Appointment with dermatologist went well!

So the result of my dermatology appointment (with elizabeth derrick at brighton general hospital), is I apparently have both unprovoked and provoked vestibulodynia, slight vaginismus and sensitive skin that becomes inflamed after pressure. She actually knew what she was talking about, was very knowledgeable, understanding & was very easy to talk to, she had a sense of humour too which helped make me feel much more relaxed !

First she asked me for a bit of background info about when I first noticed the pain and if Id had an infection or illness or anything traumatic had happened, not just gyneacoligally, any stressful life event (I hadn't, but had a Uti and was on pill) She then asked me who I had seen before, what things I'd tried etc. She asked about any allergies or if anyone in my family had any excema/skin conditions etc (which they don't. ) she then asked to look at my elbows ( :S ! Haha ) but couldn't see anything abnormal.

Then she examined me and used the tip of a cotton bud to press on areas, asking me to rate out of 10 each area. Most areas she pressed weren't extra painful on top of the constant burning I have but a few points were about 7/10 and the whole area felt very tender. She also inserted a finger into me and felt about! She moved it slightly side to side to see if that was uncomfortable which it was, but not unbearable. Then I got dressed and she discussed with me what was going on. She also did something interesting, she asked me to give her my arm and lightly scraped me with her pen. About half a minute later the area came up very red. She said this was very interesting because it meant my skin was very sensitive to pressure and the histamine released causes the redness. My arm is still a bit sore! She thinks this is also the case with my vagina and that even the slightest pressure could aggravate me. She emailed my GP to tell her opinion of it and also recommended referral to a gyno-physio. Also she suggested that I massage the area and try to relearn what it feels like to not have pain down there. Also suggested dilators and even check out Ann Summers vibrators... :/ not too sure haha, & using lidocaine and lube when having sex. She wants me to up the amitryptline to at least 50mg a day and use lidocaine ointment 2x daily. She said at night you can soak a cotton ball in the lidocaine and insert into vagina. I am feeling very positive and pleased someone had actually understood!

Hi Tinkerbelle! That is great news. Hearing this has made me think I'll take myself off to a vulval dermo. Mine pain/discomfort is only on my pubic hair areas - literally, only where the hair grows, so I'm starting to think it's more skin related than anything else. I'm up to 50mgs of ami too - it's much more uncomfortable than 20mgs so take your time getting up there! The 40mgs - 50 mgs progression was my hardest to get used to. Actually, I did read somewhere that ami has antihistamines in it which is probably why she told you to go up.

It's so hard to tell if it's working, but I'm giving it till beginning of March and if it's not working enough by then, I'll swap to Lyrica.

While we're on the topic - does anyone else only have pain on their pubic hair areas? The women's health physio I saw was really confused by this. Especially as when I have a Brazilian wax I'm pain free for about a week until the hair grows back. Anyone else had this?

Yay Belle, that appointment sounds like it went wonderfully! And there's definitely a lot to be said for re-training your brain regarding sensations from the vaginal area -- I've seen some ideas that chronic pain can result from a misattribution of pressure signals in the brain. Re-training with dilators is the easiest way to do this, because you can choose whichever size is 100% comfortable and work up from there (some patients start with the very very smallest one, which is about the diameter of a pencil, but everyone is different!). It's almost like training for a long distance race, you push yourself to a level such that you are a little past the comfort zone, but NOT in pain, such that you acclimate to newer and higher limits.

As far as the amitriptyline goes, one of its two primary mechanisms of action IS via antagonism of multiple histamine receptors in the body. This is responsible both for its anti-inflammatory and its anti-depressant effects.

Georgia, one thing I've been told is that if you have any kind of pain like vulvodynia/vestibulitis/etc, to refrain from shaving/waxing pubic hair and to just trim instead. The idea is that it might contribute to local inflammation to shave or wax, especially as hair growth returns. Does the pain persist for a long time after the pubic hair grows in, or is it more of an immediate effect?

Yes dilation helps IF its muscle problems. Mine was all nerves and dilation did nothing until after my surgery. But it sounds like you're onto something here so let us know how it works! I used my vibrator after surgery in lieu of dilators and accidentally left it in the shower and my cleaning lady saw hahaha EMBARASSING!!!

Sounds so positive Tinks, you are moving forward how wonderful, my best warmest wishes are with you xxx

Alana, that is funny!!!!   I don't know if dilating would work for me either, unless I'm burning really bad I don't actually have a problem with sex, although I am sometimes too clenched up at first but I usually relax. Surprised she thought I had a slight vaginismus though!

Georgia and Allesandria, I didn't know that about ami containing antihistamine, very interesting! Thanks for the support , If I have no luck with the ami after a few months I too will ask to try Lyrica.

Georgia I definitely recommended you give it a go with a vulval dermo! It's good to see a broad range of specialists to get different opinions and treatment ideas. She did seem keen for me to try again with lidocaine although I haven't found it that useful in the past, it really stings and barely seems to numb, but I'll persevere! She said it's not just to control pain synptoms, it's to re-programme the nerves to stop feeling pain at all.
And about the pubes, I often come up all spotty and rashy after shaving and it can feel sore and very itchy. I used to shave EVERYTHING all off but now I tend to just leave it au naturel and just shave bikini line if I'm on holiday or going swimming! I have attempted both waxing myself and epilating and that will not be happening again!!!!!!!!!!!! ha!

Hi Girls!

Thanks for all your help and replies!

Alessandria, come to think of it when the hair grew back it was a bit more painful than it should have been, although it's too tempting being pain free when hair free!

Tinkerbelle, yours and mine sound so similar, I'm definitely going to see a dermo. I've not been prescribed licodaine but a while ago I bought some over the counter and it definitely helped. Thanks for posting!

I've also being trying the sudocream this week! I don't know if it's the ami or the sudocream but something is helping!

Woo that's positive Georgia! Xx