[Question #6832] Constant Vaginal Irritation/burning/itching &

12 months ago

Hello, I’m a 29 YO F and I have been having constant burning/irritation/itching for 2 days now that seems to be worsening. In the last week I had 2 sexual partners who were not new partners but I did not use a condom the whole way through. The first partner was 1 week ago and there was anal sex involved before vaginal so I am thinking this may have triggered these symptoms. However my symptoms began 2 days ago, having been closer to the second sexual partner which was 4 days ago, and there was no anal interaction. I have a mostly clear discharge so far. However I have always had a problem with chronic yeast infections and when I insert my finger in the vagina usually white discharge is in there. My bigger concern is a bulge coming out of what seems to be my vaginal opening.. there are bumps and it seems like a cluster. I have been applying vagisil with little relief.. (however the cream I am using is probably expired and I’m concerned to buy anything due to COVID exposure) I do have a history of high risk HPV infection and am wondering if this could be part of the cause. The bulge of what seems to be lesions do have white clumps on them that I can remove with my finger but my underwear doesn’t have much yeast like discharge. Now that I look it I see all white at the opening of my vagina, so this is probably yeast? I am concerned about the rest of my symptoms and the bulge of abnormal tissue which seems clumpy at the opening of my vagina. I am concerned my symptoms could be attributed to my HPV, if I’ve contracted something, or if it’s partly due to the anal sex I had. I have had bumps before and I’ve always thought it could have been warts due to my hx of HPV. They are small flesh colored raised round bumps... I know tingling/pins and needles sensation is a s/s of herpes and I believe I have experienced that but it’s hard to distinguish from the constant irritation I’m experiencing. It feels like a throbbing inflammation/pain/burning/itching at the vaginal opening. I have a gyno appointment monday. I am very concerned... please help.

H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
12 months ago
Welcome to the forum. Thanks for your confidence in our services.

But I'm afraid I can't help very much. No STD is a likely cause of the symptoms you describe, and in general we don't try to solve genital symptoms problems other than those that are STD related. You're doing exactly the right thing by seeing a gynecologist. I'll comment, but please don't expect definitive answers.

Having had an ongoing or recurrent problem with vaginal yeast infections, you're in the best position to judge whether the irritaiton symptoms are from yeast or something else. The "bulge" sounds like some sort of anatomic problem, not an infection. Speaking as a non-gynecologist, it sounds like it could be a problem of pelvic relaxation, i.e. weakness of the muscles and ligaments of the perineum (the floor of the pelvic cavity, i.e the space between the vagina and rectum). This is seen primarily in women who have had damage during vaginal childbirth to perineal muscles, nerves, or ligaments. If you've never delivered a baby vaginally, then I would think pelvic relaxation unlikely. Your gynecologist will understand alll this far better than I do. If you indeed have an active yeast infection, that's the likely explanation for the white spots on the bulge.

HPV doesn't cause irritation, itching, or inflammation of any kind, and certainly not pelvic/vaginal relaxation or any other sort of vaginal area swelling or lump. Nothing you describe even hits at HPV. And herpes doen't behave at all like this. Don't get hung up on anxillary herpes symptoms like tingling, "pins and needles", and so on. Without visible blisters or open sores, herpes is very unlikely; and it never causes ongoing inflammation that would be confused with chronic or recurrent yeast.

I'm also reasonably certain none of this has anything to do with your recent sexual events. As I said above, no STD is a likely explanation. That said, sex can certainly increase irritation or inflammation from a preexisting condition like a yeast infection. And common sense dictates you be tested for STD; having more than one sex partner in a short period of time obviously implies STD risk, and you should expect the gynecologist to recommend and undertake testing at least for gonorrhea and chlamydia. But even if positive, these would not explain your symptoms.

So as implied above, the main thing now is to follow through on your planned gyn appointment in a few days. In the meantime, it would be best to avoid self treatment of any kind. For sure don't douche, for example. And avoid sex for the time being, until your gyn says OK.

Sorry I can't be more helpful, but perhaps these comments will help reduce your ferars of STD. Let me know if anything isn't clear.

HHH, MD
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12 months ago
Thank you for your timely reply! I appreciate your comments they have helped put my mind at ease. I will follow through with my gyn appointment and go from there.

One more thing I’d like to clarify though,  having had high risk HPV in the past which resolved. Could this hx of HPV be related to having small flesh colored bumps on the labia that are usually in clusters?

And if so, is this more so caused by having dormant HPV or is it probably the result of a new onset of HPV exposure?  I haven’t gotten checked in a while so I’m not sure if I’ve gotten HPV since I have been sexually active. 

I’ve always guessed these bumps were genital warts since warts are caused by certain HPV strains. 

It’s something I’ve noticed in the past and never really understood. 

Any insight you can provide me with would be helpful. Thanks in advance!
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
12 months ago
The high risk (potentially cancer causing) types of HPV rarely cause warts. However, multiple HPV infections are common and could cause "flesh colored bumps". On the other hand, the word "usually" suggest to me that the bumps apparently come and go, i.e. intermittently visible? If so, they definitely aren't warts. In addition, warts usually have a typical, frond-like appearance, not smooth bumps. If you google genital warts, you can find lots of photos. And if the bumps are present when you see the gynecologist, probably s/he will be able to tell you what they are.---
12 months ago
Yes the bumps seem to come and go...

One last question I’ve also now started to have a brownish discharge could this be related to any STD in particular? 
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
12 months ago
If they come and go, for sure they aren't warts. Probably you're seeing variable prominence of normal mucus glands, which can vary with mentrual cycle and with underlying inflammation, such as a yeast infeciton.

Any of several infections can cause colored discharge (yellow, green, brownish, etc); or nonspecific infection or irritation. That includes STDs, but not necessarily. But this is another reason to expect your doctor to test you for common STDs. That should include trichomonas, which I didn't remember to mention above. (But don't settle on just a microscopical test of discharge. Like gonorrhea and chlamydia, trich requires a DNA test for proper diagnosis.)

Normally threads are closed after two follow-up comments and replies. However, I'm interested in hearing the outcome after you've seen the gynecologist. But no more comments until then, OK?
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