femalenetwork.com

Hi there! I am a member of femalenetwork.com and I came across a particular area of the site. I am hoping someone can help me. I am afraid of going to gynecologists here in the Middle East because I don't trust practitioners here. I had a gyne in the Philippines, but sad to say I lost contact with her. My problem right now is the area down there (outer labia). I always had this problem before and my great gyne always had a solution for it.

It all started when I went to swim in a pool that did not have chlorine. I thought it was OK and nothing will happen to me, but I was wrong. After a day I had an irritation down there. It was just itchy, and I did not have a discharge like before. However, I could not help but scratch it and that's when I noticed a bump. I don't know what it was and now it's swelling. I don't know what to do. I feel so uncomfortable and it's painful when I walk and sit.

My mother recommended penaten cream and water mixed with vinegar. So I followed it, making some of the soreness go away, and it doesn’t itch any longer. But the pain and swelling is still there. I don't remember what my gyne gave me before, but I recall it was a cream. Please help me.

Vhea

Many conditions can cause itchiness and swelling in the labial area. What would be necessary is to describe the location, character of the discharge, and timing of the symptoms.

To adequately describe the location, you may use this diagram:

 

If it is just the labia majora (or labium majus) and labia minora (or labium minus), look closely using a mirror at the itchy area: do you observe any wounds or ulcers (small excavated breaks in the surface), discharge, or vesicles (clear fluid containing bubble like blebs)? Inspect likewise the inner surface the labia extending into the outer vagina.

If the area is just red but with accompanying white cheese-like discharge then it might be yeast infection. If it has vesicles, it may be a herpes infection. If it has ulcers, find out if it is of infectious origin and check if it is acquired through intercourse. Apart from yeast, bacterial vaginosis (an overgrowth of natural vaginal bacteria called Gardnerella) and organisms such as Trichomonas and Neiserria gonorrhea (the latter two are sexually transmitted) are common causes of vaginal discharge. The treatment for each infection is varied and specific. One suppository, cream, or ointment may not cure all infections. Yeast can be treated with an antifungal cream, ointment, or oral medication such as fluconazole, nystatin, miconazole, or clotrimazole. Vaginosis and trichomonas respond to metronidazole either in tablet form or in suppository. These medications and creams need to be used continuously for at least one to two weeks to be effective. One or two applications will definitely not suffice. Gonorrhea needs an intramuscular injection of ceftriaxone.

If there is a big swelling coming from the lower half of the labia majora region, it might be a Bartholin’s cyst or abscess. Mild infection may respond to antibiotic treatment but if there is abscess formation (meaning the entire gland is filled with pus), it has to be surgically drained through a procedure called marsupialization. This is done under regional anesthesia and helps prevent recurrence.

Lastly, some substances such as chlorine, scented liners, or some types of feminine wash may cause allergic reaction in our vulvar area. These can be treated with steroid cream. However, take utmost care when steroids have to be used. The presence of infections--either superimposed on an allergic reaction because of scratching, or an infection that was wrongly assessed to be an allergy--precludes the use of steroid containing medications because this will aggravate or cause a flare up of the infection.

The most important thing to do, therefore, is to get a good assessment of the condition from a health professional so appropriate treatment can be applied.

 

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