showering before bed, using tampons instead of pads, and sleeping without underwear will likely minimize symptoms. i have also seen people use coconut oil to prevent flare ups during vulnerable times, but have never tried myself

Any ideas about what triggers flare ups? Is itching intense?

Toilet paper irritates my skin. Does anyone else have this problem?

I do, for sure. Sometimes my skin has been so sensitive that it's torn & bled a little.