Doctors...Where to Start?

Hi all!

[Skip ahead to the bottom for my question; the rest is just background.]

I've had vulvar vestibulitis for over five years (I'm 26), and have had the ups, downs, and further downs that I'm sure all of you can relate to. At the moment, my only treatment plan is lifestyle adjustment:
- the Mister and I haven't had sex in five years, and lately, ANY sexual activity is just too scary for me
- I don't (nor have I ever!) use any scented products (laundry detergents, personal cleansers, hand soap, etc, etc)
- I no longer use tampons (just cotton-based pads)
- I gave up panties (save for those times when the pads are in use), and instead wear boxer-briefs (no touching, and when they do, it's 100% cotton)
- I don't bike or engage in much exercise, and I sit awkwardly and re-position myself often
- Lidocaine (2% gel) for the times when I really need it
- (there are probably lots more things I'm not thinking of; it's mostly second-nature at this point)
*I followed the low oxalate diet strictly for a year, with no noticeable change, so I stopped (limiting oneself to so few foods proved damaging to my well-being, and with no beneficial effect, I had no reason to stick with it).

So here I am now, in particular pain because of what I believe is a post-menstrual yeast infection on top of the vulvodynia, and I feel just utter hopelessness and despair over what to do next (I'm overwhelmed, and the pain itself is overwhelming, leaving me feeling paralyzed). I have a referral to a dermatologist who apparently specializes in vulvar pain, but all of my gyn. appointments have yielded little visible irritation, and I'm worried I'll be dropping a ton of money to just hear "Well, it's not x, y, or z dermatological condition." I've heard many of you mention pelvic floor muscle physical therapy, so I suppose I should try that next? (I'm also looking into seeing a neurologist, and maybe trying Neurontin; I have Raynaud's and Erythromelalgia, so it would be a "three birds with one stone" kind of deal.) In the meantime, though, what can I do about the [potential] yeast infection? Usually, I do nothing, and grit my teeth and wait for a week or two for things to settle down, because
a) much of the time, the doc just says, "No yeast. No bacteria. I guess it's just the vulvodynia," and
b) is there any way to get an exam without getting "an exam"? Especially in this increased pain, there is NO WAY I can handle an exam -- speculum or not. (And it's not just during, but AFTER. If it was only "during" that I felt pain, I'd take some pain meds and grit my teeth. But since the pain from an exam lasts for DAYS afterwards, I just can't deal with that.)

Any suggestions for a desperate sufferer?

Hi and welcome, if you suspect yeast simply buy an over the counter oral treatment and take it, if it is a yeast infection that will help and if not it won't hurt, it's the easy way to figure that problem out without having swabs etc. There isn't a way to get an exam without having an exam unfortunately, can't help you much with that one! Physical therapy is a great idea, the pelvic floor is usually dysfunctional in women with V so biofeedback is a good start but also all the muscles around the pelvis should be examined and the position of the pelvis too in case there's any misalignment. Meds can help some women, I'm on Ami and Lyrica but not having much success with either but it's worth a try. It sounds like you've not tried alot of things so far so don't give up hope, get an oral yeast treatment, try the meds and get your pelvic floor checked as a starting point. Let us know how you get on.