EDIT: Thanks to everyone for their input. To clarify, I have seen 3 other gyn's and 2 psychotherapists since my initial diagnosis and have attempted to treat the issue with the following:
Lidocaine 2% gel/as needed
Lidocaine 5% gel/as needed
I have also had a biopsy done for lichens sclerosis, which came back negative.
My husband told me to not worry about the expense of the surgery, but to figure out if this is an avenue I want to pursue.
During the exam, which my husband attended, we were able to see a very clear definition on the labia minora between the area with normal amount of nerve endings and the area that is over-saturated with them.
Dr. Goldstein does not participate in any insurance plans as a matter of course, and did not 10 years ago. I am only 36 hours out from the updated diagnosis and treatment recommendation, so I'm still doing research, including trying to track down other doctors in the NYC area that are able to perform this surgery. I will also be trying capsaicin this weekend as well. Please continue to share your advice, either by commenting or in a PM.