Brief Answer:
Few causes may be the reason for the irritation, treatments recommended

Detailed Answer:
Hello and welcome to 'Ask a Doctor' service.

I carefully read your query. I understand the distress with the local irritation you are experiencing.

There are a few conditions to consider as the possible cause of your local irritation.

First of all, a good examination with a vaginal speculum examination by a doctor is the best way to know the cause and the proper treatment.

Yeast infection can sometimes be a cause, Monistat would be expected to have helped in the case of a yeast infection, sometimes oral Fluconazole is needed to help with a genital yeast infection so taking Fluconazole 200mg as a single oral dose might be helpful for yeast infection.

Another possible cause is local dermatitis, if you use any chemicals locally any soaps or cosmetics that contain perfumes, these might irritate and cause dermatitis so you will need to use only warm water to wash the genital area during the day and avoid any shampoo or soap locally. Some steroid cream twice a day (Hydrocortisone) twice a day may be tried to reduce local irritation.

Vulval atrophy is another possible cause of symptoms due to lack of estrogen so having some vaginal lubricants and vaginal estrogen creams might help reduce your symptoms.

To conclude I would recommend you to:

- use Fluconazole 200 mg single oral dose (may require a prescription from the local physician)
- use local Hydrocortisone cream twice a day in the vulval area for 1-2 weeks
- avoid any washing products locally, wash only with warm water
- wear cotton underwear (that you change daily) to avoid irritation
- use vaginal lubricants and vaginal estrogen creams to help with vaginal atrophy along with the local symptoms and irritation it may bring.

I hope this answers your query.
Let me know if I can assist you further.

Regards,

Dr. Antoneta Zotaj,
General and Family Physician

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