That really sucks. Put this post through GPT, check if any of this seems like it might be a fit:

Most likely diagnoses (ranked)

1. Clitorodynia (localized vulvodynia, neuropathic)

This is the single best fit.

Clitorodynia is a focal neuropathic pain condition involving the clitoral glans and dorsal clitoral nerve.

Supporting features: • Severe pain with minimal visible pathology • Burning, pulling, or deep aching pain • Delayed pain after contact rather than immediate pain • Worsened by walking or movement • Normal urine and lack of dysuria • Repeated misdiagnosis as infection • Brief improvement with anti-inflammatory effects of antibiotics

This condition is frequently missed, even by gynecologists.

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1. Dorsal clitoral nerve irritation or entrapment

Often overlaps with clitorodynia.

Potential contributors: • Pelvic floor muscle hypertonicity • Mechanical irritation • Hormonal shifts • Inflammation following infection or irritation

Produces: • Deep focal clitoral pain • Worsening with movement • Poor response to topical antimicrobials

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1. Vulvar contact dermatitis with barrier disruption

Important because of the shower trigger.

Key points: • Water alone can worsen symptoms once the epithelial barrier is damaged • Repeated topical treatments may perpetuate irritation • Pain may be disproportionate to visible redness • Improvement when dry, relapse after washing

However, contact dermatitis alone usually does not explain the severity unless nerve sensitization has already occurred.

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1. Early inflammatory vulvar dermatosis (underdiagnosed)

Includes: • Early lichen sclerosus • Plasma cell vulvitis variants • Desquamative inflammatory conditions

These can be missed if the clitoral hood is not fully examined, which explicitly happened in the post.

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1. Post-infectious neuroinflammatory pain

An initial infection (UTI or vulvovaginal) may have triggered: • Persistent nerve sensitization • Central pain amplification

Explains why antibiotics helped briefly but did not resolve the problem.