[43F] With extreme menstrual cramps, vaginal itching, and swelling

What might be happening

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

• Vaginal Yeast Infection (Candidiasis): This is a common fungal infection that can cause itching, swelling, and discomfort in the vaginal area. While Monistat (an over-the-counter antifungal cream) is a common treatment, it may not always be effective, especially if the infection is severe or resistant.

  • Treatment: Prescription antifungal medications may be necessary. Your doctor might prescribe a stronger topical cream or an oral antifungal medication.

• Bacterial Vaginosis (BV): This is another common vaginal infection caused by an imbalance of bacteria. It can cause itching and swelling, although it typically also involves a discharge with a fishy odor, which you have not reported.

  • Treatment: Antibiotics prescribed by a doctor are usually effective in treating BV.

• Sexually Transmitted Infections (STIs): Given your concern about a potential STI and the fact that you are awaiting test results, it's possible that an STI could be causing your symptoms. Some STIs can cause vaginal itching, swelling, and discomfort.

  • Treatment: If an STI is diagnosed, your doctor will prescribe the appropriate antibiotics or antiviral medications.

• Contact Dermatitis: This is an allergic reaction that can occur due to contact with irritants such as soaps, lotions, or even latex. It can cause itching, swelling, and discomfort.

  • Treatment: Identifying and avoiding the irritant is crucial. Topical corticosteroids may help reduce inflammation and itching.

• Hormonal Changes: As you mentioned that you are approaching menopause, hormonal fluctuations can sometimes cause vaginal dryness, itching, and discomfort.

  • Treatment: Hormone replacement therapy (HRT) or vaginal estrogen creams may be recommended by your doctor.

What you can do

While you wait for your STI test results and a formal diagnosis from your healthcare provider, here are some steps you can take to alleviate your symptoms:

1. Avoid Irritants: Refrain from using scented soaps, lotions, or other personal care products that could irritate the vaginal area.
2. Wear Loose Clothing: Opt for loose-fitting, breathable clothing and cotton underwear to reduce irritation and allow the area to breathe.
3. Stay Hydrated: Drink plenty of water to help maintain overall health and potentially reduce symptoms.
4. Over-the-Counter Relief: While Monistat hasn't helped, you might try a different over-the-counter antifungal cream or consult a pharmacist for recommendations.
5. Cold Compress: Applying a cold compress to the affected area may help reduce swelling and provide some relief from itching.
6. Journal Your Symptoms: Use MDandMe to journal your symptoms, track your progress, and share longitudinal medical notes with your healthcare provider. This can help in identifying patterns and triggers.

What you should look out for

Seek medical attention more urgently if you experience any of the following:

• Severe Pain: If the pain becomes unbearable or significantly worsens.
• Fever or Chills: These could indicate an infection that requires prompt medical attention.
• Unusual Discharge: If you notice any new or unusual discharge, especially if it has a strong odor or is accompanied by pain.
• Difficulty Urinating: If you experience pain or difficulty while urinating.
• No Improvement: If your symptoms do not improve or worsen despite trying the above measures.

Remember, while I can provide information and suggestions, it's important to consult with a healthcare professional for a formal diagnosis and appropriate treatment.