With any health condition I think it's normal to be impatient for treatment to work. I'm not sure it's being impatient rather than that after so much pain for so long we just yern for it to go & quickly.
I had a gynae about 6 years in after repeated GPs said they had no idea what was causing the pain. I'd actually given up going to them, can you believe, because id be sent away with dermovate which just made my pain worse. It was only because my husband phoned the GP & had a furious conversation with them about them doing nothing that I was referred to this gynae. She diagnosed me with a few different things I didn't have & refused to consider I could have symptoms caused by menopause. She got angry with me because every time her treatment didn't work, I asked again, could this be menopausal.
So it's hard to trust the professionals. I've been told by my GP I have lichen too. Given dermovate which will just damage my thin sore vulva & not had any more than a 'sight' diagnosis.
Like you I'm not confident that I have a complete diagnosis or correct treatment. It took 6 months of daily pessaries & cream for me to not notice any pain & occasionally have sex. But it didn't last more than a few months. I do know a gynae often doesn't know a thing about how menopause affects that area. I can't remember from your other posts, have you seen a menopause specialist? Also did I add on one of your posts the suggestion of lidocaine 4%? (My memory is bad!) because it is a massive help.
I think you are early days but both daily cream & pessaries for months was the only help for me. So surely you need that too?
It does seem lots of us are told we have multiple conditions in my case, I'm not convinced. It is waring having no trust in who we see, either. It's concerning you aren't able to work, either, and you say things are worse because you've been doing more. That's just not right. You shouldn't have to spend your life doing nothing because of the pain.
Are you able to have a private consultation? I'm at the stage where I'm considering it. Or do you have someone to advocate for you with your GP or gynae so they can be firm about how your life is affected? I've found that I'm so worn out with all this I sometimes just accept what I'm told.
I do feel for you, literally too! We should be able to get what we need but often don't. But persevere, if you get enough dosage, it should work or at least if not then perhaps it would indicate other types of GSM meds should be tried. I think you've seen the link to the different options on her.