- Most common cause of Vulvodynia
- Cyclic flares with symptom free intervals
- Pain worse just before or during Menses
- Pain exacerbated after intercourse (day after)
- History of frequent Antibiotics
- Minimal Vaginal Discharge
- Saline Preparation and KOH Preparation (See Vaginitis)
- Candida culture and speciation
- Consider biopsy after Eliminating Candida
-
Clotrimazole or Terconazole Cream
- Acute
- Apply qhs for 10 days then
- Apply 1/2 applicator Mon-Wed-Fri for 2-4 months
- Maintenance
- Apply qhs for 5 days before Menses each Month
-
Fluconazole 150 mg
- Weekly for 2 months then
- Bi-Monthly for 2-4 months then
- Monthly prior to Symptom flare
- Physical Therapy with biofeedback
-
Low-Oxalate Diet
- Oral Calcium Citrate (Citracal) 200 mg bid
loading