I second the vote on M&R trying a Koobie saddle. I went through many saddles, many with cut outs, that did not work for me. Chafing between the labia major and minor... Ouch! Koobie's the only thing I'll ride any more. And the women to whom I've recommended it have tried it & loved it! A split all the way down the nose and channeled all the way down... You never know, it could work!

And I agree, less padding helps. It seem counter intuitive but it's just more fabric and stuff pressing on the "bits".

But bottom line, M&R. You gotta do what's right for you. I like doc's advice, a reconstructive doc connected with a university. Get references. Get three opinions. Best to you.