A Vagina Dialogue: Pelvic Pain (Part 3 of 3)

• Jun. 14, 2012
• Topic: Sexual Health, Menopause

No, we’re not suggesting we talk to our vaginas...but hey, while we’re on the subject, let’s talk about them. Our vaginas and our bladders, our uteruses and our rectums – let’s deal with all those parts of our bodies that we’re not supposed to talk about in “polite” conversation.

So, we see our gynecologists once a year, right? You might be thinking: “Got that covered. What else is there to talk about?” But what you might not realize is that an annual GYN exam is not the only way to deal with issues in the “down there” region.

Virtua female pelvic medicine specialist Joseph Maccarone, MD, says there are three primary issues that women most commonly bring to his practice. He’s been helping women solve these issues since 1993, and it turns out there have been significant recent advances in the treatment of pelvic problems. This is “not your mother’s pelvic medicine” – today’s women have access to all sorts of promising new procedures for pelvic organ prolapse, incontinence, and pelvic pain.

There’s so much great info, we’ll cover it in a 3-part series. Read part one about pelvic organ prolapse or part two about incontinence. Part three covers pelvic pain...

Pelvic Pain

If you’re experiencing chronic pelvic pain that doesn’t quite fit the descriptions of the aforementioned issues, you will want to see your doctor to rule out a condition called interstitial cystitis (often abbreviated as IC). “Often I will see IC patients who report that they feel as though they have a persistent urinary tract infection, and yet testing has revealed no such infection,” says Dr. Maccarone. IC is a chronic inflammatory condition of the bladder and urethra, and as is the case with many chronic inflammatory conditions (say arthritis, asthma, or lupus) doctors do not yet definitively know what causes it.

To be diagnosed, women undergo a procedure called cytoscopy, where a small camera is inserted through the urethra and into the bladder. This outpatient procedure is performed under general or regional anesthesia.

Once diagnosed, treatment for IC includes:

• Medication (can include anything from antihistamines to anti-depressants, or in some cases medicines that are put directly into the bladder [called “bladder instillations”]).
• Physical therapy, including vaginal tissue massage. “In contrast to treatments for incontinence, where we are looking to strengthen pelvic muscle tone, women with IC often require assistance in relaxing and loosening the pelvic muscles,” says Dr. Maccarone.
• Alternative therapies, which can include diet modification, stress management and acupuncture.

So there you have it – everything you ever wanted to know about female pelvic medicine, but were too afraid to ask. Let’s hug our mothers tighter for enduring the “grin and bear it” mentality of the previous generation, and see our doctors for the new generation of treatment options to free us from our pelvic problems and help us live happier and fuller lives.