instruction: hello doctor I am experiencing pain during sex during three separate sexual encounters over the last few months no sex in between these encounters upon recent inspection a white spot was noticed on the inner portion of the vulva which seems to be the source of the pain outside of sexual intercourse there is no major symptoms but may have slight discomfort I have used canesten topical ointment for 14 days and experienced some relief but did not resolve
output: hi image is not much clear but looks like some inflammatory changes there must be vuvlovaginitis or bartholin gland infection if previously there was no pain during sex and now pain is there then there should be some problems there may be skin infection or hair follicle infection paraurethral glands are there ti urinary tract infection also can give pain there is one chance your partner may have some problem do urine routine and culture sensitivity report do one ultrasound scan of perineum to find out any cystic swelling keep the area clean drink more water change pads more frequently during menstruation can take tablet doxycycline 100 my for seven days azithromycin go one time for two days this is empirical treatment for diagnosis we have to do some test and need to see clinically along with per speculum examination can take any antacid to prevent acidity avoid oily spicy food I hope this helps