Clitoral pain, loss of sensation and injury

[Limey8]

I've experienced itching and soreness in my vulva for over a year, as well as clitoral sensitivity and irritation. I started experiencing loss of sensation during sex and sometimes had no feeling at all in my clitoris. When I could orgasm it took a long time and they were weak and muted. My clitoris had also changed in apperance, it was smaller and the skin around it looked quite swollen. I saw a doctor who tested me for thrush and other infections (which came back negative) 6 months ago and said I looked normal on examination. I continued trying to enjoy sex and orgasms but the loss of sensation was worse and I was getting very frustrated and probably overdoing it. I noticed pain after using sex toys. The last orgasm I had a couple of weeks ago caused me terrible pain afterwards. I was very sore and tender and I became very itchy. One night I woke up to find myself scratching the area over my clitoris. A day later when showering I noticed my clitoris had turned a dark red/purple colour. The pain got even worse the next day. I went to see my gp and she said it had been bleeding and my clitoirs was bruised. She prescribed me a steroid cream and is also referring me to a vulva clinic. I'm not sure how long the wait will be. But I am now getting nerve pain in my clitoris, going into my lower abdomen, and into my thighs. It is sharp and stabbing, aching and burning. My clitoris has changed in apprance again, it looks even smaller than before. It hurts to sit for too long, walking makes it worse and lying in bed is also causing pain. I'm really struggling at work because of this. Paracetamol are not helping with the pain. My whole body feels irritated and unwell. I keep feeling nauseous and fatigued. I dont know what to do. I really need some help.

[Tree_Tops Moderator]

Hi Limey8 ,

I'm sorry to hear you're in pain. Pain in the clitoris can be caused by a multitude of reasons. If your doctor has ruled out skin diseases and infections, you may have clitorodynia. Here is a link about the condition: vulvodynia.com/conditions/c...

If you've never had a scan, I would ask your doctor about ruling out a herniated disc or cyst in the sacral or lumbar spine, injury of the pudendal nerve or the dorsal clitoral branch of the pudendal nerve.

In the meantime, here are some self-help measures:

• Avoid perfumed soaps, vaginal hygiene products and douches.

• Don’t use scented toilet paper or wipes.

• Use plain lukewarm water to wash your vulva and always wash after you’ve had sex.

• Wash your underwear in a non-bio washing powder and avoid fabric softener.

• Opt for 100% cotton underwear.

• Avoid tights and tight-fitting trousers.

• Refrain from using anti-fungal creams when you haven't tested positive for an infection, as this can further irritate the vulva.

• Use lubricants, as they can help during intercourse (my GP recommended the brand Yes).

• If sitting causes you pain, try sitting on a doughnut-shaped cushion.

I hope this information helps!

[Limey8 in reply to Tree_Tops]

Thanks so much for your reply and for sending me the link. It does sound like it could be clitorodynia. Do you know if doctors in the UK know about this condition? Are there any specialists you know of who treat this? I live in the north west. I read about a pelvic pain clinic in Manchester.

My referral to the vulva specilist will be at my local hospital which isn't too far from Manchester. Is it ok to request these types of tests or referral to the pain clinic when I go to that appointment? Or would I need to go back to my gp?

I know nothing of this so I'd probably look unsure as to what I'm asking for. Maybe I could print out the information and show the doctor? Sorry to ask so many questions!

[Tree_Tops Moderator in reply to Limey8]

You’re welcome! I’m happy to provide information that may be helpful 😊

Health professionals who have an interest in vulval disease should be familiar with clitorodynia. The British Society for the Study of Vulval Disease (BSSVD) a database of UK clinics and services, searchable via their interactive map or a downloadable PDF list. You can check if your local hospital's vulva specialist is listed on the BSSVD's clinic map: bssvd.org/patient-informati...

I would ask the vulva specialist about a scan. Imaging with an MRI of the lumbar spine/sacral spine may be helpful, as problems in the spine can sometimes refer pain to the clitoris/vulva. You may also want to discuss further evaluation for potential pudendal nerve or dorsal clitoral branch injury. Finding the root cause of your pain is key to effective treatment, so it’s worth exploring all possible avenues.

I would also like to add that some have found relief from a physiotherapist who specialises in pelvic floor disorders. The POGP website (thepogp.co.uk/patients/phys... lists NHS and private physiotherapists by region. Pelvic health physiotherapy is not widely taught in UK undergraduate training, so many physiotherapists lack understanding of pelvic structure problems.

If the cause of the clitorodynia/vulvodynia is neuropathic in nature, oral tricyclic antidepressants, such as amitriptyline and nortriptyline can be used. These medications work by reducing the transmission of pain signals, thereby decreasing the pain.

Printing out this information can serve as evidence to support your concerns and guide your discussion with your doctor.

And there’s no need to apologise, it’s better to ask questions than to leave with unanswered concerns!

[Konagirl60 in reply to Tree_Tops]

I agree….it could be her pudendal nerve.

[redraws1811]

It sounds exactly like your hypogastric response is stuck in a loop-- sucking in your stomach for years is the pre cursor to this condition, from there the pelvic muscles get really tight over time. The progression of symptoms makes me think this-- Itching is often a sign of blood flow problems for example. This isn't the sort of thing that gets better quickly--it takes time.

In my opinion you should consult an expert in holistic pelvic health and do a deep dive into your regular habits. There is no such thing as TMI here. They will know what to avoid and what to do, and neither may be obvious. Good luck.

[Midori83]

Hi, I am sorry to hear that. Do you remember how it started? For example, after playing a sport, or after a fall or even pelvic surgery?

Do you have any urinary symptoms as well? You probably need to see a urogynaecologist specialised in pelvic neuropathy (vulvodynia), and a pelvic health physio one you have a diagnosis.

The neuropathic pain causes your muscle to spasm, which leads to poor blood flow and loss of sensation in the genital area. This tightness can cause small skin cuts and dryness.

I hope this helps.

[Konagirl60]

It sounds like a nerve injury of some sort. Have they offered you Amytriptyline?

[Limey8]

Hi, no I haven't been offered any medication. She said the swelling and bruising should go away within 2 weeks. She didn't mention pain relief though. I got the nhs referral letter and tried to make an appointment online but it said there were none available at this time, so I couldn't book. Apparently the hospital will contact me and it said the average wait is 16 weeks wait for an appointment. I think I will call them on Monday rather than waiting. I will have to go back to my gp and ask about pain relief while I am waiting for this appointment. It seems so long to wait.

[Nike101]

I am so very sorry you are experiencing this. I am a male but am experiencing symptoms of pudendal neuralgia, rectally. Your symptoms possibly sound like a nerve problem. I am also experiencing the deep radiating pain, nausea at times, and similarly my whole body feels unwell. I have been forced to take time off work. Pelvic pain is something that nobody ever makes it, it’s utterly dreadful isn’t it! It’s sounding possibly like your pudendal nerve, sitting too long also hurts me and walking up hills makes it worse.