[39F] With persistent unilateral vaginal pain and history of significant labial swelling

What might be happening

Based on the information you have provided, here are some possible explanations for your symptoms:

• Recurrent Bacterial Vaginosis (BV) or Vaginal Infections: Even though your tests have come back normal, it's possible that a low-grade infection is persisting or recurring. BV and other bacterial infections can sometimes be resistant to certain antibiotics or may require a longer course of treatment.

  • Treatment: Typically involves a longer course of antibiotics or a different type of antibiotic. Probiotics and maintaining good vaginal hygiene can also help.

• Vulvodynia: This is a chronic pain condition affecting the vulva, which can cause burning, stinging, or irritation. The exact cause is often unknown, but it can be triggered by infections, hormonal changes, or nerve damage.

  • Treatment: May include medications such as pain relievers, antidepressants, or anticonvulsants. Physical therapy and counseling can also be beneficial.

• Bartholin's Cyst: Although the ER did not find anything to drain, a Bartholin's cyst can cause significant swelling and pain. These cysts can sometimes become infected and require antibiotics.

  • Treatment: Warm sitz baths, pain relievers, and in some cases, surgical drainage or removal.

• Chronic Pelvic Pain Syndrome: This condition can cause persistent pain in the pelvic region, including the vagina. It can be related to various factors, including muscle tension, nerve pain, or previous infections.

  • Treatment: May involve a combination of medications, physical therapy, and lifestyle changes.

What you can do

While it's important to consult with a healthcare provider for a formal diagnosis and treatment plan, here are some steps you can take to manage your symptoms:

1. Maintain Good Hygiene: Keep the vaginal area clean and dry. Avoid using harsh soaps or douches that can irritate the area.
2. Warm Sitz Baths: Soaking in a warm sitz bath for 15-20 minutes a few times a day can help alleviate pain and discomfort.
3. Avoid Irritants: Wear loose-fitting, cotton underwear and avoid tight clothing. Also, avoid using scented products in the vaginal area.
4. Pain Management: Over-the-counter pain relievers like ibuprofen or acetaminophen can help manage pain.
5. Probiotics: Consider taking probiotics to help maintain a healthy balance of bacteria in the vagina.
6. Track Symptoms: Use MDandMe to journal your symptoms, track progress, and share longitudinal medical notes with your provider. This can help identify any patterns or triggers.

What you should look out for

Reasons to see a doctor more urgently include:

• Severe Pain: If the pain becomes unbearable or significantly worsens.
• Fever: If you develop a fever (temperature over 100.4°F) or chills.
• New Symptoms: If you notice any new symptoms such as unusual discharge, bleeding, or swelling.
• Ineffective Treatment: If the current treatment plan is not providing relief or if symptoms return immediately after stopping antibiotics.

Remember, while this information can help guide you, it is not a substitute for professional medical advice. Please consult with a healthcare provider for a thorough evaluation and appropriate treatment.