What are the causes of chronic vulvar pain?

Patient's question:

I suffered from vaginitis and urethritis with vestibular pain last August. After treatment, the inflammation has subsided. All tests are normal, and there are no signs of infection, but the pain in the vulva has not improved yet. I have seen over ten doctors, but none can identify the problem. I would like to ask experts what might be the cause of this pain?

Doctor's answer:

Is vulvar pain related to menstruation? Does it hurt after sexual activity? I have already treated bacterial vaginosis, but the pain still persists. A double-contrast examination should be performed to check for nodules on the posterior vaginal wall. A color Doppler ultrasound should also be conducted to determine if the uterus is enlarged and whether there are small tumors. If so, it could be endometriosis. There are nodules and masses on the posterior vaginal wall, causing pain during sexual activity, as well as a sense of heaviness and pulling. It is best to visit a gynecologist for an examination. It is likely caused by poor personal hygiene.

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