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.
Hi. Image is not much clear. (attachment removed to protect patient identity).  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. There may be skin infection or hair follicle infection. Paraurethral glands are there. UTI (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 mg for seven days, Azithromycin 1 gm 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.