear medical analysis by our expert Gynecologic Oncologist. Click here.

Above answer was peer-reviewed by : Dr. Kampana