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Dr. Owen
Dr. Owen, OB/GYN (Doctor)
Category: OB GYN
Satisfied Customers: 55754
Experience:  Board Certified: Ob/Gyn & Preventive medicine, US Medical Graduate
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When I have sex my posterior fourchette stings

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When I have sex my posterior fourchette (the bottom part of the vagina entrance) stings whenever my boyfriend tries to stick his penis in me.

Its slightly swollen, red and stings when I pee after sex is over. What is wrong and how should I fix this issue?

Dr. Owen :

How long has this been happening? Have you ever had a baby vaginally? How long have you been sexually active? Is there any itching?

Customer:

I have been sexually active for about four years. I have never been pregnant and its been happening for about a year now. There is no itching. Every time I go to my ob/gyn she just tells me it a yeast infection. However, I would use the medicine for a yeast infection and it reoccurs after the infection was cured.

Dr. Owen :

Does the yeast medication ever help at all?

Customer:

There is absolutely ZERO help.

Dr. Owen :

Are you actually seeing an ob/gyn or just a doctor who can do pelvic exams? Has your doctor discussed getting a biopsy of of the vaginal area where you have the recurring problem, in addition to getting a culture where you have to wait 3-5 days for the results?

Customer:

She is an OB/GYN, has never done a biopsy but does a culture every time I go and it is negative every time.

Dr. Owen :

So, as you know this is NOT a yeast infection and the next step is to get a small biopsy.This could be a vaginal irritation such as Lichen planus, lichen sclerosus, or many other possibly vaginal problems, but you need a biopsy so this can be put under the microscope to look at the cells. Given this has been going on for so long now, and no cultures have become positive, this means this is a vaginal skin problem that only a biopsy would be able to diagnose you with. So this is important given the length of time you have had this problem. And, you might just need a steroid cream such as Triamcinolone to help.

Customer:

So if this is a vaginal infection what would cause the swelling and burning?

Dr. Owen :

Well this is unlikely to be a vaginal infection - since the cultures are normal. But more like a 'skin' disease of one of the types I described above.

Customer:

This is kind of weird but if you have an idea of what it might be?

Dr. Owen :

Thank you for the picture (not displayed here for privacy). Have you ever had an injury to this area, or been raped, because the right side of your labia does not appear to be as big as your left side?

Customer:

No never. I honestly never had a problem until I got on birth control.

Dr. Owen :

I think that area that is red towards the bottom of your vagina deserves to be biopsied so that you can get a proper diagnosis.

Customer:

So do you have an idea of what it is

Dr. Owen :

I really cannot tell what it is from the picture - I would really need a much closer look, and a personal camera would not be able to do that. But I do see the redness you are talking about. Do you have 2 small blisters? I see two small white spots on the picture...

Customer:

I don't think so, they may be I cant tell. They hurt to touch.

Dr. Owen :

The reason I am asking - have you been evaluated for HSV - herpes? Because this could be a herpes infection too.

Customer:

I was born with herpes simplex 1.

Dr. Owen :

Given your symptoms of the pain - it could very well be a type of vaginal herpes too. Well herpes either 1 or 2 can affect the vagina.

Customer:

So could I just use the cream I have for my herpes and see if that helps.

Dr. Owen :

If this is herpes, then the yeast medication would definitely NOT help, but medication such as Acyclovir or Vatrex would help. You can try the cream - but you might try the Pills - and just go to sick call to get Valtrex or Acyclovir (pills or capsules).

Customer:

Okay I will try that as well.

Dr. Owen :

I wish you the best

Customer:

Okay thank you so much. I really appreciate it.

Dr. Owen :

Show this interaction to your doctor (or at least remind yourself what we discussed).

Take care.

Customer:

Okay will do. Thanks.

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