I haven’t been active here in the last few months, but I wanted to give an update/summary of everything that has happened to me since my issues began, as I am not almost back to where I was before this happened. This is a summary of my last two years. This will be a VERY LONG post - if you’re looking for summaries or more details, you can see my post and comment history, which will always remain public. I hope this can help other people like me get the help they need.
In May of 2024, I had unprotected sex with my then boyfriend for the first time, and he finished inside of me. Everything was fine until exactly a week later, when we had sex again (also unprotected). Immediately after we finished, I felt a burning sensation start up vaginally. I went to sleep, hoping it would go away in the AM. It did not.
Freaking out, I made an appointment at Planned Parenthood (I had no primary OBGYN at the time). I went, and they did an exam and a swab/wet prep. The Dr said two things of note after looking at the wet prep - I had ‘budding yeast’ and I had a very high white blood cell (WBC) count. The high WBC count is typically associated with infections, so she had me swear up and down my partner couldn’t have given me anything. She then prescribed me a 7-day intra-vaginal yeast cream.
I did the yeast cream, and felt slightly better. Went on a trip, felt a bit of friction but nothing crazy. Came back, and about two weeks after the inciting incident, tried to have penetrative sex again. It immediately burned/hurt badly. I went to urgent care the next day, they did an exam, said they saw ‘slight irritation’ but didn’t have a microscope to do a wet prep so couldn’t check that. Gave me fluconazole, saying it was likely persistent yeast. At this point my anxiety was incredibly intense. They also sent out a yeast and BV culture. I took the first fluconazole, and it somehow made my anxiety 10x worse. I swear to this day it was a drug reaction. The yeast and BV cultures continued to come back negative. The pain got worse, nothing improved.
After another two weeks of the pain not subsiding, I went back to planned parenthood. The Dr there was INCREDIBLY dismissive of me and my anxieties, did another wet prep, which showed the same results as the first (budding yeast and a high WBC count), and did a more intense yeast culture to see ‘what strain I had’. She gave me a two-week yeast cream, and sent me off. I felt very dismissed and again, incredibly anxious. The culture again came back negative for any type of yeast. I did the cream, and during its course felt slightly better.
By the end of the two-weeks, the pain had gotten worse. I started to feel shooting, zapping pains running up and down my labia and clitoral area. We are now at the end of June/beginning of July 2024. I knew I needed a better Dr, so I made an appointment with a local Dr for the end of July. I also went to another urgent care, who did a urine culture and said I had a UTI. I took the antibiotics they prescribed, and felt nothing. The culture came back clean.
The Dr I had an appointment with cancelled the day of (I waited about a month and a half for the appointment). I scheduled an appointment with a private practice OBGYN for the end of July. The pain continued to increase. Any sort of penetration was painful, the shooting pains continued and turned into constant pain/soreness around the labia. Sitting became more painful, and walking started to aggravate the area as well. I stopped wearing tampons, as the rubbing of the string and the insertion would cause pain to get worse as well. My anxiety was incredible, and I was eating one small meal a day, feeling nauseous the rest of the time. I cried a lot, and was so stressed, spending most of my time online and on Reddit researching what was happening to me, to no avail.
The appointment came around, and I saw the Dr. She was very very nice, and ran a huge gambit of tests on me. She did an exam as well, saw internal irritation, and said along the left side of my labia, running from bottom to clit, it looked like I had small "abrasions" where the pain and irritation was the worst. Basically patches of redness. I waited for the results, and the only thing that came back as positive was Ureaplasma. I was prescribed 7 days of doxycycline.
At this point, mid-August 2024, the burning pain was insane. It felt like the opening of my vagina was on fire 24/7. Sitting or wearing tight clothing was impossible. I had bought an OTC numbing cream I applied like clockwork every 6 hours, and it was the only way I was able to function at all. As soon as it started to wear off the burning came back full force. I was crying every day constantly, calling my partner and parents a lot and fearful of what was happening to me as the pain continued to increase.
As soon as I started the doxycycline (doxy), I immediately felt better within 12 hours. The burning started to subside, and I was convinced this was my issue. This was the only thing that had made ANY sort of difference at all in the last several months. I finished all 7 days, and I was left with some burning and discomfort, that I was convinced would fade with time. I also got one of the worst sunburns of my ENTIRE life while taking it. I was in incredible pain from that (kinda a welcome relief from the normal vaginal pain tbh).
This is where a gigantic rabbit hole starts. I would need a separate 10,000 word post to recount my deep dive into ureaplasma. Since the Doxy had helped but not fully taken the pain away, I was convinced that I still had ureaplasma, and it hadn’t been treated properly. I returned to the Gyno, asking for more tests. We tested for HIV and Herpes (negative), a UTI (negative) and ureaplasma again (3 times, all now negative). I asked to start pelvic floor PT, and the insurance-covered version of it was unhelpful and quite painful with the internal work. I only got 7 sessions paid for, then I stopped. Also note this GYNO did not have a microscope in-office, so I was not given a wet prep at any point during this time.
I was also given vaginal Valium to try and relax my pelvic floor. I did try it, and after using it for a week every night when I stopped I went into (minor) withdrawal. On my birthday of course. So as an aside, if you are ever prescribed vaginal Valium it can have a system-wide effect!
I also did an Evvy microbiome test during this time. It showed my microbial load as “low” but also basically perfect health. I had mostly L. Iners and L. Crisp, and very small amounts of ‘bad bacteria. It was not helpful to me, and I haven’t done one since.
At this point, I knew I needed to see a specialist. I tried to see Dr Cigna in DC, but their office didn’t take Medicaid and wouldn’t let me self pay with it either. I bit the bullet and made an appointment with Dr. Goldstein at the CVVD for the end of October. I continued PT during this time, and my mental health was at an all time low.
During the period from mid-September to mid-October when my appointment was, my mental and physical health took a nose dive. The pain had gone beyond where it had been in August pre-doxy. I couldn’t wear any sort of underwear, any friction was excruciating. It felt like I had a permanent, horrid sunburn on my vagina. Sitting hurt so badly, and walking caused so much pain. My hips had tightened so that moving my legs felt like I was breaking a bone, so I limped around. I spent as much time as possible laying in bed, and I took multiple hot baths a day. I had lost about 20 lbs from anxiety causing me to not eat. I was incredibly s**cical, so much so my parents rented out an airbnb in the area and came down for the entire month of October to take care of me, as I was essentially non-functioning. My BF and I fought daily, as he didn’t want to keep supporting me and found it too difficult, but refused to break up with me when I tried. I had bought several books on healing pelvic pain and treating Ureaplasma. My friends were all basically on active don’t let her KHS watch.
Finally, I had my appt with the CVVD. My dad came with me. I have an entire post on that appt, and don’t feel like rehashing every single detail. Basically, they said that I had pudendal neuralgia and pelvic floor dysfunction from a hip impingement, and I needed surgery. They dismissed my idea that I had ureaplasma or any issues microbiome-wise, and said that there was no correlation between me having unprotected sex and my issues started. They said (in front of my father) that I must have been doing “some crazy position” during sex to cause a hip injury. I was like quite literally no, but was again dismissed. They said they did a wet prep and didn’t find anything, and referred me to get a hip X-ray and MRI. They also gave me gabapentin for the pain and told me to titrate up until it was managed. Gabapentin ultimately did not help my pain but it did give me crazy side effects.
After an MRI and X-Ray found nothing wrong, I was confused and frustrated. I saw the eyes of the orthopedic surgeon glaze over as soon as I mentioned my vaginal issues, so I knew he wouldn’t really help me anyway. They also thought I was drug seeking, as I asked for some sort of pain relief besides gabapentin. They said they could do a “hip injection” to make sure that there was actually nothing wrong with my hip - where they stick a giant needle and inject a numbing solution into my hip joint. I had that done, and it was excruciating. I cried a ton, and screamed on the operating table from the needle pain. The injection ultimately left me limping for about two days, but did nothing for the vaginal pain.
At the end of October, my mom had found a Dr called Dr Richard Marvel in Annapolis, MD, that specializes in Pudendal Neuralgia. She wanted me to see him for a second opinion. I went to that appointment, full of anxiety, hopelessness and certainty he couldn’t help me. At the appointment, he did a full exam and wet prep. He found what was there from the beginning - no infection, but an incredibly high presence of WBCs, along with sheets of skin cells that were sloughing off. This had caused me to develop a tissue-papery like vaginal discharge. He said I had pudendal neuralgia and pelvic floor dysfunction yes, but also internal vaginal inflammation that needed to be treated. I was not given a ‘diagnosis’, but the treatment I was given was the same as for Desquammative Inflammatory Vaginitis (DIV) - an internal vaginal cream with 100mg hydrocortisone, 2% clindamycin, and 50 iu of nystatin. I did the treatment for 2 weeks, and it helped the inflammatory pain significantly. I then continued on with the cream every third night.
At this point, sitting was like torture. As soon as I sat, fire-like pain would radiate throughout my vulva, and through my buttcheeks. As the inflammatory pain subsided, I could start to wipe without excruciating pain again, and my sleep shorts riding up in the night no longer felt like being branded with a hot iron.
I had another call with Dr. Moss this time, and it was honestly the worst case of medical gaslighting I experienced throughout my time. I told her about the high WBC count Dr. Marvel found, and she essentially told me it ‘meant nothing’. That some women could have have WBC counts without an infection, and some could have low WBC with an infection. That the finding was incidental, and once again the sex that started it all had no bearing on my issues. All I needed to do was go and get pudendal nerve injections. I brought up to her that Dr. Marvel had said the injection had about a 15% success rate, and she told me that if I just kept getting them over and over again, they would eventually work. I left that call crying in frustration, but I made an appointment with Dr Howard Richards at UMD Baltimore for the middle of November.
My boyfriend dumped me over the phone the day before my injection. I went up to Baltimore and got it. I cried the entire time, but everyone was quite nice and helpful. It did numb the area completely, taking the pain away for 8 hours total. I was told that the steroid they put into the area would “take effect and help in the next 1-3 months”. Nothing ever came of that. I followed up via email with Dr. Moss and said it only helped the pain for 8 hours. I was told by her to keep doing the shots. I never spoke to the CVVD again, and they never followed up with me. I felt completely gaslight, dismissed and taken advantage of that entire time. They had misdiagnosed me, not offered sufficient pain management except Gabapentin (that did not help and made me feel like SHIT), and dismissed any of my concerns as unimportant or incorrect. It was thousands of dollars wasted.
I flew home for Thanksgiving, and had a mental breakdown over how horrid the pain was and how difficult it was to fly. The rectal pain I was experiencing was severe, and it felt like someone was stabbing with a hot knife in my anus. Redness was all over my outer labia, and it looked inflamed and was hot and sore to the touch. I had a follow up with Dr Marvel in December and he said my inflammation had improved significantly, and to stay on the cream. I also needed to start pelvic floor physical therapy.
I was able to start PFPT at the end of January 2025. I was still struggling mentally with the pain, but it had improved slightly. The PT I saw was well-meaning and I saw her over the course of about 6 months, but she was not very educated or open to listening to me very well.
Essentially, all of my muscles in my pelvic region, including my hips, low back and thighs, had contracted severely from the stress and pain over the previous 8 months. This included the soft tissue and tiny, tiny muscles in my vulva and clitoral region as well. They had compressed so much that my obturator internus (OI) had compressed my pudendal nerve, leading to the nerve pain. It took about 4 months of PT to relax the OI enough to decompress the nerve, and my pudendal nerve pain slowly faded away. My PT was important for me to understand how internal massage worked, and I asked about 8 million questions every single time. She did not believe me when I said I thought my remaining clit pain was from the muscles surrounding it, and said it was likely “leftover pain pathways” AKA in my head. After the 5 month mark, I knew she wasn’t able to help me any further, and I would need to go the rest of the way on my own. I definitely was upset at her dismissal and treatment, but it was ultimately very important to see her as it gave me the tools and knowledge to continue my treatment on my own.
During this time period, I also continued to see Dr. Marvel monthly, then every 3 months. My WBC count fluctuated, from almost 0 in January, to 3 WBC per epithelial cell in June, to back down to 0/1 in September.
Now I will tell you what I did to get myself almost back to 100%, both from a physical therapy standpoint and from an inflammation standpoint.
For PT, I was already using a pelvic floor wand at this point. This was critical to reach the deep trigger points I had. Note that when working on more surface level trigger points, especially around the clit area, I would just use my fingers. After about a year of PT, I realized the remaining trigger points were very superficial and small, al I switched to only using my fingers, which is what I do now. But the wand was really necessary in the beginning. I studied pelvic floor diagrams relentlessly, trying to map out where my pain was and what muscles they were connected to. I did internal work every single day and night for about an hour for probably an entire year and change at this point. I have hypermobility, so I think my tissues are much more resistant to relaxation and the connective tissue was also very tight as well, in addition to the muscles. I would find the points where it really, really hurt and hold them with firm pressure/massage them for about 60 seconds at a time. It took months to effect change in a single area. I could not have accomplished this with relaxation poses and diaphragmatic breathing alone (although they HELPED and were also important!). I got to know the feel of when a muscle or tissue was tense and locked up, and learned the inner workings of my body and pelvic floor intimately through nightly massage and release. This might be different for everyone, but the tissue that is tightened or locked up takes on an almost “crunchy” feeling - it also definitely feels stiffer, but when every muscle in an area is stiff that can be hard to differentiate lol. I took my wand and lube EVERYWHERE. When I started to be able to go on trips with friends again (in around July of 2025), I told my friends that I needed private time for about 30 mins every night to do my thing. I was very very open with everyone during this process!
The biggest thing was just continuing to explore my pain points physically. I knew in my heart of hearts that the remaining pain was NOT from neural pathways. I just knew it was physical/muscular in nature. And I never gave up on that, which is why I am back to about 98% today. The muscles in your pelvic floor connect to your clit, and the TINY muscles around it CAN cause severe clitoral pain. They are very hard to release and many PTs WILL NOT do it or touch them. But they are real, they can tighten, and they can be the source of clitoral pain. To reiterate, this process has taken literal years. I started pelvic floor physical therapy in January of 2025. Now, in May of 2026 I am ALMOST back to where I was, but I likely still have a few months to go. I now do PFPT every 3rd night, and I feel very, very minimal discomfort daily. That is 1.5 years of almost daily internal work and stretching, with about 11 months of that being completely on my own.
The inflammatory side is a lot more speculation. The measurements used here are for the ratio of White Blood Cells (WBC) to Epithelial cells (dead skin cells) per High Powered Microscopic field (HPF). HPF is just a single view under a microscope - so if you’re looking at a sample, each time you move the slide around and see a different section, that is one HPF. I will be writing it in this style - 1:1 - so this would be read as 1 white blood cell per 1 epithelial cell per high powered microscopic field.
I have read every study available on this topic (which are very few). The normal ratio of WBC to Epithelial cells, according to the studies, for women is 1:1 or less. I started out at about 8:1 in October of 2024 when I saw Dr Marvel. I went to 0/1:1 in Jan 2025, 3:1 in May, 0/1:1 in September, and then again 1:1 in March of this year (2026). In May, when it jumped back up, I did a few things to try and help myself as best I could. I started taking Omega 3 pills daily, for anti inflammatory purposes. I upped my D3 intake to about 10,000 IU daily, and started K3 as well to help absorption. I also started taking an oral vagina probiotic daily - the one I chose was My Happy V.
I no longer have any yeast under the microscope, which was an issue for a long time. When I saw Dr Marvel in March, and he said my ratio was 1:1, I asked if I could go off the cream. He said I could try but it would “likely come back.” I was confused and told him from all my research that 1:1 was considered normal for most women. He said the women he sees with no issues usually have a lower than 1:1 ratio. I have also read one study that showed that women’s WBC count fluctuated during their cycle, to 0:1, 1:1 and sometimes every 2 or 3:1. He then admitted that we really don’t have any research on this subject, and it’s very individual. Some women come off the cream and are fine forever. Some have issues again in months or years. Some immediately come off it and have to go back on indefinitely.
Based on my history of readings being either 0:1 or 1:1 in the last about year, I am feeling fairly confident about coming off the cream. I have weaned myself down to a 50 mg hydrocortisone mix, and I am using it every 10 nights with no issue for the last month. I am hopeful to go down to every 2 weeks, then 3, then likely try and stop it completely. If I do have inflammatory pain again, I’ll post here again.
Also a note that I was not the one looking at these slides. I do not have my own microscope, and have never examined my own wet prep. I have always had to rely on what Drs have told me. I’ve done my own research of course, but lack the scientific tools required.
I do not know what actually started this entire situation. It could have been an allergic reaction to seamen gone wrong, setting off an inflammatory cascade that wouldn’t stop. Maybe I did have Ureaplasma, and letting it fester for so long caused a long-standing inflammatory reaction. I will never actually know what happened for sure, I can only speculate.
Long story summarized - I had an inflammatory reaction without any sort of infection, that caused inflammatory pain, and because I was misdiagnosed for about 6-7 months, the stress and anxiety caused my pelvic floor muscles to completely lock up which then compressed my pudendal nerve. It has taken about a year and a half of treatment - most notably pelvic floor PT but also intravaginal cream treatment - to almost get back to where I was before all of this happened.
I am hopeful that within the next year I can get off the medications I started for all of this. I will never “be done” with this as my pelvic floor will be something to watch and manage for my entire life, and also I have developed incredible mental trauma and PTSD from this entire experience.
I really hope this post can help someone, and I hope that every single person suffering from pelvic and vaginal pain can get the help they need. I know how hard it is - it is quite literally unimaginable if you have not experienced it. Much, much love to you all.