I thought I'd just add my story here in case it helps anyone.
This was actually the symptom (vaginal dryness) which made it incredibly clear to me that I was low in estrogen. And caused a light bulb to go off in my head. Which eventually led to starting HRT.
I had been feeling occasionally scratchy/sharp/****ly discomfort there but very intermittently. I couldn't see anything wrong at all. I thought maybe I had thrush so I treated using Canesten. But it was still there a few days after finishing. I read online that I could do 2 courses of Canesten before going to my GP, so I did another course. Still didn't fix it...
I went to a GP I'd never seen before, expecting an exam. She gave me a self-swab to go and do in the toilets at the doctors surgery. I don't know if I did a good job with this, it was kinda hard in the cubicles! The swab came back normal and didn't find BV or thrush.
I was falsely reassured at this point and decided I'd been imagining things and didn't do anything further for a couple of months. Then things got worse and I decided there was something going on... By now I'd realised it could be low estrogen/vaginal dryness after doing some googling and reading online.
I went back and saw another GP, again expecting an exam. This GP gave me Vagifem and said she didn't want to do an exam immediately because it might hurt me and she wanted me to take Vagifem for 3 weeks and then go back and she would take a look. (How many more times would I have to psych myself up for a pelvic exam that never happened, I wondered....).
So I went away and started the Vagifem. Things got a bit better but because the location of my soreness was on the outside in my vulva, the Vagifem wasn't really getting anywhere near there. I had a video consult with a Newson dr to start systemic HRT at this time and she was happy to prescribe me some Ovestin as well, for the vulva. This really helped.
I also bought some YES products. I used the YES VM internally on the nights when I didn't do Vagifem (with Ovestin externally) and the YES OB every morning. It was quite a routine.
I went back to the GP after 3 weeks on Vagifem and the exam was so comfortable, I didn't even realise she was doing it. I thought she had given up because she couldn't get the speculum up there - only for her to say she'd had a look and blah blah... And I realised the estrogen had made me so comfortable up there!! (I did think my smear test last year had hurt more than usual but I hadn't realised that was a sign of low estrogen.)
The GP said I was a little red and irritated on the outside and she added the Ovestin to my NHS prescription. So I am now on Vagifem 2x weekly and Ovestin the same nights and the other days of the week, I use YES OB every morning. I don't use the YES VM internally at the moment.
I also got some pelvic floor dilators because I realised all this is about 'use it or lose it' and I wanted to go confidently into smear tests and pelvic exams, knowing that they wouldn't hurt me. So twice a week, I use a dilator up there for 10 minutes. It scores zero on the sexy charts for me. Now I am also on testosterone and have my libido back, I just have to fix my relapsed sex life with my long-suffering husband and replace that with a penis