extreme burning, urination problem

[pwachy]

I am writing because I need urgent advice about a problem.  I went for my yearly gyno appt. today. I was there for a long time because I had a lot of questions. My main concern was why I have so so so much frequency to urinate but not alot is coming out.  I also have an extreme burning sensation  coming from I think the vagina or bladder or from the vulva area.  This pain is only after I go and finish wiping. When I was at the appt. today I don't know why my genital area was burning so much more than usual.  Maybe my discharge was irritating it.  I knew when she put the speculum in that it was going to feel uncomfortable.  But it was more than uncomfortable.  I felt excrutiating pain inside and had to tell dr. that it was killing me.  And I have a high tolerance for pain. Also when she did the internal and felt inside,  my ovaries and pressed on my pelvic area, the pressure felt was tremendous.  It usually hurts but not like this time.  I was so terribly sensitive.  The Dr. said it could be from vulvodynia or IC.  what do you think.  please respond soon.  

[Lennox Hoyte, M.D.]

If your gynecologist has ruled out sexually transmitted infections, and vaginal tears or atrophy (this can happen due to loss of estrogen in menopause), and your urine culture is negative, consider musculoskeletal source for your pressure/pain. Sometimes musculoskeletaql trigger points can cause a feeling of urinary urgency which can be corrected with physical herapy applied to the pelvic floor muscles. The problem of burning after wiping after urination suggests some atrophy of the vaginal lining. If you are post menopausal or have had your ovaries removed, you may be a candidate for vaginal estrogen therapy to restore the moisture in your vaginal walls. This may be helpful in curing that burning that you feel after you wipe. Sometimes even after curing the pelvic muscle trigger points, some women still have the urinary frequency/urgency. In those cases I would start my patients on a medication like Detrol or Vesicare which is a medication that can calm the bladder muscle down, and reduce the feeling of a need to urinate.

Dr. Hoyte

[pwachy]

thank you so much for your response but I am not premenapausal or menapausal yet.  So what you said does not apply.  What else could it be